Background: Many people with advanced dementia live and die in nursing care homes (NCHs). The quality of life, care and dying experienced is variable. There is a need to identify appropriate, cost effective interventions that facilitate high quality end of life care provision appropriate for this population.

Aim: To establish the feasibility of conducting a cluster controlled trial in nursing care homes to understand the impact on quality of dying of the Namaste Care intervention for people with advanced dementia, compared to usual end of life care.

Design:
a) Realist Evidence review: To determine which Namaste care intervention elements work best for people dying with advanced dementia in the NCH context.
b) Intervention Refinement: Consultation workshop (n=8-12) with care home staff (from 4 NCHs) and family members of people with advanced dementia(n=4-8), using findings from the Realist Review to refine the Namaste Care intervention.
c) Feasibilty study in context of a cluster controlled trial: A feasibility study in 8 sites (6 intervention and 2 control) in the context of a cluster controlled trial (and embedded qualitative process and economic evaluation) to facilitate future design and measurement choices for a full trial.

Setting: Nursing care homes (NCH) in England.

Target population: Patient: People with advanced dementia (FAST=6-7) prognosis