Can We Help Care Providers Communicate More Effectively With Persons Having Dementia Living in Long-Term Care Homes?

McGilton, Katherine S.; Rochon, Elizabeth; Sidani, Souraya; Shaw, Alexander C.; Ben‐David, Boaz M.; Saragosa, Marianne; Boscart, Véronique; Wilson, Rozanne; Galimidi-Epstein, Karmit K.; Pichora‐Fuller, M. Kathleen

doi:10.1177/1533317516680899

Cited by 49 publications

(81 citation statements)

References 35 publications

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“…They further stated that the training would impact on care delivery as they were now more aware of the unique needs of each individual resident. The final study in the intervention category focused on communication workshops; however, no significant difference was found in levels of confidence or competence following training …”

Section: Resultsmentioning

confidence: 99%

“…The final study in the intervention category focused on communication workshops; however, no significant difference was found in levels of confidence or competence following training. 19 Non-intervention studiessense of confidence The first of the two non-intervention studies focusing on confidence was a needs assessment addressing knowledge deficits in caring for people with BPSD. 24 Data were not statistically analyzed, but it was found that only one-fifth of staff felt confident in managing BPSD with non-pharmacological approaches.…”

Section: Study Characteristicsmentioning

confidence: 99%

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What influences self‐perceived competence and confidence in dementia care home staff? A systematic review

2019

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Background Dementia care staff working in long‐term care settings are often exposed to a variety of complex situations that can be emotionally challenging, and a lack of adequate support and limited training opportunities may contribute to high levels of staff turnover in this area. Good‐quality training may be beneficial for improving the quality of care provided, and in improving staff confidence and morale. This systematic review aimed to establish how dementia care home staff perceived their own competence and confidence in relation to the care they deliver, whether there are any specific interventions that improve these feelings, and whether feeling more competent and confident impacts on care delivery. Method A search of the literature focusing on staff perceptions of competence and confidence identified 14 873 studies. Following the removal of duplicates and papers that did not meet the inclusion criteria, 19 studies were included in the review and subject to quality assessment. Results Studies varied in terms of quality and design, and were categorised as either intervention or non‐intervention studies. Four studies found a significant increase in feelings of competence and confidence following intervention, although many studies did not statistically analyze their data. The most successful interventions seemed to be those that involved practical support alongside education, and non‐intervention studies highlighted the importance of specific dementia and palliative care training with regard to feelings of competence and confidence. Conclusion Teaching alone may not be an adequate method of training dementia care staff, and the most successful interventions were those where practical support was also provided. Most studies suggested that improvements in competence and confidence also had benefits for care delivery and staff wellbeing. More research needs to be done using validated outcome measures and with competence and confidence as the primary aim.

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Section: Resultsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

What influences self‐perceived competence and confidence in dementia care home staff? A systematic review

2019

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“… [ 55 ] McGilton et al Canada Hearing and vision screening tools for long-term care residents with dementia: protocol for a scoping review 2016 Journal article—protocol for pilot study The pilot study looking at effective screening tool for residents with dementia and communication impairment: hearing and vision. [ 44 ] McGilton et al Canada Can we help care providers communicate more effectively with persons having dementia living in long-term care homes? 2017 Journal article—mixed methods study Determine the effects of a communication intervention on residents’ quality of life (QOL) and care, as well as care providers’ perceived knowledge, mood, and burden.…”

Section: Resultsmentioning

confidence: 99%

Giving permission to care for people with dementia in residential homes: learning from a realist synthesis of hearing-related communication

