Psycho-educational Approaches in Long-term Care Homes: Direct Care Workers and Managers’ Perspectives

Abstract

The majority of the Direct Care Workers (DCWs) in long-term care (LTC) facilities have no formal qualifications or training on dementia and experience high levels of stress and burnout as a result of dementia-related symptoms and behaviours. Psycho- educational (PE) approaches can be effective in supporting DCWs, yet, they are underdeveloped within the context of formal care. Therefore, this study aimed to explore the expectations and concerns of care home managers (service managers and top- level managers) and DCWs about PE interventions. A qualitative, cross-sectional study was conducted. Individual interviews with 8 managers (75% female; mean age 45.5 ± 10.26) and 8 focus-group interviews with a total of 58 DCWs (female; mean age of 44.72 ± 9.06) of 4 LTC facilities were performed. All interviews were recorded, transcribed and analysed through thematic analysis by 2 independent judges. Managers’ main expectations were related to the opportunity to improve DCWs’: understanding and attitudes towards dementia; ability to interact with residents; motivation and job satisfaction. DCWs expected to: acquire knowledge and practical skills to deal with dementia; develop their knowledge about resident's biography; enhance their ability to deal with job strain; share experiences and improve group cohesion. Lack of time and support to translate learning into practice and sustain potential benefits over time were anticipated as the main barriers by both elements. There were coincident expectations and concerns among both managers and DCWs. Findings underscore the importance of targeting both DCWs-level and manager-levels perspectives to the planning of a sustainable PE intervention for DCWs.