Implementation of the Veder Contact Method in daily nursing home care for people with dementia: A process analysis according to the RE-AIM framework

Aims and objectives
To perform a process analysis of the implementation of the Veder contact method for gaining insight into factors that influence successful implementation.

Background
Research showed that the original Veder method, which is a ‘living-room theatre performance’ provided by actors, positively influenced mood and quality of life of people with dementia. Training caregivers to execute such ‘performances’ and accomplish the same effects as actors proved difficult. However, key elements of the method were considered suitable for application in daily care, resulting in the development of a modified version of the method, named the Veder contact method. The Veder contact method combines elements from existing psychosocial interventions, e.g. reminiscence, validation and neuro-linguistic-programming with theatrical, poetic and musical communication, and applies this into daily care.

Design
For this process analysis a multiple case study design was used with the nursing home ward (n = 6) as the unit of analysis.

Methods
Eight focus groups with caregivers (n = 42) and 12 interviews with stakeholders were held. Using the Reach, Effectiveness, Adoption, Implementation, Maintenance framework, a thematic analysis was conducted.

Results
The reach of the intervention (43–86%) and aspects of implementation-effectiveness (e.g. increased experienced reciprocity in contact with residents) facilitated implementation. For adoption and implementation, both facilitators (e.g. development of competences, feasibility of the Veder contact method without requiring extra time investment) and barriers (e.g. insufficient support of management, resistance of caregivers against the Veder contact method, organisational problems) were identified. Little effort was put into maintenance: only one nursing home developed a long-term implementation strategy.

Conclusions
The Veder contact method can be applied in daily care without additional time investments. Although adopted by many caregivers, some were reluctant using the Veder contact method. Organisational factors (e.g. staffing and management changes, budget cuts) impeded long-term implementation.

Relevance to clinical practice
The findings from this study can be used for the development of successful implementation strategies for the Veder contact method and other person-centred care methods.