Alzheimer's Association Quality Care Campaign and professional training initiatives: improving hands-on care for people with dementia in the U.S.A.

2009 ◽  
Vol 21 (S1) ◽  
pp. S25-S33 ◽  
Author(s):  
Elizabeth Gould ◽  
Peter Reed

ABSTRACTIn the U.S.A., direct care workers and licensed practical nurses are the professionals who provide the most hands-on care to people with dementia in nursing homes and residential care facilities – yet they do not receive adequate training in dementia care. Dementia care training needs to be universal with all disciplines at all levels of care. Even though there is variability on recommended hours and content, most studies emphasize the importance of dementia care training as a distinct component of required training for any professional or paraprofessional working in long-term care. In 2005, the Alzheimer's Association launched its Quality Care Campaign to improve dementia care through state and federal advocacy; consumer education and empowerment; and staff training. This paper describes the effectiveness of Alzheimer's Association training as measured by knowledge gained and providers' intention to change their behavior immediately after attending the training.Overall, findings indicated that the participants responded positively to evidence-based training in dementia care that emphasized the importance of (i) leadership, (ii) team communication and collaboration, (iii) support and empowerment of direct care staff, (iv) awareness and practice of specific dementia care issues, (v) resident and family involvement in care, and (vi) professional self-care.

2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Lynn Chenoweth ◽  
Tiffany Jessop ◽  
Fleur Harrison ◽  
Monica Cations ◽  
Janet Cook ◽  
...  

Antipsychotic and other tranquilising medicines are prescribed to help care staff manages behaviour in one-quarter of older people living in Australian long-term care homes. While these medicines pose significant health risks, particularly for people with dementia, reliance on their use occurs when staff are not educated to respond to resident behaviour using nonpharmacological approaches. The Halting Antipsychotic use in Long-Term care (HALT) single-arm study was undertaken to address this issue with 139 people 60 years and over with behaviours of concern for staff living in 24 care homes. A train-the-trainer approach delivered person-centred care education and support for 22 HALT (nurse) champions and 135 direct care staff, dementia management education for visiting general practitioners (GP) and pharmacists, use of an individualised deprescribing protocol for residents, and awareness-raising for the resident’s family. The HALT champions completed open-ended questionnaires and semistructured interviews to identify the contextual elements they considered most critical to facilitating, educating care staff, and achieving success with the study intervention. They reported that person-centred approaches helped care staff to respond proactively to resident behaviours in the absence of antipsychotic medicines; the champions considered that this required strong managerial support, champion empowerment to lead change, reeducation of care staff, and the cooperation of families and GPs.


Dementia ◽  
2016 ◽  
Vol 15 (3) ◽  
pp. 289-303 ◽  
Author(s):  
Clive Baldwin ◽  
Michelle Greason

In recent years there has been an increasing interest in the concept of citizenship as a lens through which to understand dementia practice. This move from an individualist, personhood-based approach towards an understanding of people with dementia as a group facing social and structural discrimination parallels, in some ways, that previously seen in the realms of disability and mental health which have sought to politicize those experiences. In so doing, the debate has sought to reconfigure power relations, insisting that members of such discriminated groups are people with power entitled to the same from life as everyone else. Much of the discussion to date has, understandably, focused on the larger issues of social inclusion, rights and responsibilities – reflecting the traditional concern of citizenship of individuals’ relationship to the state or the society in which they live. More recently, there has been a move to conceptualising citizenship as a practice – something that is realised through action and in relationship – rather than a status bestowed. In this paper, we seek to contribute to the discussion by introducing the concepts of midi- and micro-citizenship, taken from organisation studies, as a further means by which to link the personal and the political, and as grounds to build citizenship-alliances between people with dementia living in long-term care (LTC) facilities and front-line dementia care staff. We will then seek to illustrate the usefulness of these concepts in understanding citizenship in practice in LTC facilities through analysis of data drawn from focus groups involving LTC staff, and interviews with family carers whose relatives live in LTC facilities. In conclusion, we will explore some of the possibilities that such an approach holds for dementia care practice.


2015 ◽  
Vol 27 (12) ◽  
pp. 2045-2057 ◽  
Author(s):  
Lynn Chenoweth ◽  
Yun-Hee Jeon ◽  
Jane Stein-Parbury ◽  
Ian Forbes ◽  
Richard Fleming ◽  
...  

