P4-126: DEVELOPING A SUCCESSFUL, PERSON-CENTERED MEMORY CARE WORKFORCE: 2018 DEMENTIA CARE PRACTICE RECOMMENDATIONS

Abstract The Alzheimer’s Association (AA) Dementia Care Practice Recommendations (DCPR) outline ten recommendations to achieve quality care with a person-centered focus. The AA has developed tools to assist care communities (CC) to evaluate their status within the recommendations by working with a trained coach to maximize adoption and implementation of these recommendations. The purpose of this pilot was to evaluate the acceptability and feasibility of pairing trained DCPR coaches with CC teams to implement the DCPR tools. Seven CCs were recruited and four received the DCPR overview and self-assessment. Of the four CC, one withdrew and did not receive the intervention. The remaining three were located in a suburban area, nonprofit, and with memory care units. Data was collected from November 2019 through March 2020. Nine CC staff participated with a mean age 35.8 years and had worked for 11.8 years. Baseline mean scores on the Organizational Readiness to Implementing Change (ORIC) scale were 4.6 for the commitment domain and 4.4 for the efficacy domain. Mean scores on the Nursing Home Employee Satisfaction Survey were high. Sixty-nine percent of CC participants were satisfied with their jobs (greater than 4). Findings from mid-project interviews with the coaches revealed difficulty with scheduling appointments, significant efforts needed to get the “right” people at the table and need for the DCPR tools to be more user-friendly. No post-intervention results were collected due to closing of the CCs to visitors due to COVID. The DCPR tools shows promise and are being evaluated in additional CCs.

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The Need for Person-Centered Measures for Dementia Research and Care

Innovation in Aging ◽

10.1093/geroni/igab046.1008 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 262-263

Author(s):

Sam Fazio ◽

Sheryl Zimmerman ◽

Laura Gitlin

Keyword(s):

Psychosocial Care ◽

Dementia Care ◽

Assessment Tools ◽

Care Practice ◽

Practice Recommendations ◽

Item Development ◽

Dementia Research ◽

Detection And Diagnosis ◽

Person Centered Approach ◽

Guide Care

Abstract The importance of person-centered medical and psychosocial care has become widely recognized, but there is abundant evidence that care is not always person-centered. In 2018, the Alzheimer’s Association published their evidence-informed Dementia Care Practice Recommendations, which address nine domains all grounded in a person-centered perspective. Following that work, the Association launched LINC-AD -- Leveraging an Interdisciplinary Consortium to Improve Care and Outcomes for Persons Living with Alzheimer's and Dementia. An early effort of LINC-AD, and the focus of this symposium, examined what measures are available to guide care and assess outcomes, and the extent to which they embrace person-centeredness. The results have been disappointing. This session will highlight the importance of person-centered measures in five domains of the Dementia Care Practice Recommendations, based on comprehensive reviews of literature. Each paper, presented by LINC-AD research advisors, will examine available measures and raise questions about gaps using a person-centered lens. Katie Maslow will describe frequently used measures and identify person-centered measures that could be added to studies of alternate procedures intended to increase detection and diagnosis. Drs. Mast and Molony will discuss a person-centered approach to item development and testing for assessment. Emilee Ertle will discuss the need to measure interpersonal and contextual factors associated with behavioral expressions. Drs. Prizer and Zimmerman will compare measures of dressing ability and their person-centered components. Dr. Calkins will examine the strengths and limitations of environmental assessment tools. As Discussant, Dr. Gitlin will integrate the findings from all five presentations, suggesting directions for the future.

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Measurement for Something as Personal as Dressing is Not Personalized

Innovation in Aging ◽

10.1093/geroni/igab046.1012 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 263-264

Author(s):

Sheryl Zimmerman ◽

Lindsay Prizer

Keyword(s):

Caregiver Burden ◽

Daily Living ◽

Dementia Care ◽

Critical Assessment ◽

Care Practice ◽

Practice Recommendations ◽

Outcomes Of Care ◽

Donabedian Model ◽

Guide Care

Abstract In 2018, the Alzheimer’s Association set forth Dementia Care Practice Recommendations in nine domains, one being support for activities for daily living (e.g., dressing, toileting, eating/nutrition). For example, preservation of dressing independence is important for dignity, autonomy, and to decrease caregiver burden. Measurement is necessary to guide care and assess outcomes related to dressing, but availability of related measures to assess processes, structures, and outcomes of care has not been examined; more so, the extent to which the related measures are person-centered is completely unexplored territory. This session will present a critical assessment of available measures grounded in the Donabedian Model. Of 21 identified measures, 4 assessed dressing alone, 16 included dressing as part of a larger scale, and 1 included dressing as a part of a scale to screen for dementia; none were person-centered. This session will suggest modifications to and need for new measures for person-centered dressing.

