Service Evaluation of Learning Disability and Dementia Training for Care Staff

To ascertain care staff's knowledge of dementia relating to aetiology and/or pathology, symptoms and care/treatment; and explore their perceptions of the importance and adequacy of dementia education and training opportunities. Thirty-five care staff working in three secure dementia care facilities were recruited. Dementia knowledge was surveyed using the Staff Knowledge of Dementia Test (SKDT). Perceptions of dementia education and training were examined via semi-structured individual interviews. An average of 21 out of 33 SKDT questions (SD = 4.0) was correctly answered. Knowledge discrepancy was attributed to participants' cultural and ethnic origin and the length of residency in Australia of migrant care staff. Participants acknowledged the importance of dementia education and training but were critical of the content relevancy to direct care practices. There is a need to improve care staff knowledge of dementia, and dementia education and training should include direct practical competencies required for effective care delivery.

ObjectivesThe aim of this study was to establish the impact of dementia education and training on the knowledge, attitudes and confidence of health and social care staff. The study also...

To explore care staff knowledge about falls and confidence, motivation and opportunity to undertake fall prevention strategies, in residential aged care (RAC) along with preferences for fall prevention education. Falls account for the majority of adverse clinical events in RAC settings. Care staff in RAC settings are in a key position to influence residents' actions to prevent falls, provided they have the necessary knowledge and skills. A cross-sectional survey design with a purposive sample of 147 care staff at eight RAC facilities was undertaken in 2015. A custom-designed questionnaire examining knowledge, confidence, motivation and opportunity to undertake falls prevention strategies was used. Only 39 (26.5%) care staff were aware that the residents they cared for were at high risk of falls. Care staff knowledge of intrinsic falls risk factors was very limited, for example, only 18 (13.53%) observed for side effects of medication and just four (1.04%) were aware of continence issues. Conflicting duties also limited care staff time to undertake falls prevention strategies. Preferences for falls prevention education indicated face-to-face interactive discussions in the workplace (n=98, [66.7%]) with reminder posters displayed around the facility (n=80, [70.8%]). Residential aged care organisations need to engage with care staff to provide tailored falls education incorporating learning preferences and targeting knowledge gaps, to improve awareness of intrinsic risk factor impact and uptake of evidence-based prevention strategies. Despite care staff being highly motivated, they have limited opportunity to assist residents with fall prevention within their workload. RAC management and funding bodies must address opportunity for care staff to fulfil this crucial role to benefit resident safety. This study identified gaps in care staffs' knowledge and skills in undertaking falls prevention strategies in residential aged care settings. These findings will assist residential aged care organisations and health professional educators to design evidence-based falls prevention education tailored to their care staffs' needs and preferences to facilitate adoption.

BackgroundDespite approaches to provide effective dementia training in acute care settings, little is known about the barriers and enablers to implement and embed learning into practice. We were commissioned by Health Education England to develop and evaluate a new dementia training intervention ‘Dementia Education And Learning Through Simulation 2’ (DEALTS2), an innovative simulation toolkit to support delivery of dementia training in acute care across England. This study aimed to explore barriers and enablers experienced by trainers implementing DEALTS2 and extent to which it impacted on delivery of training and staff clinical practice.MethodsWe conducted twelve one-day DEALTS2 train-the-trainer (TTT) workshops across England in 2017 for National Health Service Trust staff employed in dementia training roles (n = 199 trainers); each receiving a simulation toolkit. Qualitative data were collected through telephone interviews 6–8 months after TTT workshops with 17 of the trainers. Open ended questions informed by the Kirkpatrick model enabled exploration of implementation barriers, enablers, and impact on practice.ResultsThematic analysis revealed six themes: four identified interrelated factors that influenced implementation of DEALTS2; and two outlined trainers perceived impact on training delivery and staff clinical practice, respectively: (i) flexible simulation and implementation approach (ii) management support and adequate resources (iii) time to deliver training effectively (iv) trainer personal confidence and motivation (v) trainers enriched dementia teaching practice (vi) staff perceived to have enhanced approach to dementia care. Trainers valued the DEALTS2 TTT workshops and adaptability of the simulation toolkit. Those supported by management with adequate resources and time to deliver effective dementia training, were likely to implement DEALTS2. Trainers described positive impacts on their teaching practice; and perceived staff had enhanced their approach to caring for people with dementia.ConclusionsTrainers explained individual and organisational barriers and enablers during implementation of DEALTS2. The flexible simulation and implementation approach were key to supporting adherence of DEALTS2. To ensure wider implementation of DEALTS2 nationally, Trusts need to allocate appropriate time to deliver effective dementia training. Future research should measure staff behaviour change, patient perspectives of the intervention, and whether and how DEALTS2 has improved health and care outcomes.

