Basket | Login | Register

 
 
 
 

PO9. Training and education of care professionals

Detailed programme, abstracts and poster presentations

PO9.2. Dementia aCROsSLO- Improving the quality of life for persons with dementia on cross-border area Slovenia Croatia

CVETKO Tatjana

Primary Health Centre KOPER, Slovenia

Background: Dementia's friendly environment for people with dementia improves their quality of life. Supportive living environment and educated caregivers are fundamental at managing and organizing social and home care. In Istria, the cross-border area of Slovenia and Croatia, there was no systemic support for people with dementia living at home or in institutional settings.

Aim: to improve the living environment for persons with dementia and their families in community 

Methods: educational programme for professionals, media events for lay public, optimizing living conditions, developing a network of social assistance at home, preparing manuals for professionals.

Results: The project has linked partners on the outskirts of both countries - Slovenia and Croatia. Three elderly homes of diverse traditions and the mutual need for quality improvement had the same goal of providing better care for people with dementia in the institution and local community. To enhance the knowledge about dementia, a 6-week training program with lectures and workshops twice a week for all employees was carried out to enable exchange of knowledge and experiences. The manual for professionals in institutional care was prepared.  

The development of social assistance network for the elderly in two communities with use of modern assistive technology enable professionals to exchange good practices in area. Many public events for relatives and lay public were supported with media and leaflets which contributed to the recognition of dementia. A web page of the project demenca.eu was created with extensive informational support and professional literature in the local language. Design experts carried out the optimization of one living space in each elderly home and prepared a guidebook of recommendations on living environment.

Conclusions: With the knowledge of professional and managerial staff in the region, we can influence the development of supportive environment for people with dementia, regardless where they live.

PO9.3. Appropriateness improvement and variability decrease of home enteral nutrition (HEN) in people with advanced dementia in “AUSL Romagna”

BOSCHI Federica1, BENATI Giuseppe1, TELLARINI Davide2, MARCONI Giorgia3, DE CAROLIS Stefano3, MARGIOTTA Alessandro4, GHERARDI Mauro4, CILLA Donatina1

1AUSL Romagna, FORLI', Italy, 2AUSL Romagna, Faenza, Italy, 3AUSL Romagna, Rimini, Italy, 4AUSL Romagna, Ravenna, Italy

Many studies confirm that the association between dementia and weight loss increases through the stages of dementia severity. Deleterious effects of weight loss are well known. When early, mild or moderate dementia is present, HEN should be performed to overcome a crisis situation and specific clinical goals are present. In people with advanced dementia no significant difference between mortality rates, quality of life, pressure ulcers, physical and mental function has been found in people receiving HEN and those without. The initiation of tube feeding in the advanced stage of dementia should be mostly considered as inappropriate. “AUSL Romagna” is part of the Emilia Romagna region (Italy) and inhabitants of this territory are about 1.200.000. In 2015 a clinical network in clinical nutrition was established in “AUSL Romagna”. During the last years, an annual survey about prevalence of HEN was organised. In 2018, data about HEN prevalence with advanced dementia ranged from 59 to 239 patients per million inhabitants. We than decided to develop a specific project to improve the appropriateness of HEN in people with advanced dementia. A multidisciplinary group was established. At time one, a clinical audit was projected and implemented to establish clinical behaviors in setting up a tube feeding in people with CDR 4-5 stages. Time two of the project was made up by the development of a local and multidisciplinary position paper about nutrion in advanced dementia. Paper training has started providing three local events that involve both hospital and territory (GP, nurses). At time three a new clinical audit will be performed about acquired clinical behaviors and training efficacy.

In conclusion, expected result is an improvement of appropriateness in decision to adopt HEN in advanced dementia in “AUSL Romagna”, thus leading to decreased differences in current behaviors and a real gain in quality of life.

PO9.4. Development of a mobile application to monitor psychotropic drug prescriptions

JANUS Sarah, RASING Naomi, TEUNENBROEK Charlotte, ZUIDEMA Sytse

University Medical Centre Groningen, Groningen, Netherlands

Introduction: Rational use of psychotropic drugs as treatment of neuropsychiatric symptoms is seen as an important indicator for ensuring basic safety. A mobile application was developed based on the Dutch “Multidisciplinary guideline for problem behaviour in dementia” (Zuidema et al, 2018) to stimulate awareness among prescribers in elderly care. We investigated whether the use of the application: (1) led to more appropriate psychotropic drug prescriptions for neuropsychiatric symptoms, and (2) was experienced as user-friendly by participating physicians.

Method: We conducted a pilot study with interviews with two physicians for the development of the application. The feasibility and effect of the application was studied using a pre- and post-measurement for 4 months (December 2018 -April 2019, intervention period). The primary outcome of the study was the appropriateness of the psychotropic prescriptions measured by the researcher. Secondary results were the experienced user-friendliness of the app by the participating physicians and the log data on the use of the application.

