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P10. Training of care professionals

Detailed programme and abstracts

P10.1. What works is what matters: how care workers in care homes learn to care for people living with dementia

LATHAM Isabelle1, BROOKER Dawn1, MITCHELL Theresa2, DE VRIES Kay3

1Association for Dementia Studies, University of Worcester, Worcester, United Kingdom, 2University of Worcester, Worcester, United Kingdom, 3De Montfort University, Leicester, United Kingdom

Dementia care in UK care homes is primarily delivered by non-professionally qualified staff, with in-work, competency-based training the means to develop skills. Current policy and regulation emphasise formal training to improve care quality for people living with dementia, thus influencing care organisation’s decision-making. Research also primarily focusses on the effectiveness of training for quality improvement. However, investigations of workplace learning indicate that learning to work is not primarily shaped by formal training, being instead characterised by informal opportunities within everyday interactions and problem-solving. However, there is little research addressing this alternative view of learning within care work generally, or from the perspective of workers in the dementia care context.

This study answered the question: how do care workers in care homes learn to care for people living with dementia? Using focussed, critical ethnography it explored the learning to care landscape within two care homes. Data from observation (63hrs), semi-structured interviews (15) and in-situ interviews (50) were analysed thematically. Findings showed that care workers experience a multi-level learning process encompassing three themes. At micro-level, workers learn through day-to-day conduct of their work via a mechanism labelled “what works is what matters” in which learning occurs only if it helps resolve problems and situations encountered. Within this micro-level process are three components utilised by workers: personal resources, resident influences and cultural knowledge. Cultural knowledge comprises macro-level influences generated primarily from workers’ “interactions with colleagues” and secondarily “training”.  Significantly, this micro/macro-level interaction enables the care home’s organisational culture to influence the practice learned. Furthermore, informal means of learning predominate often intermediating formalised training and instruction. In particular, the flexible and relational requirements of person-centred approaches specifically emphasise these informal means.  A reconceptualised ‘Learning to Care System’ is recommended to enhance care practice quality by exploiting informal learning mechanisms and addressing organisational culture’s influence.

P10.2. Scotland’s Dementia Champions programme: education with the experience of people with dementia at its heart

JACK-WAUGH Anna1, RITCHIE Louise2, MACRAE Rhoda2, BROWN Margaret2, SHARP Barbara3

1University of the West of Scotland, Dumfries, United Kingdom, 2University of the West of Scotland, Lanarkshire, United Kingdom, 3Alzheimer Scotland, Lanarkshire, United Kingdom

The Dementia Champions Programme was commissioned as part of Scotland’s first dementia strategy in response to the poor hospital care experiences people living with dementia were experiencing. Funded by the Scottish Government in collaboration with NHS Education for Scotland, and the Scottish Social Services Council, this educational programme has been running since 2011. The programme aims to provide enhanced dementia care education to qualified health and social care professionals to support them to champion and lead positive change in their hospital care settings. Over 1000 health and social care professionals have completed the programme to date.

This presentation will outline findings from the longitudinal pre and post-test intervention data collected from 524 participants.  The findings show that the programme had a statistically significant positive effect on participant’s knowledge of dementia, approaches to dementia care and confidence in their ability to achieve the learning outcomes of the programme. It will also present the findings of a doctoral study that used grounded theory to illuminate the educational, professional and practice impact of the programme on participants.

Key elements of success are attributed to the programme’s clear educational and theoretical underpinning, a human rights focus to care provision and consistent focus on the future role of participants as dementia champions. The champions’ programme directly challenges stigma and aims to reconceptualise what it is to experience dementia. The participation of people with dementia and family carers plays a vital role in achieving this.

The findings have implications for how dementia care is taught in both the first and continuing professional education of all health and social care staff.

P10.3. Developing person-centred care practice around the world through staff training and development

PERRY Wendy

Dementia Services Development Centre, Stirling, United Kingdom

The Best Practice learning programme has been running now for twelve years, and has been used to develop the knowledge, skills and practice of over 12,000 care staff and volunteers in the UK. Since 2017 the Dementia Services Development Centre (DSDC) in the University of Stirling has been partnering with the Jockey Club Centre for Positive Aging (JCCPA) to bring the Best Practice in Dementia Care programme to Hong Kong.  Following the translation of materials into Cantonese, JCCPA staff were trained by the DSDC to develop Best Practice facilitator training courses.  Over the past three years the JCCPA has used the Best Practice Programme to train over 1200 health and social care staff in Hong Kong.  Researchers from the Chinese University of Hong Kong, Jockey Club Centre for Positive Ageing and the University of Stirling looked at the effects of the Best Practice programme on staff knowledge, attitude, sense of competence related to dementia care and job satisfaction and explored how the staff dementia care attitudes and practices have been influenced immediately following training and again at a twelve month follow up.

