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P16. Dementia care training

Detailed programme and abstracts

P16.1. Taking the role of the other; putting people with dementia at the centre of education for the dementia workforce

WAUGH Anna

Education and skills development for a health and social care workforce to deliver high-quality care for people with dementia is viewed as an international concern (Collier, Knifton and Surr, 2015; Mustafa et al., 2013).  The total number of people with dementia worldwide in 2016 is estimated at 47.5 million and is projected to nearly double every 20 years (WHO, 2016).

Commissioned by the Scottish Government and NHS Education Scotland, Scotland’s National Dementia Champions Programme Banks et al. (2014), was developed and is now in its eighth cohort of delivery and evaluation. Many Dementia Champions reported a uniqueness to their experience on the programme particularly seeing people with dementia, their profession and themselves in a different light. These expressions promoted research to be undertaken to explore the Champions experiences in partial completion of a Professional Doctorate Programme in Nursing.

This study used a theory-methods package of Symbolic Interactionism (SI) and Constructivist Grounded Theory (CGT) to construct a Grounded Theory of learning experienced by Dementia Champions. The aim of the study was to explore the experiences and meaning of those experiences, reported by some participants of the Scottish Dementia Champions Programme. The reported experience of change in their professional and personal selves in relation to people with dementia was the focus of this study. Dementia Champions (n=19) from health and social care were interviewed using intensive interviewing and focus group techniques.

Being close up: taking the role of the other for learning was a resulting core concept of the theory. Champions described interacting directly with people with dementia living well with their diagnosis in a range of educational opportunities as being key stimulus for change in perception and knowledge. The study outcomes and implications for future educational practice will be the focus of this presentation.

P16.2. Effectiveness of the blended care self-management program ‘Partner in Balance’ for early-stage dementia caregivers: results of a randomised controlled trial

BOOTS Lizzy, DE VUGT Marjolein, KEMPEN Gertrudis, VERHEY Frans

Background: The benefits of e-health support for dementia caregivers are increasingly recognised. Reaching early-stage dementia caregivers could prevent high levels of burden and psychological problems in the later stages. The Medical Research Counsel (MRC) framework was followed to develop the blended care self-management program ‘Partner in Balance’ (PiB) together with potential users.

Objective: The current study evaluates the effectiveness of PiB compared to a control group.

Methods/design: A single-blind randomised controlled trial with 80 family caregivers of people with (very) mild dementia was conducted. Participants were randomly assigned to either the 8-week PiB program or a waiting-list control group receiving usual care (low-frequent counselling). Primary proximal outcome included self-efficacy (CSES), primary distal outcome symptoms of depression (CES-D). Secondary outcomes included mastery (PMS), quality of life (ICECAP-O), and psychological complaints (anxiety (HADS-A) and perceived stress (PSS)).

Results: A significant increase in favour of the intervention group was demonstrated for self-efficacy (care management P=0.002, service use P=0.001), mastery (P=0.001), and quality of life (P=0.032). Effect sizes were medium for quality of life (d=0.58) to high for self-efficacy (d=0.85 and d=0.94, respectively) and mastery (d=0.94). No significant differences between the groups were found on depressive symptoms, anxiety and perceived stress.

Discussion: This study evaluated the first blended care intervention for caregivers of people with early-stage dementia and demonstrated a significant improvement in self-efficacy, mastery and quality of life. Contrary to our expectations, no differences between the groups were found on symptoms of depression, anxiety and perceived stress. However, levels of psychological complaints were relatively low in the study sample. Future studies including long-term follow up could clarify if an increase in self-efficacy results in a decrease or prevention of increased stress and depression on the long term. The program could provide accessible preventative care to future generations of early-stage dementia caregivers.

P16.3. We have a new hospital! Future proofing the dementia workforce 2017 and beyond

GARTON Julie, WAUGH Anna, BROWN Margaret, CRAIG Donna

NHS Dumfries & Galloway commissioned a new hospital which is currently under construction, as part of this exciting development, a replica of a single bedroom was installed in the current Dumfries & Galloway Royal Infirmary.

Alzheimer Scotland Dementia Nurse Consultant Julie Garton, formed a team of educationalists and practitioners to deliver simulation to support staff to become familiar with the new hospital environment. Additionally, the simulation facilitates an understanding of the potential new challenges people with dementia and sensory difficulties may encounter in this new environment. The overall aim of this ‘Walk in my Shoes’ implementation, is to provide staff with a wider appreciation of the breadth and depth of challenges the physical and social environment can present to the person with dementia. By developing this understanding it is hoped that staff will appreciate the imperative to deliver person-centred care, whilst providing opportunities for the facilitators to challenge stigmatising beliefs and attitudes, signpost the workforce to services and offer a professional ear to staff who may be in the role of family carer. The strategy is ongoing and has developed to include a wider audience from health, social care and the voluntary and independent sector.

In this presentation, how ‘Walk in my shoes’ was utilised to support staff moving into the new hospital will be outlined. Background data on participants length of service and prior learning experience about dementia will be discussed. Then a pictorial report on how ‘Walk in my shoes’ was delivered by a flexible team and how participants evaluated their experience will be outlined. This will include a Dementia Champion discussing the impact, participating in ‘Walk in my shoes’ had on her as an experienced practitioner.

Attendees of this concurrent session will have the opportunity to sample some of the simulation techniques incorporated in ‘Walk in my shoes’ and debate the underpinning teaching and learning strategies incorporated to develop person-centred care.