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Adaptive Reuse of Distressed Malls for Dementia-Friendly City Centers: Outcomes From Community Focus Groups

Innovation in Aging ◽

10.1093/geroni/igaa057.198 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 61-61

Author(s):

Emily Roberts

Keyword(s):

Spatial Configuration ◽

Public Spaces ◽

Dementia Care ◽

Model Of Care ◽

Community Revitalization ◽

Existing Structures ◽

Group Outcomes ◽

Midwestern University ◽

Memory Care

Abstract It is estimated that 5.4 million Americans have some form of dementia and these numbers are expected to rise in the coming decades, leading to an unprecedented demand for memory care housing and services. In searching for innovative options to create more autonomy and better quality of life in dementia care settings, repurposing existing structures, in particular vacant urban malls, may be one option for the large sites needed for the European model of dementia villages. These settings may become sustainable Dementia Friendly City Centers (DFCC), because in the case of enclosed mall construction, the internal infrastructure is in place for lighting, HVAC, with varied spatial configuration of public spaces. This presentation describes the community engagement research being conducted by a research team at a Midwestern university, laying groundwork for the DFCC model for centralized dementia programs, services and attached housing. Focus group outcomes from four disciplines (caregiver, physician, designer, community development) detailed four principle themes including : community revitalization, building sustainability, urban regreening and the nurturing of innovation to further a culture of dementia care which is inclusive, progressive and convergent with the needs of an aging. The DFCC model can be seen as one opportunity to make life better not only for those with needs associated with dementia now, but also for ourselves in the future, therefore educating and updating future stakeholders about the value of this model of care will be critical in transforming current hurdles into future opportunities.

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Evaluation of a multifunctional technology system in a memory care unit: Opportunities for innovation in dementia care

Informatics for Health and Social Care ◽

10.3109/17538157.2015.1064428 ◽

2016 ◽

Vol 41 (4) ◽

pp. 373-386 ◽

Cited By ~ 10

Author(s):

Amanda Lazar ◽

George Demiris ◽

Hilaire J. Thompson

Keyword(s):

Dementia Care ◽

Technology System ◽

Memory Care

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OP27 Dissemination and implementation in dementia care practice: a systematic scoping review

Journal of Epidemiology & Community Health ◽

10.1136/jech-2016-208064.27 ◽

2016 ◽

Vol 70 (Suppl 1) ◽

pp. A19.2-A19

Author(s):

I Lourida ◽

R Abbott ◽

I Lang ◽

M Rogers ◽

B Kent ◽

...

Keyword(s):

Scoping Review ◽

Dementia Care ◽

Care Practice ◽

Dissemination And Implementation

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Attitudes to dementia and dementia care held by nursing staff in U.K. “non-EMI” care homes: what difference do they make?

International Psychogeriatrics ◽

10.1017/s104161020500150x ◽

2005 ◽

Vol 17 (3) ◽

pp. 383-391 ◽

Cited By ~ 33

Author(s):

A. J. D. Macdonald ◽

R. T. Woods

Keyword(s):

Cognitive Impairment ◽

Nursing Homes ◽

Medication Use ◽

Dementia Care ◽

Care Homes ◽

Care Practice ◽

Senior Nurse ◽

South East England ◽

Training And Support ◽

State Examination

Background: There is doubt about the value of training in dementia care in U.K. nursing homes. We decided to estimate the association between nursing staff's attitudes to dementia and dementia care and their recognition of cognitive impairment in residents and other indicators of care practice in nonspecialist nursing homes derived from a probability sample of 445 residents in South-East England, and to relate this to previous training.Methods: Prospective survey. The most senior nurse on duty was interviewed about each resident sampled, about their own training and experience, their attitude to restriction of egress and covert medication use, and asked to complete the Attitudes to Dementia Questionnaire (ADQ) and the dementia Care Styles Questionnaire (CSQ). Nurses were also asked about care practices in relation to restriction of egress and covert medication use in the home. Residents were interviewed using the Mini-mental State Examination (MMSE).Results: One hundred and fifty-eight nurses were interviewed. Increased person-centered attitudes seem to be associated with better recognition of cognitive impairment independent of training and experience. The espousal of restrictive practices was also associated with better recognition, but only when analysis included nurses reporting on only one impaired resident.Conclusions: More person-centered attitudes are associated with better recognition of cognitive impairment, despite perverse U.K. regulatory incentives; the need for training and support in developing person-centered dementia care for staff in “non-Elderly Mentally Infirm” (“non-EMI”) care homes is supported by these results.

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