Results: For the development the physicians used the application on a smartphone or tablet, thinking out loud. The app was adapted according to physicians’ input. For the pre-and post-measurements, a total of 63 physicians participated in the study and had access to the application between December 2018 and April 2019. At this moment the data from the measurements are being processed.

Discussion: The application could be a useful tool for doctors to actively evaluate their prescriptions and stimulate awareness. We expect that the application will lead to more appropriate prescriptions according to the Dutch guideline. A possible threshold mentioned is that the application is a stand-alone tool - not connected to existing prescription systems - which provides an additional action for the physicians during prescribing.

PO9.5. Hands-on Dementia. The interactive way to understand dementia. A method to feel the symptoms of dementia

WILHELMI Monika

Hands-on Dementia, Remscheid, Germany

What do people who suffer from dementia experience every day? It is not easy to understand what moves people with dementia and what motivates their action. But understanding is the key to entering the world of someone who is different to what we are. To better comprehend how people with dementia feel the interactive training material Hands-on Dementia was developed. People with dementia react in a different way, sometimes apparently pointless and very emotional. Often this leads to insecurity, especially in trainees. With the help of Hands-on Dementia, we are able to develop a deeper understanding and empathy for people who suffer from dementia. Hands-on Dementia is a method to strengthen self-awareness that can be used in the education of care and nursing staff. Trainees and volunteers can easily learn the symptoms of dementia, but it is hard to grasp what everyday life feels. How do apraxia and aphasia influence the daily routine? In 13 common situations, Hands-On Dementia simulates different symptoms of dementia. With Hands-On Dementia the brain of trainees is misled. Trainees experience how it is when the most basic things become difficult and they feel the shame, despair and helplessness many people with dementia have to endure. This experience enables trainees to develop more understanding and empathy. The material leads through an ordinary day: getting dressed, having breakfast, driving a car, spare time…The martial encourages autodidactic learning. There are important moments of self-reflection but also medical and psychological information. Hands-on Dementia exists in German, French, English and Italian language, a translation into Dutch is in progress. Hands-On Dementia was developed by Leon Maluck, a 21-year-old student of psychology.

Psychological psychotherapist Monika Wilhelmi will present the method and share her rich experience in using the material in different contexts.

PO9.6. Doing “good” to do well for those with dementia: Developing good practice recommendations and program plans

VAN DER SCHOT Astrid, HIPPLE WALTERS Bethany

Trimbos, Utrecht, Netherlands

Many healthcare systems in Europe struggle with understanding how to effectively improve care provided for those with dementia. It can be difficult for policymakers, clinic and hospital administrators, and clinicians to access the newest evidence and guidelines for dementia care, as well as to understand new evidence, understand how to extract meaningful guidance from academic literature, and how to implement this guidance in real-life settings. As part of the EU Joint Action Act on Dementia, dementia specialists and implementation experts from the Trimbos Institute developed practical tools for quickly gleaning recommendations from literature, for structuring practice changes based on new recommendations, and for developing implementation strategies to put these plans in place in pilot programs. Selection criteria themes included program relevance, theory basis, intervention characteristics, effectiveness, stakeholder participation, program sustainability, ethics, and program transferability. For Act on Dementia, the data collected via the criteria was used to develop recommendations for good practices in crisis and care coordination in dementia care, such as the need for multidisciplinary, patient-centered care. The criteria’s themes, as they represent needed components of dementia programs, were used to shape an intervention and implementation planning tool. For Act on Dementia pilot programs in five countries, this planning tool guided clinicians and project leaders in developing dementia care programs using good practice recommendations. While each pilot project had a unique dementia care aim, the tool ensured that each project leader was able to effectively plan their program, create intervention strategies, and seek out support in improving care through the use of good practice recommendations. The selection criteria and the intervention and implementation planning tool can be used by healthcare systems throughout Europe. It is a quick and feasible way to develop good practice recommendations and create new programs to improve dementia care.

PO9.7. Process evaluation into the response of nursing homes towards the implementation of the case conference concept WELCOME-IdA

HOLLE Daniela1, TEUPEN Sonja2, GRAF Rabea2, MÜLLER-WIDMER René2, REUTHER Sven3, HALEK Margareta2, ROES Martina2

1Hochschule für Gesundheit (hsg), Bochum, Germany, 2German Center for Neurodegenerative Diseases, Witten, Germany, 3Städtische Seniorenheime Krefeld, Krefeld, Germany

Background: The implementation of structured case conferences (WELCOME-IdA) is an important tool to enable nursing staff to conduct a proper analysis and management of challenging behaviour of nursing home residents with dementia. A process evaluation of the implementation of WELCOME-IdA was carried out to gain insight into the adoption process of WELCOME-IdA.

Methods: This study was part of a larger process evaluation using a qualitative design. 34 semi-structured telephone interviews and 15 focus group interviews were conducted in four nursing homes (NHs). The interviews were analysed using deductive content analysis, although inductive categories have been developed.