Impact of ‘DEALTS2’ education intervention on trainer dementia knowledge and confidence to utilise innovative training approaches: A national pre-test – post-test survey

Workforce Dementia Training Needs and Preferences for Residential Aged Care.

SummaryThe present paper describes the findings of a pilot study funded by the NHS Executive Primary and Community Care Research Initiative Small Projects Scheme that investigated the knowledge and attributions of dementia held by care staff who work with older adults with learning disability. Meetings took place with 21 members of care staff identified as keyworkers to older adults with learning disability living in residential houses provided by Solihull Healthcare NHS Trust, Solihull, UK. The results suggest that staff have knowledge of ageing at a similar level to that of college students. Forgetfulness was the sign that they would most expect to see if they thought someone was suffering from dementia. When a change in behaviour was attributed to dementia, it was most likely to be viewed as ‘stable, uncontrollable’ with staff feeling pessimistic about being able to change the behaviour.

Purpose– The purpose of this paper is to provide a commentary on “Why study the history of learning disability?” by Goodey.Design/methodology/approach– In his paper, Goodey makes the point that the term “learning disability” is not a fixed, stable concept, but one which has changed and evolved over time. This commentary explores the difference between care staff and professional understandings of people with learning disabilities including how these have changed in recent times.Findings– Care staff knowledge is likely to be based on direct experiences of particular people with learning disabilities whilst professional knowledge is likely to be based on theoretical concepts of general application. These differences in source of knowledge may interfere with desired collaboration between staff and professionals.Originality/value– This commentary suggests that differences in understandings should be recognised and the application of theory to practice is far from simple.

BackgroundThe health and social care workforce requires access to appropriate education and training to provide quality care for people with dementia. Success of a training programme depends on staff ability to put their learning into practice through behaviour change. This study aimed to investigate the barriers and facilitators to implementation of dementia education and training in health and social care services using the Theoretical Domains Framework (TDF) and COM-B model of behaviour change.MethodsA mixed-methods design. Participants were dementia training leads, training facilitators, managers and staff who had attended training who worked in UK care homes, acute hospitals, mental health services and primary care settings. Methods were an online audit of care and training providers, online survey of trained staff and individual/group interviews with organisational training leads, training facilitators, staff who had attended dementia training and managers. Data were analysed using descriptive statistics and thematic template analysis.ResultsBarriers and facilitators were analysed according the COM-B domains. “Capability” factors were not perceived as a significant barrier to training implementation. Factors which supported staff capability included the use of interactive face-to-face training, and training that was relevant to their role. Factors that increased staff “motivation” included skilled facilitation of training, trainees’ desire to learn and the provision of incentives (e.g. attendance during paid working hours, badges/certifications). “Opportunity” factors were most prevalent with lack of resources (time, financial, staffing and environmental) being the biggest perceived barrier to training implementation. The presence or not of external support from families and internal factors such as the organisational culture and its supportiveness of good dementia care and training implementation were also influential.ConclusionsA wide range of factors may present as barriers to or facilitators of dementia training implementation and behaviour change for staff. These should be considered by health and social care providers in the context of dementia training design and delivery in order to maximise potential for implementation.