ABSTRACTBackground:Well-being and various forms of agitation in people with dementia can be improved in a person-centered long-term care setting. Data obtained during the Person-Centered Dementia Care and Environment (PerCEN) randomized controlled trial shed light on the factors that influenced the adoption and outcomes of person-centered interventions in long-term care from the perspective of study participants.Methods:Data were obtained from PerCEN participants: individual semi-structured interviews with care managers (29), nurses and care staff (70); telephone surveys with family members (73); staff reports of care approaches; and 131 field note entries recorded by the person-centered care and environment facilitators. Data were interpreted inductively using content analysis, code building, theme development, and synthesis of findings.Results:All data sources confirmed that, when adopted, the person-centered model increased the number and variety of opportunities for resident interaction, improved flexibility in care regimens, enhanced staff's attention to resident needs, reduced resident agitation, and improved their well-being. Barriers and enablers for the person-centered model related to leadership, manager, staff and family appreciation of the model, staff's capacity, effective communication and team work among direct care staff, care service flexibility, and staff education on how to focus care on the person's well-being.Conclusions:Successful knowledge translation of the person-centered model starts with managerial leadership and support; it is sustained when staff are educated and assisted to apply the model, and, along with families, come to appreciate the benefits of flexible care services and teamwork in achieving resident well-being. The Australian New Zealand Clinical Trials Registry number is ACTRN 12608000095369.


2021 ◽  
Author(s):  
Sebastian Lubczynski

Our built environments have a direct correlation with our mental and physical health. This correlation is ever more evident with the process of ageing and the declining of neurological and physiological capacities of the human body. Architecture as Third Skin: Spatial Dimensions of Stimuli for Dementia Care thesis-project asserts that architecture, supported by evidence-based knowledge, can create an environment that triggers positive neurological changes in its users, negotiating the functional and social necessities of people with dementia in supporting their needs. The architectural model that informs this inquiry is explored through the design of a community-based Dementia Respite Care Centre, providing short and long term care as well as physical and mental therapy for those with early-to mid-stage dementia. Situated in Toronto, this thesis-project proposes a model that provides direct care for the specialized needs of dementia patients early in their illness condition to maintain independence and encourage living and ageing.


2021 ◽  
Author(s):  
Sebastian Lubczynski

Our built environments have a direct correlation with our mental and physical health. This correlation is ever more evident with the process of ageing and the declining of neurological and physiological capacities of the human body. Architecture as Third Skin: Spatial Dimensions of Stimuli for Dementia Care thesis-project asserts that architecture, supported by evidence-based knowledge, can create an environment that triggers positive neurological changes in its users, negotiating the functional and social necessities of people with dementia in supporting their needs. The architectural model that informs this inquiry is explored through the design of a community-based Dementia Respite Care Centre, providing short and long term care as well as physical and mental therapy for those with early-to mid-stage dementia. Situated in Toronto, this thesis-project proposes a model that provides direct care for the specialized needs of dementia patients early in their illness condition to maintain independence and encourage living and ageing.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Julian Hirt ◽  
Melanie Karrer ◽  
Laura Adlbrecht ◽  
Susi Saxer ◽  
Adelheid Zeller

Abstract Background To support the implementation of nurse-led interventions in long-term dementia care, in-depth knowledge of specific supporting factors and barriers is required. Conditions and structures of caring for people with dementia differ widely, depending on the country and the care context. Our study aimed to describe the experiences and opinions of nursing experts and managers with regard to facilitators and barriers to the implementation of nurse-led interventions in long-term dementia care. Methods We conducted a qualitative descriptive study using individual interviews based on qualitative vignettes as a useful stimulus to generate narrations allowing to study peoples’ perceptions and beliefs. The study took place in nursing homes in the German-speaking part of Switzerland and in the Principality of Liechtenstein using purposive sampling. We intended to conduct the interviews face-to-face in a quiet room according to the participant’s choice. However, due to the lockdown of nursing homes during the COVID-19 pandemic in spring 2020, we performed interviews face-to-face and by video. We analysed data thematically following Braun and Clarke to achieve a detailed, nuanced description. To verify our interpretation and to ensure congruence with participants’ perspectives, we conducted member checks. The Standards for Reporting Qualitative Research (SRQR) served to structure our manuscript. Results Six dyads of nursing home managers and nursing experts from six nursing homes took part in our study (n = 12). Our thematic analysis yielded seven themes reflecting facilitators and barriers to implementing nurse-led interventions in long-term dementia care: «A common attitude and cohesion within the organization», «Commitment on several levels», «A needs-oriented implementation», «The effect and the public perception of the intervention», «A structured and guided implementation process», «Supporting knowledge and competencies», as well as «Resources for implementing the intervention». Conclusions To support the implementation of nurse-led interventions in long-term dementia care, active commitment-building seems essential. It is necessary that the value of the intervention is perceptible.Commitment-building is the precondition to reach the persons involved, such as nursing home managers, nursing staff, residents and relatives. Furthermore, nurses should precisely inform about the intervention. It is necessary that the value of the intervention is perceptible. In addition, nurses should adjust the interventions to the situational needs of people with dementia, thus. Therefore, it is important to support dementia-specific competencies in long-term care. Findings indicate that the barrier is determined by the intervention and its implementation – and not by the behaviour of the person with dementia.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 182-183
Author(s):  
James Faraday ◽  
Clare Abley ◽  
Catherine Exley ◽  
Joanne Patterson