Results: The results show a variance in the response towards the key elements of WELCOME-IdA. NHs adopted the roles in WELCOME-IdA (moderator, case reporter, keeper of the minutes, reflection partners), even though the selection of the staff members differed in the NHs. The group size of 5-8 participants per case conferences was partially adopted. The core nursing teams who participated continuously in all case conferences were not adopted at all. The process structure of WELCOME-IdA was adapted in a way that the assessment of the residents´ behaviour and the selection of the domains for the behaviour analysis were conducted in advance to WELCOME-IdA. The evaluation of the interventions was organized differently.

Conclusions: The scope of response implies that the concept of WELCOME-IdA does need further adaptation to the requirements of nursing processes in NHs. The results provide important information on the selection of role keepers, the selection of the participants of the case conferences and the selection of the case. Furthermore, the results provide insights how knowledge of the structured training was circulated and transformed into self-organized case conferences, and was circulated throughout the entire processing of one case. Thus, these results can be used to optimize the intervention and the implementation.

PO9.8. A cluster randomized controlled trial on the effects of tailored intervention and implementation plans using participatory action research on inappropriate psychotropic drug use in nursing home residents with dementia

VAN TEUNENBROEK Charlotte1, GROOT KORMELINCK Claudia2, ZUIDEMA Sytse2, GERRITSEN Debby3, SMALBRUGGE Martin4

1UMCG, Groningen, Netherlands,2Groningen, Netherlands,3Nijmegen, Netherlands, 4Amsterdam, Netherlands

Background: Although guidelines recommend a restricted use of psychotropic drugs because of serious side effects and a limited effectiveness, psychotropic drugs have yet a substantial place in the treatment of neuropsychiatric symptoms. Furthermore, only 9.4% of psychotropic drugs is prescribed appropriately. Therefore, we aimed to develop a strategy using participatory action research to optimize implementation and to enhance the effects of chosen interventions to reduce inappropriate psychotropic drug use. In this study we aim to assess the effects of our strategy on inappropriate psychotropic drug use.

Methods: We carried out a randomized controlled trial integrated with participatory action research, which allowed us to adapt to local differences and needs of nursing homes. Within the intervention group a problem analysis was carried out to identify local needs. With this analysis as the basis a tailored intervention- and implementation plan was chosen. Primary outcome was the reduction of inappropriate psychotropic drug use as measured with the APID index, secondary outcome was the percentage of psychotropic drug use. Results were analyzed using multilevel analysis according to Twisk et al.

Results: The study was carried out in 16 nursing homes in the Netherlands and we included 576 residents with dementia at baseline, of which 312 used psychotropic drugs. Preliminary results show a small reduction of inappropriate prescribing behavior, yet this reduction is not significant. The multilevel analysis, taking into account the degree of implementation (extent of performance) will be carried out once the process evaluation is finished. In addition, data on percentage of psychotropic drug use will be analyzed and presented at the conference.

Conclusion: Preliminary results show that both control and intervention groups show a reduction of inappropriate psychotropic drug use. The reduction as appointed to our intervention is small and not significant, possibly due to suboptimal implementation.

PO9.9. Dementia knowledge, attitudes and training needs of student and qualified speech-language pathologists: A countrywide study

SCERRI Charles, SACCASAN Nicola

University of Malta, Msida, Malta

The number of individuals with dementia in the Maltese Islands is increasing and is projected to reach 3.3% of the total population by the year 2050. As a result, there is a greater demand for healthcare professionals to provide the necessary services that these individuals require. Speech-language pathologists are increasingly being called for to assist individuals with dementia with communication and swallowing impairments. Nevertheless, they may not be adequately prepared to engage and effectively care for these individuals. The main objective of this study was to assess, through a specifically designed questionnaire, the level of dementia knowledge, attitudes and training needs of students reading for a degree in speech-language pathology at the sole tertiary education institution in the Maltese Islands as well as those who are already qualified and practicing their profession in the community and acute/long-term institutional settings. The results have shown that both students and qualified speech-language pathologists lack adequate knowledge on dementia, in particular, on risk factors and aspects of caregiving. Qualified speech-language pathologists had more positive attitudes towards individuals with dementia and lower training needs compared to students. The findings demonstrated that both students and qualified speech language pathologists required more dementia-specific training. It is therefore essential that such training is provided as part of the curriculum of the undergraduate course and through continuous professional development schemes for qualified speech-language pathologists. This study continues to support evidence that there is an increased need for ongoing training and education in the field of dementia for students and healthcare professionals who will or already are providing services to the increasing number of individuals being diagnosed with dementia in the Maltese Islands.

