Factors influencing Namaste program success
Dr Sara Karacsony shares findings of international research on the implementation of the Namaste Care program.
A systematic review of factors influencing the implementation of the Namaste Care program for people with advanced dementia in nursing care homes across six countries has confirmed the lessons of our Australian study.
I wrote about the lessons we learned in our ARIIA-funded project in the September-October 2024 edition of this publication in the article titled Lessons from implementing enhanced sensory care. The full findings of this study are being prepared for publication.
This latest research, published by BMC Geriatrics in January 2025, looks at implementation of the program in Australia, Canada, Iran, the Netherlands, United Kingdom and the United States of America, where the program originated.
The authors from the International Observatory on End of Life Care at Lancaster University in the UK conducted a database search of studies between 2018 and 2024 on the use of Namaste Care for people with advanced dementia in nursing care homes.
They adopted a framework synthesis of results that combines quantitative and qualitative data in their analysis to identify the main themes and insights.
The article aimed to explore the contextual elements of Namaste Care in nursing care homes and how interrelated factors such as the frequency and duration of Namaste Care sessions, staff education and engagement, and environmental adaptations influence the feasibility and effectiveness of the program.
The five key themes presented as either barriers or enablers include:
- frequency and duration of Namaste Care sessions
- Namaste Care environment and personalisation of care
- staff engagement
- training and continuous involvement
- involvement of family members and volunteers.
Similarly to my article published in AAA, the authors identified organisational leadership and an organisation-wide approach as fundamental for successful uptake of the intervention.
They found the original design of the Namaste Care program – which offers twice-daily sessions of two hours each every day – to be challenging for care homes within the published studies and with most facilities found to have reduced the number and duration of sessions.
One of the issues identified in the review is that actual frequency of sessions is not specified in the studies, nor is the participation rate for individual residents. The authors then had problems determining the necessary dose – frequency and duration of sessions – to achieve the intended benefits.
They found the main reason for the variability in frequency and duration of sessions is related to staff availability and conflicting schedules within the daily routines of the services reviewed.
However, one of the practical solutions they also discussed is involving family caregivers and volunteers. Their participation can help alleviate the barrier of staff shortages and enable partnerships that build trust between paid caregivers and family members.
The authors recommend clarifying the role of family members and volunteers within the program to avoid confusion around the objective of Namaste Care and for effective scheduling that will make it feasible for families to attend.
They also identify educational preparation as essential to prepare family members for seeing people in the more advanced stages of dementia, without which they risk feelings of anxiety and potential discouragement from continuing their involvement with the program.
Another important finding is the education of staff. The review found a variety of educational approaches, resources and formats across the studies and disparities among staff in terms of education opportunities. Staff education is necessary – and needs to be ongoing due to staff turnover – because staff need to learn how to connect with residents within the program in promoting physical comfort and high-sensory care practices, ensuring staff are well prepared for the program’s delivery and in attaining the benefits for residents.
The authors conclude that implementing Namaste Care in nursing care homes presents various challenges along with significant opportunities to address the gap in quality of life for residents with advanced dementia.
With strong leadership and addressing the key themes using practical solutions to support implementation, the Namaste Care program can be sustainably integrated into care routines, ensuring the substantial benefits of this program – namely, improved quality of life, reduced behavioural symptoms, and, at times, obvious pleasure and enjoyment – are realised.
The review also recommends detailed documentation of changes to usual care practices alongside the implementation challenges to better understand what works in practice. This process information can then feed effectively into the evidence base to ensure Namaste Care’s successful implementation and sustainability.
Read the full article, Implementing Namaste Care in nursing care homes for people with advanced dementia: a systematically constructed review with framework synthesis
Dr Sara Karacsony is a senior lecturer at the University of Tasmania and the Australian Champion for Namaste Care
We hope you enjoyed this article – please add your comments below
Visit our features portal for more in-depth stories
