The evaluation of palliative care as a complex health technology for people with dementia in nursing homes

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BelgiumVrije Universiteit Brussel (VUB) Belgium
Early Stage Researcher (ESR11)


Rose Miranda

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Prof. Lieve Van den Block

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Lara Pivodic

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As part of INDUCT, Rose Miranda evaluates palliative care as a complex health technology for people with dementia in nursing homes. Rose has a BSc degree in Nursing in the Philippines. She also has Honours BSc in Health Science and Research MSc degrees from VU University Amsterdam, The Netherlands.

In addition, she has practical experiences in the field of geriatric nursing, dementia patient care, health technological innovations, and evaluation studies. Her primary research interest is on the utilisation of innovative health technology to improve dementia care in Europe and worldwide.

PhD Yes
Start date September 2016
Duration 36 months


The ESR will pilot/evaluate the PACE intervention over a one year period in two nursing homes, one with an open and one with a closed ward for people with dementia. This extends an ongoing European study (PACE 2014-2019) developing and evaluating a complex palliative care intervention in long term care facilities in a cluster controlled randomised trial across six countries (involving 24 intervention facilities). This complex health care technology concerns the integration of palliative care using a step-wise approach and involving several resource packs, protocols and tools for staff/management. ESR11 will evaluate the extent to which this complex health technology, which is developed for long term care facilities in general, is applicable/feasible for nursing homes (or wards) primary involved in taking care of people with dementia, hence whether the intervention tools take into account the specific needs and problems of taking care of people with moderate/advanced dementia.

Expected Results

The ESR will be involved in collecting, collating and analyzing the data gathered during implementation of the intervention (via structured diaries of trainer and staff responsible for the intervention) and after as part of a post-evaluation scale up (via interviews and focus groups with staff and family of residents with dementia). After translation of the material, the ESR will perform a qualitative process analyses following the MRC guidance on process evaluation of complex interventions (Moore et al 2014), analyse barriers and facilitators to implementation for dementia and provide detailed guidance on best practice for effectively adapting the PACE intervention to people with dementia.

Planned secondment(s)

Two secondments of 3 months. Firstly to UK-CZ to explore the context of long term care in a new setting and secondly to Hertfordshire University (CRIPACC) to study mixed methods for evaluating complex interventions.



Miranda, R., Penders, Y. W. H., Smets, T., Deliens, L., Miccinesi, G., Vega Alonso, T., Moreels, S., Van den Block, L. (2018). Quality of primary palliative care for older people with mild and severe dementia: an international mortality follow-back study using quality indicators. Age Ageing, afy087-afy087.

Smets, T., Onwuteaka-Philipsen, B. B. D., Miranda, R., Pivodic, L., Tanghe, M., van Hout, H., . . . Van den Block, L. (2018). Integrating palliative care in long-term care facilities across Europe (PACE): protocol of a cluster randomized controlled trial of the ‘PACE Steps to Success’ intervention in seven countries. BMC Palliat Care, 17(1), 47.


Miranda, R. (2017, March) – Quality of palliative care for community-dwelling people with dementia in Europe – Seminar on “Dementia” at Vrije Universiteit Brussel, Brussels, BE

Miranda, R (2017, May) Congress on quality indicators in palliative care: where are we now and what is our future? (Congres kwaliteitsindicatoren in de palliatieve zorg: waar staan we en wat is de toekomst?) at the Flemish Parliament, Brussels, BE –

Miranda, R. (2017,May) – Short oral presentation at ‘Definition of dementia’ at the PACE Consortium meeting – Treviso, IT –

Miranda, R (2018) Caregivers’ understanding of palliative care in dementia – 10th World Research Congress of the European Association for Palliative Care (EAPC), Bern, Switzerland.

Miranda, R (2018) Caregivers’ understanding of palliative care in dementia – International Seminar of EAPC RN and the EAPC Reference Group on Public Health and Palliative Care.


Miranda, R (2017) Alzheimer Europe Newsletter: INDUCT project is researching palliative care as a complex health technology for people with dementia –

Miranda, R and Van Dael, A (2018) Alzheimer Europe Newsletter: Advances on the study of complex health technologies for people living with dementia –

Miranda, R (2018) British Geriatrics Society Newsletter: Discussing palliative care for people with dementia living at home and in care homes –

Miranda, R (2018). Participated at the 2018 European Alzheimer’s Roundtable to advocate for the extension of palliative care services for people with dementia

Miranda, R (2018) Special post to celebrate the International Day of Older Persons for the European Association for Palliative Care (EAPC) blog. Improving palliative care for older people in nursing homes –