PO9.10. The use of simulation video feedback to improve educational outcomes in dementia training

MCALISTER Janice

Erskine, Bishopton, United Kingdom

The need to have robust, valid and relevant educational systems in place that improve clinical outcomes for people with dementia has been a national priority in Scotland over a number of years (Scottish Government 2011). At Erskine, where we provide care for veterans from across Scotland and beyond, it is our belief that those living with dementia have a right to be cared for by skilled and knowledgeable staff who exercise care and compassion at every interaction. The use of simulation is often used as part of a mixed methodological approach within educational fields, in particular virtual training programmes have often been developed in dementia care.

At Erskine, however, we have developed a purpose designed simulation suite that goes beyond the norms of virtual and experiential learning. We recognized the fact that we live in a society where the use of video and social media has become the norm. Our simulation programme therefore incorporates a complete video and audio component, where staff utilize age simulation suites and carryout everyday tasks within a safe environment whilst being video recorded, although the value of simulation should not be underestimated, I would however argue that the key component is the video playback. Only by utilizing this can staff and family members observe their own behaviour first hand, which often differs from self reporting. Participants are able to visually and audibly watch themselves, identifying similarities in their behaviour to behaviours carried out by residents resulting in improved understanding.  Subsequent debriefing sessions allow for discussion around behaviour similarities, characteristics, reasons and normalization of behaviour. In doing so participants are better equipped to create a care environment that is enabling, supportive and meets the needs of our residents within an environment that has a person centered culture at its core.

PO9.11. How can a standardised criteria help develop the quality of life of people with memory-related diseases?

TOMMOLA Satu, POHJANVUORI Anita

The Alzheimer Society of Finland, Helsinki, Finland

Care and services should always be based on the patient’s individual life history and their involvement in decision-making. A standardised criteria is of help in comparing and developing the quality of care and services offered to people with memory-related diseases.

The Alzheimer Society of Finland has published Quality of Life and Care Guidelines of people with memory-related diseases in 2016. The publication provides an overview of various aspects of good care and the quality of life and an explicit criterion to evaluate and develop care and services from those perspectives.

The criteria is based on the National Memory Programme and the National Memory Programme Implementation Plan, as well as current legislation. In 2018, the National Institute for Health and Welfare performed a follow-up survey on the application of the Quality of Life and Care Guidelines for care units in Finland (n=2799). 51.4% reported that the criteria were being applied in their unit.

Recent distribution and implementation has been systematic and visible. Last autumn, five workshop pilots were organised in two different regions for professionals in care units. The workshops began with a theory section which was followed by group work on preassigned topics. The goal was to explore how well a workshop approach is suited to implementing the criteria. The respondents (n=112) felt that the criteria was well-suited for developing the quality of care in their units.

Another pilot for two memory units has started in January 2019 and the results will be ready in September. The pilot identifies how work methods and processes have changed after the implementation of the criteria.

The aim of these actions is to highlight the working methods that will support the development of quality of life and care and guide to share more information between care units to develop memory work in the future.

PO9.12. Developing an intervention to enhance communication between nursing staff and people with dementia in nursing homes

VAN MANEN Annick, METZELTHIN S.F., HAMERS J.P.H., ZWAKHALEN S.M.G.

Maastricht University, Maastricht, Netherlands

Communicative abilities of people with dementia progressively decline due to their condition. In order to deliver adequate care, skillful communication is essential. This study aims to develop an intervention to enhance the communication between nursing staff and people with dementia in nursing homes.

The developmental process included the following stages. First a review of existing interventions was performed. Subsequently, current and desired communication practices in dementia care were discussed in working groups (n=4). Experts (n=7) were interviewed regarding the characteristics of desirable communication in the care for people with dementia and appropriate training methods. Additionally, observations (n=9) in nursing homes were performed to explore possibilities of integrating an intervention in daily care practice. This resulted in a preliminary intervention consisting of group meetings, practical meetings, coaching-on-the-job, and informative newsletters. To evaluate feasibility and barriers/facilitators for implementation of the intervention, a pilot test was carried out on a nursing home ward. A coach guided the program with two participating nurses. The implementation process was evaluated by collecting field notes, monitoring attendance rates, and thematic analysis of semi-structured interviews with participants (n=13).

Participants of the pilot study indicated that the topic and the content of the intervention was relevant and understandable. The practical approach and coaching-on-the-job was appreciated, although participants were reluctant to provide feedback to each other. Participants considered a raised awareness of communication practices as the main outcome in this testing phase. Attendance rates were low due to ward duties during meetings and non-working days. Team cohesion and managerial influences were identified as contextual factors that influenced the implementation process.

To optimize the intervention, adaptations must be made to facilitate behavioral change and account for contextual factors that may influence the success of the intervention.

