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Table 3 Overview of three final context-mechanism-outcome configuration

From: Improving living and dying for people with advanced dementia living in care homes: a realist review of Namaste Care and other multisensory interventions

CMO1: Namaste Care provides regular, structured access to social and physical stimulation for people living with advanced dementia

Context

Mechanism

Outcome

Namaste Care provides access to social and physical stimulation through a routine/structure consisting of:

 • Designated space

 • Considered timing

 • Regular skilled facilitator

 • Repetition of intervention

 • Social interaction

 • Regular drinks and snacks

• Residents: familiarity, consistency, reassurance, recognition

• Trust develops between residents and carers

• Namaste Care is seen by staff as a core activity

• Staff are ‘intentionally present’ with residents

• Staff given permission to engage

• Decrease in agitation/behavioural symptoms/anxiety

• Improvements in mood

• Intervention become part of care home routine

• Staff satisfaction

CMO2: Namaste Care equips staff to work with people with complex behaviours and variable responses

Context

Mechanism

Outcome

Namaste Care is delivered through a multi-sensory experience (effect) that provides a ‘toolkit’ of activities (resource) for staff

• Residents are soothed and relaxed by multi-sensory experience

• Residents feel stimulated through multiple interactions

• Staff notice/are more responsive to the needs of residents

• Moments of connection are created between staff and residents

• Agitation/behavioural symptoms

• Anxiety

• Mood

CMO3: Namaste Care provides a framework for person-centred care

Context

Mechanism

Outcome

Namaste Care focuses attention on residents’ biography and preferences (person-centred care)

• Resonates with staff’s understanding of person-centred care

• Staff notice/are more aware of the needs of residents.

• Trust develops between residents and carers

• Agitation

• Mood

• Engagement

• Improved communication between staff and residents

• Improved communication between residents and family & staff and family