# SOCAV: a nurse-led support programme for self-direction in people with dementia receiving home care, involving informal caregivers – a feasibility study with process evaluation in the Netherlands

## TL;DR

This study adapts and tests a support program for nurses and caregivers helping people with dementia maintain independence at home, showing it is feasible and beneficial.

## Contribution

The study adapts a dementia care program for home use and evaluates its feasibility and impact on care practices.

## Key findings

- Nurses reported increased reflection and person-centred communication after the program.
- Informal caregivers shifted from controlling to autonomy-supportive care attitudes.
- Quantitative trends showed reduced behavioural symptoms in people with dementia.

## Abstract

To adapt the SOCAV programme—originally developed for residential dementia care—for home care use, and to evaluate its feasibility and potential to foster behavioural change in nurses and informal caregivers supporting self-direction in people with dementia.

Development and feasibility study guided by the Medical Research Council framework for complex interventions. Feasibility was evaluated using Bowen’s framework (demand, acceptability, practicality, implementation, limited efficacy). Data collection involved semistructured interviews, focus groups and reflective coaching diaries, as well as validated outcome measures (self-direction, quality of life and depressive symptoms) assessed at multiple time points. Qualitative data were analysed using qualitative content analysis (Bowen’s feasibility framework) and constant comparative analysis; quantitative data were analysed descriptively.

Two home care teams in different Dutch municipalities.

Development phase: 16 participants (4 people with dementia, 6 informal caregivers, 6 nurses). Feasibility phase: 59 participants (12 people with dementia, 14 informal caregivers, 33 nurses).

SOCAV-Home Care integrates person-centred communication training with reflective coaching for nurses and joint meetings involving people with dementia and informal caregivers. It aims to embed self-direction into daily care routines.

The programme was feasible and well-received, though demanding. Nurses reported increased reflection, more person-centred communication and greater professional confidence. Informal caregivers showed attitudinal shifts from control to autonomy-supportive care. Programme complexity, scheduling difficulties and emotional burden contributed to dropout. Quantitative trends showed reduced behavioural symptoms in people with dementia, though no statistical analysis was performed due to sample size.

SOCAV-Home Care shows potential to foster behavioural change in nurses and informal caregivers, promoting self-direction and relational care in dementia home care. Findings, grounded in rich reflective data, offer a valuable foundation for further evaluation. Simplifying delivery and enhancing flexibility are key to broader implementation. Future research should evaluate the sustainability strategies proposed and examine long-term outcomes in diverse home care contexts.

NCT07347639; Post-results.