This presentation by the DSDC will review and discuss the findings and provide a short video interview between Wendy Perry, Head of Learning and Development at the DSDC and Dr. Kenny Chui, Chief Training Consultant and Dementia Care Specialist who led the project for the JCCPA in Hong Kong. They will discuss the challenges and rewards presented by translating a care training model across cultures, and how reflective learning can be used to build empathy and person-centred practices.

P10.4. Who is in charge? Exploring the multiple roles involved in supporting people with dementia and dysphagia

COLLINS Lindsey1, OYEBODE Jan1, HART Andrew1, LESLIE Paula2

1University of Bradford, Bradford, United Kingdom, 2University of Central Lancashire, Preston, United Kingdom

Introduction: Eating and drinking are essential for life; play a key role in solidifying people’s identities as part of social groups; and have symbolic and moral significance in different cultures and societies. People living with dementia are at an increased risk of having eating, drinking and swallowing difficulties (dysphagia). Multiple health and care professionals, as well as family members are involved in supporting people living with dementia who experience dysphagia.

Methods: This qualitative study used interviews, focus groups and structured observations (using Dementia Care Mapping) to look at the different roles and perspectives involved and how differences of opinions are resolved or responded to. Inductive thematic analysis was used to identify themes that represent the experiences and areas of importance for participants.

Results: A total of 70 individuals participated in the study, including people living with dementia, family carers, care home staff and Speech and Language Therapists. 31 interviews were carried out along with two focus groups and 35 hours of Dementia Care Mapping observations.

Results: Thematic analysis of the data highlighted the challenges of multiple perspectives, including the uncertainty of roles and responsibilities; how decisions are made; how disagreements are managed; and the different perspectives different groups of people bring to the table, specifically knowing the person versus knowing about dysphagia.

Discussion and conclusions: The findings from this study highlight that supporting people living with dementia and dysphagia requires careful consideration of a range of important factors. It is important to have clear roles, responsibilities and channels of communication between people living with dementia, family members, care home staff and healthcare professionals. Care professionals will benefit from this knowledge to aid them in better supporting people living with dementia and dysphagia, particularly in residential care facilities.

P10.5. "Listen to our voice too!" - the training needs of care providers in the residential care homes

CHUI CHI MAN, Kenny

The Chinese University of Hong Kong, Hong Kong, Hong Kong

Chi dai zheng, the term for dementia used across parts of Asia under the Chinese sphere of influence, carries a negative connotation of idiocy that has long fuelled negative stereotypes of people with the condition. In such cultures, how people with dementia perceive themselves, how care staff perceive them as well and how training sessions addressing their self-perceptions can influence the care provided by staff in residential care homes. Indeed, how the care staff and people with dementia perceive each other can significantly affect the daily quality of life of both parties (Hubbard, Tester, & Downs, 2003). 

In my research findings, the residents with dementia did not perceive themselves as being ‘demented’ and were confused by that label. By contrast, perpetuating the common stigma, the care staff perceived the residents as being ‘demented’, desolate troublemakers. They felt frustrated and exhausted with caring for the residents, whom they described as naughty children or psychiatric patients. Taken together, divergent perceptions between residents and the care staff affected general interpretations of people with dementia, which puzzled residents about their situations in the residential care homes. Revealing that the psychological needs of people with dementia and the care staff are under-recognised in the dominant discourse on dementia, the findings suggest that improving familiarity with the reasons behind those needs and offering training in understanding the self-perceptions of people with dementia were crucial. In the training sessions geared towards elucidating the self-perceptions of residents, the care staff were able to reflect upon their practices and, in turn, develop a more empathetic understanding of people with dementia. Such findings suggest a new standpoint from which to understand people with dementia and promote the development of training in dignified dementia care that involves the ASK model (A-Attitude; S-Skill; K-knowledge) and a proper dementia care attitude, called "DemenTitude". 

 

 
 

Last Updated: Tuesday 30 June 2020

 

 
  • Acknowledgements

    The 30th AE Conference received funding under an operating grant from the European Union’s Health Programme (2014-2020). Alzheimer Europe gratefully acknowledges the support of all conference sponsors.
  • European Union
  • Roche
 
 

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