P16.4. Variation in dementia training provided to hospital staff in England

REILLY Siobhan, AHMED Faraz, MORBEY Hazel, HOLLAND Fiona, HANN Mark, DAVIES Linda, KEADY John, LEROI Ira, SWARBRICK Caroline, REEVES David

There are approximately 850,000 people living with dementia in the UK. Around 70 percent of acute hospital beds are occupied by older people, approximately 40 percent of whom have dementia. Improving the quality of care in hospitals is a key priority within national dementia strategies. There is evidence to suggest that dementia training approaches are highly variable. Limited research has been conducted to evaluate dementia training packages, and where evaluation takes place this often focuses on immediate, on-the-day training feedback and effects. We will present early findings from our structured Hospital Organisational Survey sent to hospitals in England (n= approx. 193). The survey recruitment is researcher-led involving telephoning and identifying dementia leads in each hospital. The survey will enable us to explore variations in 1) the dementia training strategy within each hospital, 2) the presence; timing, characteristics and format of training programmes; skill mix and mode of delivery; frequency, duration and intensity of training; staff groups in receipt of training; quality of training; resources utilised in developing and/or provision of dementia training, including costs and number of staff trained. 3) what other initiatives are implemented e.g. having a dementia champion, active participation in Butterfly scheme, Dementia Friends, carers allowed on wards at meal time. 

We aim to use existing data, such as Hospital Episode Statistics, alongside a further staff level survey to assess the variation in dementia training, health service outcome/process measures (e.g. length of stay and emergency re-admissions) and staff outcomes (e.g. confidence and knowledge). From this study we will identify specific recommendations and guidance about which elements of the training packages are potentially more effective and appropriate for use in acute hospital settings. To help to promote the study, additional endorsements were sought from a number of key stakeholders to facilitate this research, including Dementia Action Alliance and the Royal College of Nursing.

P16.5. A systematic review of dementia training programmes for staff working in hospital settings

SCERRI Anthony, INNES Anthea, SCERRI Charles

Objectives: There is increased recognition in hospital settings of a trained workforce in dementia care. During the past years, a number of studies sought to develop and evaluate dementia training programs directed to staff working in hospital settings. Although systematic reviews that critically appraised training programmes for care home staff have been published, there are no reviews that summarise training programmes for hospital staff. This review sought to address this, by collecting the current evidence on dementia training programmes directed to staff working in general hospitals.

Method: Literature from five databases were searched, based on a number of inclusion criteria. The selected studies were summarised and data was extracted and compared using narrative synthesis based on a set of pre-defined categories. Methodological quality was assessed whilst the effectiveness of the training programmes was compared by categorising the studies according to Kirkpatrick’s Evaluation Framework.

Results: The search strategy retrieved fourteen peer-reviewed studies, the majority of which were pre-test post-test investigations. There were no randomised controlled trials. The development and mode of delivery of the programmes varied considerably. However, the most favoured style consisted of interdisciplinary ward based, tailor-made, short sessions using experiential and active learning. The majority of the studies mainly evaluated learning, with few studies evaluated changes in staff behaviour/practices and patients’ outcomes.

Conclusion: This review indicates that although training programmes improve staff knowledge, confidence and attitudes, the evidence on the effectiveness of these programmes on staff behaviour and patient outcomes, is still limited. Thus, high quality studies are needed that evaluate staff behaviours and patient outcomes and their sustainability over time. Finally, this review highlights measures how to develop and deliver effective training programmes in hospital settings.

P16.6. The training program “EduCation dementia - inpatient care”

ENGEL Sabine

It has been shown that a good, cooperative relationship between staff members of long-term care facilities and relatives of residents with dementia is a basic prerequisite for optimal quality of care. But research points out that there are frequent interpersonal conflicts, which increase the risk of staff burnout, hinder the integration of the relatives, and affect the resident’s quality of life.

To improve the quality of interpersonal relationships between relatives and staff and to enhance the quality of the living space “nursing home” we designed the training program “EduCation dementia - inpatient care”. The aims of this program are: to increase general and professional knowledge about dementia and about adequate care aligned towards the needs of residents with dementia, and to promote cooperative communication within the facility.

“EduCation dementia - inpatient care” is a modular system consisting of four components: a training course for relatives, an education courses for staff members, a tandem training course, in which relatives as well as staff members partake simultaneously in joint sessions, and a workshop for facility directors. Depending on the needs the components can be conducted individually or in combination.

The findings of our evaluation study show, that relatives and staff members assessed the program as very helpful. After participating in the training they stated that they have now a better understanding of how to care for residents with dementia in a person-centred manner, how to handle interpersonal conflicts with the other party in a cooperative manner, and how to promote the integration of families. To evaluate the outcomes for the residents Dementia Care Mapping (DCM) was used. The results have shown a statistical significant improvement of wellbeing.

Since 4 years Train the Trainer courses for qualified and experienced healthcare-professionals have been successfully carried out in Germany. 

 

 
 

Last Updated: Monday 23 October 2017

 

 
  • Acknowledgements

    The 27th AE Conference in Berlin received funding under an operating grant from the European Union’s Health Programme (2014-2020). Alzheimer Europe and Deutsche Alzheimer Gesellschaft e.V. gratefully acknowledge the support of all conference sponsors.
  • European Union
  • Roche
 
 

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