Talking Mats and self-perceived involvement for service recipients with dementia in Swedish home care services: a randomized controlled trial

Older people with dementia are regularly excluded from decision-making processes and their wishes and preferences for care are often not respected. The aim of this study was to analyze whether the use of Talking Mats® (TM) help older service recipients with mild to moderate dementia to feel more involved in and satisfied with needs assessment and planning conversations within Swedish home care services, compared to usual conversation methods. This study employed a post-test only, two-armed parallel group randomized controlled trial design. The use of TM was evaluated in comparison with a control group using usual conversation methods. Inclusion criteria were service recipients from participating municipalities, ≥ 65 years scoring 12-23p on the MMSE. Randomization was conducted in blocks by site (n = 3) with allocation set at 50% per arm with concealed allocation. Once participants were randomized to study arm blinding was not possible. Post-tests were conducted with service recipients after conversations with care managers and nursing assistants. The impact of staff’s perceived acceptability, appropriateness and feasibility of TM was assessed. 101 older home care services recipients were recruited, 51 in the TM group and 50 in the control group. Non-response was relatively high > 10% in both groups. Total attrition showed 24% of the service recipients with dementia did not complete data collection following conversations with CMs, and 35% with NAs. High involvement and satisfaction were found in both TM and control group in conversations with care managers and nurse assistants. No difference between groups was detected. Dementia severity was significantly and positively correlated with self-perceived involvement. There were no significant differences between TM and control groups regarding self-perceived involvement and satisfaction after conversations with care managers and nurse assistants. ClinicalTrials.gov ID: NCT05 561,998. Registered on September 28, 2022.