PO9.13. The perception of healthcare providers on cultural-sensitive dementia care

CLAEYS Ann1, BERDAI-CHAOUNI Saloua2, TRICAS-SAURAS Sandra2, DE DONDER Liesbeth2

1Erasmushogeschool, Brussels, Belgium, 2Brussels, Belgium

Background: An increasing number of older patients from diverse backgrounds in western cities draws attention to the concept of cultural sensitive dementia care. Research highlights that patients from ethnic minority groups receive lower quality of care and less accurate diagnosis. Moreover, there is a higher prevalence of dementia in these groups.  Therefore, this paper aims to explore the perceptions and potential facilitators of cultural-sensitive care from the viewpoint of the healthcare providers.

Methods: 4 focus groups (n = 25) and 4 in-depth interviews were conducted with 4 types of respondents: student and qualified nurses, student and qualified physicians. Thematic content analysis, based on the model of Papadopoulos, Tilki, & Taylor (1998) was used to analyse the data.

Results: Results firstly suggest that healthcare providers often reduce the concept of cultural-sensitive care to (1) taking patients’ religion into account, and (2) a checklist of practical issues like language or specific foods. Secondly, healthcare providers can build up experience and knowledge on how to provide cultural-sensitive dementia care, which empowers caregivers to deal with difficult situations. In contrast, it is difficult for providers to keep the balance between cultural knowledge and potential prejudices. Lastly, the role of healthcare organisations appears to be crucial in supporting their staff to deliver valuable cultural-sensitive dementia care.

Conclusion: Our study highlights that cultural knowledge is an attribute in the model of Papadopoulos et al. (1998) that deserves further attention, as the results indicate that healthcare providers struggle with the balance between knowing aspects of cultures and having prejudices and assumptions that may eventually affect care. Cultural awareness is needed to highlight differences between cultural knowledge and prejudices. This study is part of the DiversElderlyCare project on culturally sensitive dementia care in Brussels.

Keywords: cultural sensitive dementia care, perception, healthcare provider, care services

PO9.14. Establishing ‘professional-specific’ modules and tip cards for dementia training and education

TIEN En Tzu

Taipei City Hospital, Taipei City, Taiwan, Province of China

Due to the complex nature of dementia, carers require an integrated healthcare system and multidisciplinary practitioners to support them to get through the long way. However, inadequate caring experiences and knowledge would affect the outcomes and the quality of dementia care.

In order to improve general awareness and about dementia, the Dementia Centre of Taipei City Hospital has established the first training and education centre in 2016. The courses have covered an overall understanding about dementia, including diagnosis tools, symptoms, psychological assessments, medication, non-medication treatments and group case study. 

Secondly, ‘professional-specific’ training modules have been delivered to a variety of professional backgrounds, such as doctors, nurses, pharmacists, psychologists, occupational therapists, physical therapists, social workers etc. The training courses were held specifically for certain professional backgrounds so that the participants would have the common professional languages and similar difficulties from their work, that lead the learners to exchange their experiences in the class. By using this teaching strategy, the speakers not only to deliver the evidence-based knowledge and experiences of dementia but also to encourage the learners to work together and discuss an integrated care plan.  

Thirdly, our experienced professionals selected the most useful caring principals or assessment tools to develop thirty "clinical dementia care tip cards" for our multidisciplinary team members. This educational toolkit is considerably practical and handy for those who work in busy fast-paced medical settings, allowing them to practice the clinical issues about dementia they have encountered on a daily basis. 

In conclusion, dementia requires multidisciplinary teams and multiples teaching methods to improve continuous professional development. We have delivered more than 30 times of dementia professional training courses for more than 2500 medical members in our training centre within two years. However, more tailored training and education modules designed for professionals are needed in Taiwan.

PO9.15. Training in psychosocial care in dementia in European higher education: A mixed-method analysis. The SiDeCar project.

CHATTAT Rabih1, OTTOBONI Giovanni1, CHIRICO Ilaria1, JANSSEN Niels2, DASSEN Fania2, DE VUGT Marjolein3, SANCHEZ M. Cruz4, GARCÌA-PENALVO Francisco4, FRANCO MARTIN Manuel Angel4, POVOLNÀ Pavla5, DOSTÀLOVÀ Vladimìra5, HOLMEROVÀ Iva5

1Department of Psychology, University of Bologna, Bologna, Italy, 2Alzheimer Centrum Limburg, University of Maastricht, Maastricht, Netherlands, 3Alzheimer Cnter Limburg, University of Maastricht, Maastricht, Netherlands, 4Psycho-sciences Research Group of IBSAL, Salamanca University, Salamanca, Spain, 5Institute for Postgraduate Medical Education; Charles University Faculty of Humanities, Prague, Czech Republic

Introduction: Dementia represents a public health priority worldwide. The number of studies consistently reporting the positive effects of psychosocial interventions for people with dementia, families and professional caregivers is constantly increasing. Despite the evidence, research results struggle to be transferred into higher education and then into practice. In order to foster the translational process, the SiDeCar, Eu E+ project funded through the KA2 asset, will develop an international curriculum of studies aimed at increasing psychosocial practices knowledge in dementia care within higher education (HE).