Abstract More and more people with dementia are living in nursing homes (NH). Often, they depend on NH staff for help with eating and drinking. It is important that staff have the skills and support they need to provide good care at mealtimes. This qualitative study explores mealtime care for people with dementia, from the perspective of NH staff. Semi-structured interviews with NH staff (n=16) were carried out in two nursing homes. The homes were chosen to have diverse characteristics: one home had a large number of beds and was part of a small local organization; the other had a small number of beds and was part of a large national organization. Various staff members were interviewed, including direct care staff, senior carers, nurses, managers, and kitchen staff. Interviews were audio-recorded and transcribed verbatim. A constant comparison approach was taken, so that data from early interviews were explored in more depth subsequently. From the analysis, five themes emerged as important in mealtime care for people with dementia living in nursing homes: Setting the right tone; Working well as a team; Knowing the residents; Promoting autonomy and independence; Gently persevering. This work forms part of a larger ethnographic study on the topic, which includes data from residents with dementia, and family carers. Results will inform the development of a staff training intervention to optimize mealtime care for this population.


2020 ◽  
Vol 1 ◽  
pp. 125-131
Author(s):  
Azam David Saifullah ◽  
Sri Mulyani ◽  
Eria Riski Artanti

As there is a limited long-term care options in Indonesia, people with dementia are cared for by their family. They often hospitalized as the condition progresses. Nurses are the profession with most contact. Therefore, preparing nursing students to care for people living with dementia is needed. Blended learning as e new learning strategy in dementia care for nursing student need to be evaluated to comprehend its feasibility in the future dementia care course.  This study aimed to evaluate the feasibility of a blended learning course for nursing students about dementia. A blended learning course was developed as a three-credits elective course that voluntarily joined by 42 fourth year nursing students. This course integrates the schedule, modules, and assignments in a learning management system called eLOK (Moodle based). One group pre-post test was conducted to evaluate this course using DKAS (Dementia Knowledge Assessment Scale) and DAS (Dementia Attitude Scale) as instruments. Google form was integrated to evaluate the course and the use of eLOK. Data were analysed using a paired t-test. 37 students (88.1%) completed the questionnaires. There is a significant improvement in knowledge towards dementia (t = 5.96, p value < .00) but not the attitude (t = 2.50, p value = .17) right after completing the course. Students also well appreciated the quizzes and project as the evaluation of learning outcomes of the course. Moreover, the audio-visual material in eLOK made them feel helpful in learning new topics and made new constructive experience of learning. In conclusion, this blended learning is feasible to be used as a learning method for delivering dementia care course.


2021 ◽  
Author(s):  
Yang-Hao Ou ◽  
Ming-Che Chang ◽  
Wen-Fu Wang ◽  
Kai-Ming Jhang

Abstract Background: There is an increasing awareness of caregiver's burden, especially in those caring for people with dementia. The caregiver burden has been studied extensively in Western countries; however, the interpretation of the results and replication of the intervention may deem unfit in the Chinese culture. Therefore, this study identifies the change in caregiver burden by interventional methods under current Taiwan's long-term care Act 2.0.Method: A total of 2,598 newly diagnosed dementia outpatients was evaluated by the Changhua Christian Hospital dementia care team. Eighty patients utilize one of the three care resources, including community-based services (n = 33), home-based services (n = 19), or taking care by foreign caregivers (n = 28). Participants in the control group were selected by matching their global CDR score, gender, age, and caregivers' age with a 1:4 ratio. All caregivers completed the Zarit Burden Interview (ZBI) questionnaires before and six months after utilizing the care resources. Results: The home-based and the foreign caregiver groups have the highest baseline ZBI scores with 37.63±16.14 and 36.57±17.14, respectively. The second ZBI score was assessed about six months after the baseline showing that the home-based group remained the highest caregiver burden (ZBI = 31.74±12.23) and the foreign caregiver group showed the lowest burden (ZBI = 25.68±12.09). The mean difference in the ZBI score confirmed that the foreign caregiver group had the most improvement, averaging a decrease of 17.99±31.08 points (adjust observation time). A linear regression model showed that home-based care and foreign caregiver contributes the most reduction in caregiver burden (-11.83 and -19,07 ZBI scores, respectively).Conclusion: Caring for people with dementia includes caring for their caregivers. Dementia care team should provide proper social resources, which are crucial in the alleviation of caregiver burden.


Author(s):  
Colla MacDonald ◽  
Emma J. Stodel ◽  
Lynn Casimiro ◽  
Lynda Weaver

There are obvious benefits to working in collaboration. However, real collaboration takes time; time to engage in meetings, complete accountability processes, and resolve problems. The delicate balance between democracy and efficiency can be compromised when you have to choose between equal participation and looming deadlines (Stoecker, 2003). Weaver and Cousins (2004) described this dilemma as assessing manageability or having to make a choice between achieving complete diversity on the researcher-community team and the unwieldiness of working with a large committee. Compromise is often necessary. This article describes our experiences using a collaborative approach involving university-based researchers and community professionals—in this case, long-term care (LTC) managers, administrators, and hospital-based educators and researchers—to create an online dementia care training program.


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