DementiaTrainers Buz Loveday & Associates – working to improve dementia care Effective...

DementiaTrainers www.dementiatrainers.co.uk Buz Loveday & Associates – working to improve dementia care

Effective Resources for Training Staff in

Person-Centred Dementia Care

Buz Loveday DementiaTrainers

Dave Bell Care Homes Support Team

Background

• NICE/SCIE Guidelines

• Dementia UK report

• Dementia Strategy

• Everybody’s Business

• National Minimum Standards

Who is training for?

• 70% of Care Workers have no qualifications – there’s a case for all staff to be trained including Drs and Nurses (Banerjee)

• All staff working with older people should have access to training in dementia care consistent with roles/responsibilities (NICE)

• All staff working in generic, non-specialist areas to better meet the requirements of older people with mental health problems across the board (Everybody’s Business)

What should Training Achieve?

• Improve quality of care received by people who have dementia in all areas

• Development of skills and attitudes for staff to better meet needs of clients

• Establish career pathways for staff

• Maintain workforce development/staff retention

What makes training effective?

• Part of an organisational strategy

• Reinforced through leadership

• Relevant to needs -what staff need to learn and unlearn

there’s nothing that can be done

Hopeless case

• Inspirational

The learning stairway

“Don’t know youdon’t know”

(unconscious ignorance)

“Know youdon’t know”

“Don’t know you know”

“Know youknow”

(conscious ignorance)

(unconscious understanding)

(conscious understanding)

• Inspirational

• Methods address different learning styles and abilities

4 basic learning styles (Honey & Mumford)

Activists

Theorists

ReflectorsPragmatists

• Inspirational

• Relevant, practical and applicable

• Inspirational

• Relevant, practical and applicable• Opportunity for discussion and feedback

How do we measure the effectiveness of training?

• Assess learning of participants ‘Knowing is not enough; we must apply. Willing is not

enough; we must do’ (Goethe)

• Measure outcomes for people with dementia• Measure outcomes for staff and the

organisation• Observation and anecdote• Inspection reports

Research reviews

• Kuske B et al (2007) - Nursing home staff training in dementia care: a systematic review of evaluated programs. International Psychogeriatrics, 19, 818 – 841.

• McCabe M et al (2007) – Effectiveness of staff training programmes for behavioural problems among older people with dementia. Aging and Mental Health, 11, 505-519.

• NICE/SCIE - Guidelines for Dementia (9.4 Models of Training pp 274-280). British Psychological Society/RCP, London.

Reported Research (2)• Teri L et al (2005) – STAR: a dementia specific training

programme for staff in assisted living residences. The Gerontologist, 45, 686-693.

• Burgio L et al (2002) – Teaching and maintaining behaviour management skills in the nursing home, The Gerontologist, 42, 487-496.

• McCarthy B & Dalrymple M (2003) – Supervisory feedback sustains change after training in dementia care. Paper from Alzheimer’s Australia National Conference.

• Davison T et al (2007) – Controlled trial of dementia training with a peer support group for aged care staff. International Journal of Geriatric Psychiatry, 22, 868-873

• Bryan K et al (2002) – Working with older people with communication difficulties – an evaluation of care worker training. Aging and mental health, 6, 248-254.

Resources

• Knowledge and experience of trainer!• Videos• Group exercises – eg case studies• Experiential exercises

HOW MUCH LEARNING IS RETAINED?

3 months later

Told Told and shown

Told, shown and experienced

3 weeks later

3 months later

Told Told and shown

3 weeks later

70% 72% 85%

3 months later 10% 65% 82%

Told Told and shown

3 weeks later

70% 72% 85%

‘Tell me and I’ll forget; show me and I may remember; involve me and I’ll understand’ (Chinese proverb)

“Try to understand how hard it is for us…it’s just that you can’t see the missing bits that we are having to cope without”

Christine Bryden, 2005 (9 years after her diagnosis of dementia)

How would you feel?...You’re away from home in an unfamiliar place. A complete stranger comes into your room, speaks to you in a language you can’t understand and

starts trying to pull you out of bed.

How would you feel?...You’re away from home in an unfamiliar place. A complete stranger comes into your room, speaks to you in a language you can’t understand and

starts trying to pull you out of bed.

Photo from ‘Openings’ – John Killick and Carl Cordonnier

Slide courtesy of Alzheimer’s Society

Resources

• Knowledge and experience of trainer!• Videos• Group exercises – eg case studies• Experiential exercises

Resources

• Knowledge and experience of trainer!• Videos• Group exercises – eg case studies• Experiential exercises• Role plays

PAT COOPER

Pat Cooper has been a service user for 2 years. Pat has dementia and arthritis.

Pat’s partner died a number of years ago. Pat has one son who usually visits every week. Recently he has been ill and has not been visiting.

Pat was the deputy head of a large school. Sometimes Pat thinks this is the school.

Before the onset of arthritis, Pat was very fit and active.

Pat does not have any friendships with other service users; some people consider Pat to be a nuisance.

Resources

• Knowledge and experience of trainer!• Videos• Group exercises – eg case studies• Experiential exercises• Role plays

Resources

• Knowledge and experience of trainer!• Videos• Group exercises – eg case studies• Experiential exercises• Role plays• Discussions and brainstorms

Resources

• Knowledge and experience of trainer!• Videos• Group exercises – eg case studies• Experiential exercises• Role plays• Discussions and brainstorms• Games and quizzes

Resources

• Knowledge and experience of trainer!• Videos• Group exercises – eg case studies• Experiential exercises• Role plays• Discussions and brainstorms• Games and quizzes• Real stories

• What kinds of dementia care training are happening currently?

• What resources do you use?

• What works best????

• What evidence do you have of the effectiveness of your training?

DementiaTrainers Buz Loveday & Associates – working to improve dementia care Effective...

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