Dementia is a devastating disease. It leads to helplesness, no cure exist and there is a need for good quality care to improve the patients and the carers' situation and to delay nursing home placement. Psychosial intervention programmes carried out by h ighly academic educated therapist have shown to be effective. If a majority of patients and carers should have access to such intervention it is essential to show that the intervention are effective when carried out by nurses in primary health care.
This is a 18 months randomised controlled study including 320 dyads of persons with dementia and their primary carers from 16 municipalities. They will be recruited from memory clinics, out patients clinics in geriatrics and old age psychiatry, general practi tioners and district nurse offices. Randomisation will take place at municipality level. To ensure recruitment only municipalities with more than 300 persons with dementia will be considered for inclusion. Half of participants (in 50% of the municipalitie s) will receive a specially designed support programme and the other half will receive care as usual. Eight research nurses wil be trained and carry out the intervention.The intervention towards the carers consists of four individual counseling sessions, two half days educational courses, participating in eight groups meetings to learn a problem solving method and counseling throughout the study. The patients will take part in the counseling sessions and participate in eight support group meetings. The e ffect will be measured at patients level with scales measuring depressive and behavioural symptoms and quality life. Survival and nursing home placement will be secondary measurements. At carer level the effect will be measured with a burden scale, time t o assist the patients and QoL. Measures of effects at societal level is nursing home placement and use of health resources.