Abstract
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.
Highlights
Dementia is one of the leading causes of disability in people aged > 65 years
In this article we focus on the champions’ use and satisfaction with the training program resources and recommended techniques, their perceptions of the enablers and barriers to person-centred approaches in practice and whether the person-centred care approach helped to reduce resident behaviours, and their reflections on how the person-centred care approach adopted had an influence on the culture of dementia care
As one champion found: “Helping the family to get involved in discussing their relative’s issues and needs, and what might be causing their distress, this will help the staff to feel more connected and more willing to work with the family to sort out these issues.” (AHC01). This substudy of the Halting Antipsychotic use in Long-Term care (HALT) trial provided data on the champion’s experiences of how person-centred training program helped them to provide the groundwork for a change in dementia care, their observations of the impact it had on resident behaviour, and their perceptions of its influence on dementia care culture in relation to the underlying mechanisms of the care context, management systems, staffing arrangements, and resident issues
Summary
Dementia is one of the leading causes of disability in people aged > 65 years. There is no approved treatment available to prevent progression or cure dementia. It is classified in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders [1] as a major neurocognitive disorder, encompassing a range of degenerative conditions characterised by decline in cognition, impairment in function, and frequently changes in the person’s behaviour [2]. Certain behavioural responses may change (e.g., aggression declines and apathy increases). Some of the psychological responses in people with dementia include depression, psychosis, aggression, and wandering from home [3]. Diminishing capacity and self-care ability, coupled with increasing psychological responses/behaviours, make it difficult for families to provide the level of care the person requires [2]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