Method: Data about the European state of the art in HE in dementia care is being collected via an ad-hoc online survey and then matched to the European, national and regional recommendations for dementia care.

Results: Preliminary data reveals that in Europe the 19% of the provided teachings belong to the first HE level, the 80% to the second level, and the 1% to the third level. Among them, the 38% are courses, 23% are modules and 39% are topics delivered within course and modules not directly referable to dementia care themes. The taught issues appear having a theoretical focus in the 18% of cases, being related to the practice of care in the 53% and to mixed issues in the remaining 29%. Finally, most of the teachings are provided in central/western institutes (89%).

Discussion: Aimed at producing intellectual output such as, academic syllabi for the HE students, manuals for academics, guidelines for welfare stakeholders, recommendations for politicians, the SiDeCar project will work to foster the bridging process of translation from research into practice by supporting those universities and institutes that still lack of curricula centred on psycho-social care in dementia towards the relevance of the psycho-social approach in dealing with dementia-related problems.

PO9.16. Utilising the VERA framework to improve communication between student nurses and people with dementia

CASEY Dympna1, JORDAN Fionnuala1, DOREY Amber1, SMYTH Siobhán1, GANNON Mary1, MCCARTHY Bernard 1, HOUGHTON Catherine1, DEMPSEY Laura2, MCDONAGH Rosaleen1

1School of Nursing and Midwifery, National University of Ireland, Galway, Ireland, 2Faculty of Science and Health, Athlone Institute of Technology, Ireland

Developed by Blackhall et al. (2011), the Validation, Emotion, Reassure, Activity (VERA) communication framework seeks to provide student nurses with a guide to provide person-centred care to people living with dementia.  The framework aims to enable the caregiver to communicate with the person living with dementia in a respectful manner, and accept that there is both value and meaning to the person’s speech and behaviour.  

This paper presents the findings from a small pilot control pre-post study which aimed to explore the impact of the VERA framework to promote person-centred communication between student nurses and older people with dementia in long term care.   A control group of 6 students, received standard communication training and ten students received additional communication training using the VERA framework. Data was collected using the non participant observational tool Quality of Interactions Schedule (QUIS) and three self-assessment questionnaires to assess student nurses’ confidence, dementia knowledge and communication skills.  The results of this study found that those students who received the additional VERA communication training were observed to have a significantly (Mann-Whitney U test; p= <0.05) reduced number of negative interactions with people with dementia than those students who had received standard communication training alone.  In addition, student nurses trained in the VERA framework showed a significant increase (Mann-Whitney U test; p= <0.05) in their confidence to care for people with dementia than those who had received standard communication skills training The study finding need to be interpreted with caution given the small sample size and the pilot nature of the study. Nevertheless, these findings indicate that the VERA framework has the potential to improve (1) person-centred communication between student nurses and older people with dementia and (2) students’ confidence to care for people with dementia. 

PO9.17. Teaching partners: Involving people with dementia and families in the evaluation of students’ assessment

BARBOSA Ana

University of Bradford, Bradford, United Kingdom

Whilst there is increasing evidence on the importance and benefits of patient and public involvement (PPI) in research, there is much less evidence on the implementation of PPI in education programmes. The MSc in Advanced Dementia Studies run by the University of Bradford (United Kingdom) promotes the involvement of people with dementia and families, who are ‘experts by experience’, as partners in teaching. Experts are consulted at various stages of the education process, including curriculum design, delivery and students’ assessment. This presentation reports on a focus-group involving people living with dementia and their families in providing feedback on postgraduate students’ assignments. A group comprising three people living with dementia, two family members and two lecturers worked together to review and comment on samples from a student assignment. Specifically, the group was asked to comment on the use of person-centred language and provide more positive terms and expressions when required. This feedback was then given to the students. We will describe in detail the shared learning and participatory approach used, highlight some of its potential benefits and challenges for students, education team, and experts, and discuss how to sustain a collaborative environment for involving experts by experience in dementia education. Sound clips from the transcript will be embedded in the presentation. The direct involvement of experts by experience in students’ assessment proved to be possible and rewarding. Our experience may help academics in the dementia field to have a greater understanding on how to accomplish this.

PO9.18. Allied health professionals transforming their contribution to support people living with dementia

HUNTER Elaine, MCKEAN Alison

Alzheimer Scotland, Edinburgh, United Kingdom

Background: Connecting People, Connecting Support (CPCS) (Alzheimer Scotland 2017) is an evidence informed AHP dementia policy that outlines how allied health professionals (AHP’s) can support people living with dementia and their families to have positive, fulfilling and independent lives for as long as possible with 4 ambitions to transform practice. This policy fulfils a specific commitment in Scotland’s National Dementia Strategies (2013, 2017).

