The Care Of People with dementia in their Environments (COPE) program was developed in the USA and has been found to be effective in a large randomised controlled trial. It was also effective when implemented in the ‘real world’ context in Australia. Research into the COPE program is ongoing.
COPE Australia Research Project
The COPE Australia Research Project “Evidence-based programs to improve the well being of people with dementia and their carers: Implementing COPE in the Australian health context” ran from 2016-2019 and was led by Professor Lindy Clemson (University of Sydney) and Dr Kate Laver (Flinders University). The study was funded by the NHMRC Partnership Centre for Dealing with Cognitive and Related Functional Decline in Older People https://cdpc.sydney.edu.au/ COPE Australia was an implementation project: taking the proven effective COPE program, adapting it to the Australian context and determining the strategies and processes that enable the COPE program to be adopted in existing dementia services in Australia.
The main research questions asked were:
- How is COPE adopted, implemented and made sustainable with different community health contexts in Australia?
- What are the costs associated with delivery of COPE?
- When implemented in existing services does COPE have the same size of effect for activity engagement outcome for the person with dementia and well being outcomes for the carer as when tested in the randomised controlled trial?
COPE Australia partnered with 17 organisations in New South Wales and South Australia, a mix of government services, non-government organisations and private practitioners. 38 occupational therapists and 17 nurses were trained to deliver the COPE program and then asked to deliver the program to eligible “dyads” (individuals with dementia and a family carer) through their existing service. The trained clinicians were supported to master delivery of the COPE program through group coaching telephone calls. Organisations were supported to implement the program by the research team.
We found that Australian clinicians were able to offer the COPE program in their organisation using existing funding mechanisms. This included home care funding, private funding and some packages (such as transitional care packages). Results showed that people with dementia who received the program became more engaged in activities. Care partners and families who participated in the program reported that they were better able to care for the person with dementia. Cost benefit analysis showed that the program can deliver societal and economic gains to the Australian health and aged care system.
The COPE Australia research team consisted of Professor Lindy Clemson1, Dr Kate Laver2, Associate Professor Yun-Hee Jeon1, Professor Laura Gitlin3, Dr Tracy Comans4, Associate Professor Lee-Fay Low1, Professor Maria Crotty2, Professor Sue Kurrle1, Dr Justin Scanlon1, Jennifer Culph1, Miia Rahja2 , Sally Day1, Dr Monica Cations2, Claire Spargo2.
The COPE Australia research project advisory group consisted of influential consumer and industry members: Danijela Hlis, Glenys Petrie, Jane Thompson, Joan Jackman5, John Quinn, Meredith Gresham6 and Wendy Hudson7.
1 University of Sydney, 2 Flinders University, 3 Drexel University, 4 University of Queensland, 5 CDPC, 6 HammondCare, 7 Brightwater
Original COPE Trial
The COPE program was developed and tested in a large, high quality, randomised controlled trial in the USA in a project led by Professor Laura Gitlin from 2006-2008. COPE was shown to be effective in both reducing functional dependence and increasing engagement for individuals with dementia as well as improving wellbeing and confidence using activities for carers.
Gitlin L, Winter L, Dennis M, Hodgson N, Hauck W. (2010). A biobehavioral home-based intervention and the well-being of patients with dementia and their caregivers: The COPE randomized trial. JAMA – Journal of the American Medical Association. 304(9):983-91.
Other COPE Research
Please note this page is updated annually.
COPE Connecticut translational study (underway)
Led by Professor Richard Fortinsky (University of Connecticut) this project addresses the real world effectiveness and translational ability of COPE to a home care setting.
This study will investigate:
- The effect of COPE on both the person with dementia and their carer;
- The net financial benefit of COPE; and,
- The feasibility and acceptability of the program
Fortinsky, Richard H. et al. (2016). Translation of the Care of Persons with Dementia in Their Environments (COPE) Intervention in a Publicly-Funded Home Care Context: Rationale and Research Design. Contemporary Clinical Trials 49: 155–165