Paraprofessional Caregivers Research Articles

Do interventions to prevent or stop abuse and neglect among older adults work? A systematic review of reviews

ABSTRACT Abuse and neglect among older adults impact everyone and are recognized internationally as significant and growing public health issues. A systematic review of reviews was conducted to identify effective strategies and approaches for preventing abuse and neglect among older adults. Eligible reviews were systematic or meta-analyses; focused on the older population as reported in the publications; reviewed prevention interventions; included relevant violence and abuse outcomes; written in English; and published in a peer-reviewed journal between January 2000 and May 2020. Eleven unique reviews (12 publications) met the eligibility criteria, including one meta-analysis. Included reviews mainly focused on general abuse directed toward older adults; and educational interventions for professional and paraprofessional caregivers, multidisciplinary teams of health care and legal professionals, and families. Interventions were implemented in a variety of community and institutional settings and addressed primary, secondary, and tertiary prevention. The reviews indicated weak or insufficient evidence of effectiveness in preventing or reducing abuse, yet several promising practices were identified. Future research is needed to evaluate emerging and promising strategies and approaches to prevent abuse among older adults. Effective interventions are also needed to prevent or reduce abuse and neglect among older adults.

Caregiving for Persons with Dementia: Evidence-based resources for SLPs.

Speech–language pathologists (SLPs) have an important role in supporting the caregivers of persons with dementia from diagnosis through the end of life in 4 major areas: education, training to use effective cognitive communication strategies identified for clients with dementia, psychosocial/emotional support, and counseling. Speech–language pathologists may be involved in this process from the initial diagnosis when families need guidance to navigate the vast amounts of information on the Internet and elsewhere, until they need assistance in making end-of-life decisions. Speech–language pathologists must recognize that caregivers have needs, and differing needs, depending on the stage of dementia of the person to whom they are providing care. The research in caregiving interventions for family, professional, and paraprofessional caregivers provides an understanding of effective, evidence-based approaches, resources, and promising caregiver outcomes for the SLP working with individuals with dementia and their caregivers. It is important for SLPs to know that these interventions exist and to seek out appropriate services to which to refer the caregivers of their clients. Other person-centered interventions specifically developed for SLPs to implement with their clients with dementia and their family and professional caregivers are crucial for ensuring a quality life for clients and caregivers and for meeting the demands of a quality dementia care workforce.

VIPS Communication Skills Training for Paraprofessional Dementia Caregivers: An Intervention to Increase Person-Centered Dementia Care

A communication skills intervention was developed based on Dawn Brooker's four elements of person-centered dementia care: Valuing people, Individualized care, Personal perspectives, and Social environment (VIPS). The aim of this study was to test the feasibility of a series of workshops built around VIPS, intended to increase the person-centered communication, beliefs, and attitudes among paraprofessional dementia caregivers in a long-term care facility. The effect of the intervention on communication strategies, caregiver burnout, and other variables associated with the quality of caregiving was examined using a pre- and post-test design. Details of the intervention design and execution are discussed, as are findings regarding intervention outcomes. The intervention was determined to be highly feasible based on successful implementation, positive caregiver feedback, and promising exploratory analyses of outcome measures. Following the workshops there was a reduction in caregiver depersonalization of residents and an increase in both empathy and hope for those with dementia. In addition, caregivers reported using more concrete communication strategies known to be effective with those who suffer from dementia. Given this encouraging preliminary evidence, the VIPS communication skills intervention is suggested as a useful tool to improve the quality of dementia care provided by paraprofessional caregivers in long-term care facilities.

HIV/AIDS and Spirituality in a South African Township: A Qualitative Study

The study objectives were to investigate the themes characterizing spirituality among people with advanced AIDS in a South African township. In-depth interviews were conducted with a sample of 24 individuals. The participants included eight individuals living with advanced AIDS, twelve paraprofessional caregivers, and four family members. Data were analyzed according to the principles of grounded theory. A number of themes were identified, including positive and negative associations with God, positive and negative associations with the church, positive and negative associations with ancestral spirits, bewitchment, and existential reconciliation with HIV/AIDS. Implications for research and practice are discussed through the lens of social justice.