Method: The presentation will share the findings of an 18-month review of the implementation of CPCS across health, social care and partner organisations sharing:

·         An integrated improvement approach combing relational approaches and technical approaches

·         Use of social media to raise awareness of the occupational therapy role in dementia

·         A creative and innovative tiered approach to access the skills of occupational therapy through awareness, universal, targeted and specialist interventions

·         The importance of AHP’s together to ensure spread and sustainability of occupational therapy evidence informed interventions

·         Outline how the work of AHP supports Alzheimer Scotland’s 5 and 8 pillars models.

Conclusion: CPCS has been successful in developing visible leadership to deliver both the messages within CPCS and evidence base supporting interventions. However, we still have much to do to fully deliver the 4 ambitions of CPCS. The 18-month review has offered valuable learning on what is working well and what would make the integration of CPCS to local practice even better for people living with dementia and their families in Scotland. The presentation will also share the lessons learnt in working with allied health professionals to deliver national policy and what this can mean for an international audience.

References: (1) Alzheimer Scotland 2017 Connecting people, connecting support. Transforming the contribution of allied health professionals in dementia in Scotland 2017-2020; (2) Scottish Government (2013) Scotland's National Dementia Strategy; (3) Scottish Government (2017) Scotland's National Dementia Strategy.

PO9.19. An occupational therapy internship programme supporting a workforce skilled in dementia care

HUNTER Elaine1, MACLEAN Fiona2

1Alzheimer Scotland, Edinburgh, United Kingdom, 2Queen Margaret Unversity, Edinburgh, United Kingdom

Training and education of the current and future health and social care workforce is key to the transformational changes required to improve the experience and outcomes of care and treatment for people living with dementia and their families (Alzheimer Scotland 2017).

This poster will share an approach to enhance dementia skills with occupational therapists through an innovative academic internship programme in partnership with the Scottish Dementia Working Group, Queen Margaret University, Santander Universities UK and Alzheimer Scotland.  

This unique collaboration has offered occupational therapy students and recent graduates the opportunity to enhance their knowledge and understanding of living with dementia.  In turn, this work has contributed to the development of a skilled allied health professional (AHP) dementia care workforce in Scotland, whilst also generating outcomes of value and relevance to people living with dementia, their families and carers.

Consequently, this poster aims to reflect on the evolution of this academic occupational therapy internship programme over the course of the last seven years.  Specifically, the poster will define what an academic internship is and map key project outcomes that have emerged including the most recent peer to peer resource following a diagnosis of dementia.

Lessons learnt in developing an academic internship will be shared to enable other professions and organizations to develop a similar approach.  A summary will outline the outcomes of the internship programme thus far, which include and capture the voices of people living with dementia and how that has impacted on the current and future occupational therapy workforce.   

Reference: Alzheimer Scotland 2017 Connecting People, Connecting Support. Transforming the allied health professionals’ contribution to supporting people living with dementia in Scotland 2017-2020.

PO9.20. Promoting interdisciplinary and interprofessional training to enhance the quality of services and health care

YAO Ching Yi, HSU Ya-Chuan, LIU Chien-Liang

Taipei City Hospital, Taipei City, Taiwan, Province of China

In order to create dementia-friendly communities, our hospital had community-based workshops to educate people the awareness of healthy working environment and public sector, disability-friendly bus, and community empowerment. The workshops included face-to-face and online instructions. More than 30 people were expected to serve as the volunteers; in fact, 267 people completed the initial training. More than 200 people were expected to participate the educational activity in elementary or secondary schools in each community; in fact, up to 1597 people attended the activity. Lastly, with regards to empowering dementia-friendly environments, we plan to facilitate actions in exploring cases and referring resources to individual cases through three large promotional education activities per year.

PO9.21. How to improve people’s knowledge about dementia

YAO Ching Yi, HSU Ya-Chuan, LIU Chien-Liang

Taipei City Hospital, Taipei City, Taiwan, Province of China

With the purposes of creating dementia-friendly communities, promoting the affiliated education about dementia to the society, utilizing known dementia-friendly resources, providing the maps of the resource networks for communities in twelve districts, and setting up the website “maps of keeping memories,” our hospital conducted an educational training program. More than 3193 people initially were expected to be educated in the program. In fact, up to 3398 people had the training. We offered the curriculum of dementia recognition, built up an AI knowledge base for mental health care on the social media. By means of multiple promotion activities and the educational videos of dementia-friendly communities, we educated people to know more about dementia. In this way, they are more likely to accept dementia patients and pay more attention to the issue of dementia.