Crosbie

Ferguson

Wong

et al. 2019

BMC Med

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Background Managing hearing communication for residents living with hearing loss and dementia in long-term care settings is challenging. This paper explores how care can be effective in optimising hearing communication for residents living with dementia. We argue that the underlying notion of permission or authorisation allows care staff to do what they know will be effective in providing person-centred care that enhances hearing communication. The paper also indicates that this notion of permission can usefully be applied to other areas of care home practice. Methods To address hearing-related communication in care homes, we conducted a realist synthesis (RS). As a theory-driven approach to reviewing literature, it also uses expert opinion to understand complex health situations. Using RS, we developed a theory surrounding the management of hearing-related communication in care homes. Applying formal processes to the literature search and data extraction, the analysis uncovered relevant mechanisms and contexts to help confirm, refute or refine our understanding of how hearing communication could be improved. Results Forty-three papers were selected for the realist synthesis. The documents were analysed to construct five context-mechanism-outcome configurations (CMOCs). The CMOCs represent possible care interventions to optimise hearing-related communication in care homes for person living with dementia and hearing loss (PLWDHL). They include leadership promoting positive regard and empathy through person-centred care, communication training for staff, ‘knowing the person’ and relationship building for responsive awareness of residents’ hearing needs, maintaining and monitoring hearing communication through care planning, and managing noise in the care home environment. Conclusions Leadership that provides appropriate training and resources is likely to enhance knowledge and skills, leading to staff feeling able and equipped to respond to the hearing-related communication needs of PLWDHL. Collaboration with local hearing services is likely to raise awareness of hearing loss among care home staff. Importantly, care staff require a sense of permission from leadership, to work with knowledge and autonomy in the interest of residents living with dementia and hearing loss. Electronic supplementary material The online version of this article (10.1186/s12916-019-1286-9) contains supplementary material, which is available to authorized users.

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“…Such games may also be a good way to assess cognitive status of PwD in a nonthreatening way [ 119 - 123 ]. Future work should also consider cultural and language aspects that may affect performance and engagement (for a discussion, see [ 124 ]), as well as aspects of the testers themselves [ 125 ].…”

Section: Discussionmentioning

confidence: 99%

Designing Serious Computer Games for People With Moderate and Advanced Dementia: Interdisciplinary Theory-Driven Pilot Study

et al. 2017

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BackgroundThe field of serious games for people with dementia (PwD) is mostly driven by game-design principals typically applied to games created by and for younger individuals. Little has been done developing serious games to help PwD maintain cognition and to support functionality.ObjectivesWe aimed to create a theory-based serious game for PwD, with input from a multi-disciplinary team familiar with aging, dementia, and gaming theory, as well as direct input from end users (the iterative process). Targeting enhanced self-efficacy in daily activities, the goal was to generate a game that is acceptable, accessible and engaging for PwD.MethodsThe theory-driven game development was based on the following learning theories: learning in context, errorless learning, building on capacities, and acknowledging biological changes—all with the aim to boost self-efficacy. The iterative participatory process was used for game screen development with input of 34 PwD and 14 healthy community dwelling older adults, aged over 65 years. Development of game screens was informed by the bio-psychological aging related disabilities (ie, motor, visual, and perception) as well as remaining neuropsychological capacities (ie, implicit memory) of PwD. At the conclusion of the iterative development process, a prototype game with 39 screens was used for a pilot study with 24 PwD and 14 healthy community dwelling older adults. The game was played twice weekly for 10 weeks.ResultsQuantitative analysis showed that the average speed of successful screen completion was significantly longer for PwD compared with healthy older adults. Both PwD and controls showed an equivalent linear increase in the speed for task completion with practice by the third session (P<.02). Most important, the rate of improved processing speed with practice was not statistically different between PwD and controls. This may imply that some form of learning occurred for PwD at a nonsignificantly different rate than for controls. Qualitative results indicate that PwD found the game engaging and fun. Healthy older adults found the game too easy. Increase in self-reported self-efficacy was documented with PwD only.ConclusionsOur study demonstrated that PwD’s speed improved with practice at the same rate as healthy older adults. This implies that when tasks are designed to match PwD’s abilities, learning ensues. In addition, this pilot study of a serious game, designed for PwD, was accessible, acceptable, and enjoyable for end users. Games designed based on learning theories and input of end users and a multi-disciplinary team familiar with dementia and aging may have the potential of maintaining capacity and improving functionality of PwD. A larger longer study is needed to confirm our findings and evaluate the use of these games in assessing cognitive status and functionality.

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Can We Help Care Providers Communicate More Effectively With Persons Having Dementia Living in Long-Term Care Homes?

Cited by 49 publications

References 35 publications

What influences self‐perceived competence and confidence in dementia care home staff? A systematic review

What influences self‐perceived competence and confidence in dementia care home staff? A systematic review

Giving permission to care for people with dementia in residential homes: learning from a realist synthesis of hearing-related communication

Designing Serious Computer Games for People With Moderate and Advanced Dementia: Interdisciplinary Theory-Driven Pilot Study

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