Correlates of knowledge and beliefs about depression among long‐term care staff

Despite the high prevalence of depression in long-term care (LTC), it often is unrecognized and inadequately treated. Thus, the goals of the present study were to evaluate LTC staff characteristics that are associated with knowledge and beliefs about depression. A cross sectional study of 371 LTC staff members completed a knowledge and beliefs about depression questionnaire, a short demographic questionnaire, a burden measure, and a questionnaire about attitudes associated with working with depressed residents. Relative to nurses, social workers, and activity staff, paraprofessional caregivers had a lower score on the depression measure and a higher score on the burden measure. Paraprofessional caregivers were more likely to view depression as a normal phenomenon, held less accurate beliefs about signs and symptoms of depression, and were less familiar with the effectiveness of specific treatments of depression. Educational interventions about depression should be specifically geared to meet the needs of paraprofessional caregivers who provide the majority of care to LTC residents, yet possess less knowledge about depression and its treatments.

An Interactive Multimedia Program to Train Professional Caregivers

An interactive multimedia computer training program on CD-ROM was compared with a videotaped lecture-based training program for professional caregivers of patients with dementia. Both programs promoted use of appropriate communication skills including speaking skills, reacting skills, redirection skills, and use of communication cards for redirection. Professional and paraprofessional caregivers (N = 88) were recruited as participants and randomly assigned to view one of the training programs. In a pretest-posttest design, participants rated caregiver responses in video vignettes of specific caregiving situations. At posttest, those who viewed the interactive program were significantly more likely to: (a) identify the correct responses, (b) intend to use correct strategies, and (c) have increased self-efficacy to use correct strategies, compared to participants who saw the videotaped lecture.

Childhood sexuality: a decade of study. Part II—dissemination and future directions

Objective: One goal in perpetration prevention has been to increase the awareness and competence of professionals and parents in understanding and responding to the sexual behavior of children in order to reduce the risk of children developing sexually abusive behavior. A decade of experience in disseminating information about children’s sexual development and behavior is reviewed in this paper. Method: Curricula developed at the Kempe Children’s Center, University of Colorado Health Science Center, were used to provide training to professionals and paraprofessional caregivers. The information has evolved into a variety of models for different purposes in different settings. Results: Children engage in a wide range of sexual behaviors, some of which adults observe or are told about by other children. Adults can be trained to evaluate what is developmentally expected or problematic, and to respond consistently on the basis of objective definitions and universal goals, rather than relying on the personal beliefs and values of individuals. Conclusion: Because children’s sexual behaviors may pose a risk to themselves or others, there is a legitimate need for adults to respond to what they see and hear in order to validate or correct sexual learning in childhood. Adults are often not well informed about childhood sexuality and are eager to access objective information to inform their decision making in the care of children.

Caring for individuals with severe and persistent mental illness: the contributions and challenges of residential case aides.

The challenge of helping individuals with mental illness live more independently and purposefully within the community warrants a collaborative system of caregiving between professional and paraprofessional caregivers. Residential community support aides are a crucial component of this system of care. However, current investigation of their daily work experiences is lacking. In this study, a team of researchers, employing an interpretive phenomenological approach, analyzed data from in-depth, individual interviews with 5 residential community support aides and identified a constitutive pattern: the teacher as learner. Examination of this pattern and its associated themes will identify those clinical practices that should be preserved and those that are in need of change.

In stroke, save precious time: Scoop the Patient

The success in treating ischemia of the heart and the importance of rapid treatment is stimulating much research in the application of a similar approach to the treatment of stroke. A proposed protocol, “Scoop the Patient,” is offered to bring about time-saving and, therefore, more successful results in stroke care. The protocol would be useful as a guide to action for the public as well as professional and paraprofessional caregivers to stroke patients. The importance of triage for ambulatory as well as ambulance patients is stressed. Very early arrival of the patient at the emergency room provides the doctor with the optimal time in which to initiate IV treatment with anticoagulants or thrombolytics, potentially resulting in reperfusion.

Personality characteristics of family day care mothers

This study was conducted to provide some data on the personality characteristics of licensed family day care mothers (childhood caregivers), women who might be an appropriate resource in the development of community day care programs. Forty-two women were jointly interviewed by two researchers and their responsibility was rated on an interview rating scale. The women's level of ego development and capacity for interpersonal relations were assessed using Loevinger's Ego Development Scale. The Child-Adult Situational Index was used to elicit and score the women's responses to potentially anxiety-laden, expectable child-adult interaction. Their responses indicated that they were capable of organizing and regulating their thoughts, affects, and impulses, and of appropriately responding in child-adult interactions. There were limitations in their capacity to perceive and respond flexibly to certain affect-laden situations and, in this context, evidenced features of personality rigidity. It was suggested that with training which includes both affective and didactic components, these women might improve their capacities as paraprofessional caregivers for children.