PO9.22. Developing a programme theory for dementia training in hospitals: Facilitators and barriers for implementing

AHMED Faraz1, MORBEY Hazel1, HARDING Andrew1, SWARBRICK Caroline1, KEADY John2, REILLY Siobhan1

1Lancaster University, Lancaster, United Kingdom, 2University of Manchester, Manchester, United Kingdom

People living with dementia constitute a main patient population in acute hospitals and improvement of care in this setting is a key priority within national and European dementia strategies. Dementia training packages are diverse and where these are evaluated, varying methods are used. Understanding the related processes and outcomes of a dementia training programme is critical to developing theory-based models for intervention and policies. Our study developed a logic model using the principles of programme theory to identify contextual factors, mechanisms, interaction, facilitators and barriers to dementia training in the hospital setting. A mixed-methods study, as part of the Neighbourhoods and Dementia Programme and involving people living with dementia as co-researchers, utilised three key approaches:

(1) Experiential review and consultation: Through workshops and one-to-one consultation we consulted and reflected with dementia trainers, researchers, academics, and clinicians involved in development, implementation and evaluation of dementia training in hospital settings, and people living with dementia and carers to identify mechanisms, interaction, facilitators and barriers. 

(2) Critical Interpretive Synthesis (qualitative, quantitative and mixed studies from international literature), to provide a systematic review of the current evidence base for dementia training in hospitals.

(3) Primary data collection: organisational hospital survey (n=90), staff survey (n=294), and six hospital case studies involving observation visits, focus groups and interviews, and co-research visits with people living with dementia.

We present our interactive logic model that serves as an implementation guide for planning, developing and evaluating educational dementia programmes in hospital settings. The model embeds various facilitators of and barriers to dementia training in hospitals for patients living with dementia and carers, hospital staff, and the organisation as a whole. We focus on three main facilitators: (1) Strong and supportive leadership, (2) Resources/Workload, and (3) Recognition/Acceptance of dementia training as a priority.

PO9.23. For the record: Documenting dementia training in acute hospitals across England and Wales

MORRIS Aimée, OFILI Samantha, HOOD Chloë, BUTLER Jessica

Royal College of Psychiatrists, London, United Kingdom

Alzheimer Europe’s comparison of dementia strategies highlighted the need to improve the knowledge, skills and training of professionals to deliver high quality care and support to people with dementia. In 2018, Round 4 of the National Audit of Dementia collected data from 195 hospitals and 14154 staff members about dementia training in England and Wales. A staff questionnaire and organisational checklist explored routine collection of information on the frequency, format and recording of training as well as staff feedback. The audit found that dementia awareness training is not being consistently recorded. Nearly half of all hospitals were unable to submit data on the number of staff who had received basic training. 46% of hospitals reported that dementia training was mandatory for all staff groups but only 56% of these hospitals were able to provide records relating to number of staff trained. In addition, 35% of hospitals did not have mandatory dementia training for any staffing group. Despite this most staff reported that they received some form of dementia training at their current hospital, but this was a common area suggested for improvement. “Ignorance and fear of dementia very often can lead to poor care for patients with dementia, if training was provided this would not be an issue” (RN band 5). This is particularly important given that people living with dementia admitted to hospital interact with a wide range of healthcare professionals and are not always able to communicate their needs and preferences. For hospitals to ensure that people living with dementia admitted to hospital receive the best care all staff, both in-hospital and external, should receive basic dementia training appropriate to their role. It is crucial that training information is recorded centrally and routinely updated to enable hospitals to monitor staff training requirements.  

PO9.24. Student nurses’ preferences for working with people with dementia

HEBDITCH Molly

Brighton and Sussex Medical School, Falmer, United Kingdom

Background: A current international issue is ensuring healthcare professionals are both competent and willing to work with older adults with complex needs. This includes dementia care; which is widely recognised as a priority. Yet research suggests that working with older people is unattractive to student nurses (Garbrah et al., 2017). However, factors influencing preferences for working with people with dementia are not well understood.

Aim: To explore nursing student career preferences for working with people with dementia.

Methods: This is a secondary analysis of data collected as part of the Time for Dementia study (Banerjee et al., 2017). A modified career ranking exercise was used (Stevens and Crouch, 1998) to assess changes in preferences over time and factors related to these preferences (n= 488). A content analysis of open-ended questions was conducted to identify factors influencing preferences (n= 110).

Results: Preferences for working with older adults and working with dementia decreased during training and was an unpopular career choice. At the univariate level, students’ preferences for working with people with dementia were positively associated with the experience of knowing someone with dementia, knowledge, attitudes and taking part in Time for Dementia (an educational programme). Only attitude scores were significantly associated with preferences after accounting for other variables.

Reasons given for a higher preference of working with people with dementia was enhanced skills and knowledge. In contrast, lack of knowledge and experience was cited as a reason for low preference. Negative factors also included communication difficulties with patients and the challenging nature of the work.

Discussion and conclusion: This paper adds to the literature by confirming that working with dementia is not a popular career for nursing students and outlines possible ways to promote working with people with dementia.

 

 
 

Last Updated: Thursday 07 November 2019

 

 
  • Acknowledgements

    The 29th AE Conference in The Hague received funding under an operating grant from the European Union’s Health Programme (2014-2020). Alzheimer Europe and Alzheimer Nederlands gratefully acknowledge the support of all conference sponsors.
  • European Union
  • Roche
 
 

Options