The HOME study - Michael Sharpe s CBT for the elderly

[NelliePledge]

This is even more bizarre than anything we have discussed previously. I do not have time to think about it at present but it looks unethical. Hopefully I will remember to return to it tomorrow or late in the week.

It would be interesting to hear your thoughts @Jonathan Edwards it is very worrying these are very vulnerable people - I’m wondering if Alzheimer’s Research UK and the Alzheimer’s Society are aware of and doing anything about this. Maybe they don’t know about PACE??

ETA I realise people with ME are vulnerable as well of course

 

[Barry]

Except for a few issues reality is reality

But to get a bit philosophical, whatever 'reality' might be, all we can ever have is our perception of it, no matter how we might wish to dress that up. In a way, reality is an illusion.

 

[Alvin]

But to get a bit philosophical, whatever 'reality' might be, all we can ever have is our perception of it, no matter how we might wish to dress that up. In a way, reality is an illusion.

I know what your saying but denying reality doen't make it not exist it just means one is pretending fantasy is real.

 

[Sly Saint]

 

[adambeyoncelowe]

The only benefit of this is when people wake up and realise this trial is an abomination that should be cleansed with fire. It'll then hopefully lead them to the authors' other (similarly immoral) work, including PACE. This may work in our favour yet.

I just feel sorry for all those people with dementia...

 

[Arnie Pye]

Sharpe's pointless tweet on this study :



What I find strange is that he doesn't even link to any details of the study, he just posts a photograph of a door.

 

[TiredSam]

What I find strange is that he doesn't even link to any details of the study, he just posts a photograph of a door.

It's a celebration - can't you see the baloons?

Excuse me while I move Michael Sharpe to the bottom of my list of people I'd ask to help organise a surprise party.

 

[Arnie Pye]

It's a celebration - can't you see the baloons?

I didn't even notice them, to be honest.

 

[adambeyoncelowe]

I didn't even notice them, to be honest.

That was the surprise element.

 

[alex3619]

Why do we still have to put up with uncontrolled studies?

WTF is wrong with medical science in the UK? This is methodology 101.

I am not defending this study, but there is still a place for uncontrolled studies. However you cannot conclude anything about intervention effectiveness in such studies, I think. Uncontrolled studies give you data, and later you can design a better and controlled study based on that data. To put it another way, uncontrolled studies indicate association, not causation.

Case series studies come to mind in this. However there is no doubt controlled case series are better.

Now in a study of 3500 patients it would be better to divide the cohort in half, with half as controls. That would even be cheaper than the study as it is, so there is no reason to not do it.

 

[alex3619]

In many ways politics does not exist either, reality either exists or it does not.

There is a saying, an observation by Clauswitz, that diplomacy is war by other means. I think politics is just an extension of diplomacy. Its about factions in society fighting other factions on how to spend limited resources. This is not much different from states wanting to influence affairs by diplomacy, with the main exception being that politics is often better regulated, such as via constitutions.

There is another saying: “Reality is that which, when you stop believing in it, doesn't go away.”
https://www.goodreads.com/quotes/646-reality-is-that-which-when-you-stop-believing-in-it

Its a lot like CBT-brainwashing and ME. You might be convinced you do not have ME but reality does not care.

 

[large donner]

I am not defending this study, but there is still a place for uncontrolled studies. However you cannot conclude anything about intervention effectiveness in such studies, I think. Uncontrolled studies give you data, and later you can design a better and controlled study based on that data. To put it another way, uncontrolled studies indicate association, not causation.

Case series studies come to mind in this. However there is no doubt controlled case series are better.

Now in a study of 3500 patients it would be better to divide the cohort in half, with half as controls. That would even be cheaper than the study as it is, so there is no reason to not do it.

On top of that old people dont use the internet so the BPS crowd can bully the fuck out of them and they wont know how to hit back.

Watch this space for a big bunch of bullshit study claiming to be a successful treatment using CBT on the old promoted by the SMC.

 

[Hutan]

Clearly I'm late to the party, but I'm loving that deflated look. Sharpe baffles me in so many ways, not least because why on earth would you not remove a limp balloon before taking a photo of the noticeboard?

The description of 'The HOME Study' given on the poster is:
'A study comparing two different ways of looking after older people in hospitals to see if we can improve how quickly they go home'.
Hmm.

 

[Sly Saint]

'A study comparing two different ways of looking after older people in hospitals to see if we can improve how quickly they go home'

well, not leaving them in corridors for hours when they arrive might help, and then (as has been plastered all over the news for ages) having the adequate social care in place so they can be discharged.
No amount of psycho therapy will help with either.

eta: apart from using the money to actually help with both instead of wasting it.

 

[large donner]

Is how quickly they can get them to go home a good measure of whether they needed to go home or not.

 

[Sly Saint]

It's a celebration - can't you see the baloons?

just throw in a few 'trick-cyclists'......

 

[large donner]

How will this improve social care in the home and the appropriate care or make more provision and money available for care homes for the elderly.

The BPS crowd wont care they will just do some liaison CBT to get granny to answer their questions the way they want so they can tip her into a wheelbarrow and march her of the hospital premises. Will politicians wake up to this one after last weeks debate, I think they should have one eye one this.

 

[NelliePledge]

People with dementia are -based on experience of my parent having severe dementia for 20 years - in many ways ideal for fake CBT approach. They will get worse anyway as nobody recovers from dementia so you can blame worsening on their illness progression. In earlier stages when still able to walk and talk and generally appear like “normal” they over exaggerate what they are able to still do for themselves. Eg social worker can you make yourself a cup of tea? Parent “oh yes no problem”. In reality other parent had been doing everything for at least 2 years. So ideal candidates for Cosmo quiz approach, also they stop being able to understand complex questions and also being able to write. So someone is going to have to fill it in for them. If outcome is based on reducing demand on hospital and NHS services that is going to dump even more stress onto family carers. I wonder what measures will be in place to measure the impact on carers health of people accessing NHS services less. Maybe they will be giving the carers fake CBT as well to correct their unhelpful beliefs about the situation they are in.

ETA. This isn’t all about elderly people my parent was 60when diagnosed Watch BBC documentary Malcolm and Barbara Malcom was early 50s when diagnosed.

 

[Inara]

Sharpe's pointless tweet on this study :



What I find strange is that he doesn't even link to any details of the study, he just posts a photograph of a door.

Reminds me of Stephen Kings' "It", where the clown lured the children with baloons...

 

[Arnie Pye]

Reminds me of Stephen Kings' "It", where the clown lured the children with balloons...