Due to dementia-related communication difficulties, speech-language pathologists (SLPs) play a significant role in supporting individuals with dementia and their caregivers. Nevertheless, SLP practitioners may not have received adequate dementia training during their undergraduate programme and skills updating post-qualification. Investigating the knowledge, attitudes and training needs of SLP students and practitioners would provide evidence on the need of enhancing training in dementia care and management at both the undergraduate level and through continuous professional development programmes. To assess the levels of dementia knowledge, attitudes and training needs of SLP students and practitioners. A countrywide survey was conducted with undergraduate students reading for a BSc degree in communication therapy and SLPs currently in practice. Dementia knowledge and attitudes were assessed using the Alzheimer's Disease Knowledge Scale (ADKS) and the Dementia Attitude Scale (DAS). Training needs were measured using a three-point Likert scale from a list of topics related to dementia management and care. Quantitative methods were used to analyse the collected data. A total of 49 SLP students (94.2% response rate) and 113 practitioners (57.4% response rate) completed the survey. Although SLP practitioners scored significantly better than students on the ADKS and its constructs, both cohorts showed inadequate knowledge of dementia, in particular dementia risk factors. In general, both SLP students and practitioners showed positive attitudes towards individuals with dementia, even though significant differences were observed. With respect to training needs, SLP practitioners significantly scored less compared with students denoting that, in this cohort, there was the belief that less training in dementia was required. Although SLPs have an important role to play in the management and care of individuals with dementia, the findings of this study indicated a shortage of in-depth knowledge in this area of practice. This continues to highlight the need of enhancing dementia training programmes through undergraduate curriculum development and continuous professional programmes for skills updating. What this paper adds What is already known on the subject One of the symptoms of dementia is that affected individuals progressively lose the ability to communicate effectively. With an increase in the number of people with dementia due to global ageing growth, SLPs are more likely to come into contact with such individuals and their caregivers. At present, there is little research on the levels of dementia knowledge, attitudes and training needs among individuals pursuing their career in this profession. What this paper adds to existing knowledge This study highlights a dearth of in-depth knowledge among undergraduate students and practising SLPs in various aspects of dementia management and care and argues on the need of enhancing training in this field of study. What are the potential or actual clinical implications of this work? Improving SLPs' knowledge on dementia can enhance their professional role in several areas, including the provision of information on risk factors, disease progression and its effect on communication abilities, screening of cognitive communication difficulties and developing management plans aimed at maintaining communication abilities at the highest level.

The education and training needs of learning disability staff in relation to mental health issues

Dementia Care Among United States Dialysis Providers: A Mixed Methods Study Evaluating Clinician Comfort and Knowledge

What works in delivering dementia education or training to hospital staff? A critical synthesis of the evidence

Background It is important for social care staff to understand what a learning disability is so that they can identify people with learning disabilities and provide them with the support they need.Aim To explore whether there have been changes in the knowledge of social care staff about the diagnostic criteria for learning disability more than 20 years after the researchers first explored the topic.Method A sample of 264 social care staff were asked to describe what they understood by ‘learning disability’. Their responses were compared with the three diagnostic criteria of learning disability – that is, significant impairments in intellectual functioning, significant impairments in adaptive functioning and childhood onset.Results Impairments in intellectual functioning was the most commonly identified criterion and childhood onset the least commonly identified criterion. Only 5% of participants (n=13) identified all three criteria, while 57% (n=150) identified none or only one of the criteria.Conclusion While the results are an improvement on those found more than 20 years ago, they still indicate an ongoing need for improved understanding, among social care staff, of what a learning disability is, and learning disability nurses have a role to play in this.

The purpose of this study was the examination of nursing home care staff's knowledge, attitudes, and image of elderly sexuality and the determination of a possible relationship among them. Nurses and care workers from five nursing homes in Okinawa, Japan volunteered to participate the study. One hundred fifty-two care staff answered and returned the self-administered packet for a response rate of 74.5%, with 126 of the respondents completing the questions appropriately. The packet included questionnaires containing demographic characteristics, institutional factors, the Japanese version of Aging Sexuality Attitudes and Knowledge Scale (ASKASJ) and a Semantic Differential (SD) technique for assessment of respondents' image of elderly sexuality. A computer software package, the SPSS, statistically examined average scores of knowledge, attitudes, and image on elderly sexuality. Additionally, a multiple regression analysis examined variables related to the knowledge, attitudes, and image. Pearson's correlation coefficient was utilized for further assessment of the relationship among them. The study found that "experience of learning elderly sexuality " was significantly related to knowledge, attitudes, and image of elderly sexuality. In addition, there were significant positive correlations between knowledge and attitude scores (r=0.51), knowledge and image (r=0.48), and attitude and image (r=0.38). These findings indicate that education is a key to increasing care staff's knowledge, positive image and attitudes on elderly sexuality. However, only 31.7% of the respondents received education related to elderly sexuality, mostly from sources outside the school setting. We point out the importance of incorporating the topic of elderly sexuality in educational programs. Japanese gerontological nursing educators need to encourage formal inservice programs for care staff and develop school curriculums for nursing students on sexuality in the aged.