Improving advance care planning for care home residents with dementia: Evaluation of simulation training for care home workers

Katwa, A; Jenner, Chris; MacDonald, Karen V.; Barnett, Nina

doi:10.1177/1471301218788137

Cited by 8 publications

(4 citation statements)

References 5 publications

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“…15 Research indicates that training and education about ACP improved confidence and reduced uncertainty in decision making. 16,17 There are several resources available to support ACP for individuals with dementia and their caregivers. The Alzheimer's Association Dementia Care Practice Recommendations offer updated guidance for dementia care based on a current review of evidence and expert opinion.…”

Section: Resultsmentioning

confidence: 99%

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Challenges of Agitation in Dementia: A Plea for Early Discussion

Richler

Shimizu²,

Huang³

et al. 2023

Harv Rev Psychiatry

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Behavioral and psychological symptoms of dementia (BPSD) occur frequently among people with dementia and are known precipitants for placement in care facilities. Despite the social, financial, and psychological impact on dementia care, education and discussions on BPSD have not been routinely included in advance care planning (ACP). As a result, families can face great challenges in making complex medical decisions when their loved ones are admitted to the geriatric psychiatric inpatient unit with refractory BPSD. We present the case of an 83-year-old gentleman with BPSD to illustrate universal struggles in dementia care experienced by many families, which could have been alleviated by education and discussions around BPSD earlier in the patient’s dementia course. A literature search did not yield any articles that mention discussions of BPSD in ACP. The lack of literature referencing BPSD in ACP supports our clinical experiences with the case and highlights the need for improvement in current dementia care. We propose a guideline for providers to facilitate conversations around BPSD as an integral part of ACP, including discussions of four key points related to the progressive nature of dementia, the commonality of BPSD, the lack of FDA-approved treatment for BPSD, and the difficulty in balancing agitation and sedation to allow safe placement. We firmly believe it is important to start discussion on BPSD as part of ACP as early as possible. Early education and discussion will help to facilitate meaningful care decisions as patients and families navigate the challenges associated with this progressive disease.

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Section: Resultsmentioning

confidence: 99%

“…Healthcare providers describe needing a knowledge of dementia, resources and confidence to engage in such discussions 15 . Research indicates that training and education about ACP improved confidence and reduced uncertainty in decision making 16,17 …”

Section: Resultsmentioning

confidence: 99%

Challenges of Agitation in Dementia: A Plea for Early Discussion

Richler

Shimizu²,

Huang³

et al. 2023

Harv Rev Psychiatry

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“…Using real case scenario, Katwa et al (2020) [ 61 ] evaluated a simulation training for care home workers. This one-day training was well-received by participants, showing benefits of shared learning and a better understanding of multi-disciplinary working with other HPs.…”

Section: Resultsmentioning

confidence: 99%

Advance Care Planning in Neurodegenerative Disorders: A Scoping Review

Giordano

Panfilis

Perin

et al. 2022

IJERPH

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Advance care planning (ACP) is increasingly acknowledged as a key step to enable patients to define their goals/preferences for future medical care, together with their carers and health professionals. We aimed to map the evidence on ACP in neurodegenerative disorders. We conducted a scoping review by searching PubMed (inception-December 28, 2020) in addition to trial, review, and dissertation registers. From 9367 records, we included 53 studies, mostly conducted in Europe (45%) and US-Canada (41%), within the last five years. Twenty-six percent of studies were qualitative, followed by observational (21%), reviews (19%), randomized controlled trials (RCTs, 19%), quasi-experimental (11%), and mixed-methods (4%). Two-thirds of studies addressed dementia, followed by amyotrophic lateral sclerosis (13%), and brain tumors (9%). The RCT interventions (all in dementia) consisted of educational programs, facilitated discussions, or videos for patients and/or carers. In conclusion, more research is needed to investigate barriers and facilitators of ACP uptake, as well as to develop/test interventions in almost all the neurodegenerative disorders. A common set of outcome measures targeting each discrete ACP behavior, and validated across the different diseases and cultures is also needed.

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“…Several studies have demonstrated the value to using a defined communication model within the framework of simulation training. 38–40 Simulation training is commonly used in undergraduate end-of-life care education for nurses and other disciplines 41 , 42 as it is considered more effective than classroom teaching alone for professional training in addressing complex areas of care and emotionally charged clinical scenarios. 41 , 43 , 44 Simulation training is an educational process that has long been in use in medical student training through the use of Objective Structured Clinical Examinations (OSCEs); simulated scenarios using actors and assessment of the practice of a trainee by qualified doctors.…”

Section: Practice In Rolementioning

confidence: 99%

A training needs analysis of admiral nurses to facilitate advance care planning in dementia

et al. 2019

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Education of health and social care professionals is essential in preparation to confidently and effectively support families affected by dementia to undertake advance care planning. This article describes a training needs analysis of Admiral Nurses, dementia specialists, in facilitating advance care planning for future care. Methods: A questionnaire survey was completed by Admiral Nurses attending end-of-life care masterclasses in 2017 and 2018. Both quantitative (years registered as a nurse, years as an Admiral Nurse and subjective level of confidence in completing advance care plannings) and qualitative data (interventions perceived to increase confidence) were collected. Findings: There were 75 completed responses (two incomplete returns). There was no correlation between levels of confidence and years registered as a nurse. However, there was a small positive correlation between confidence and number of years as an Admiral Nurse ( r = 0.23; p < 0.05). Themes identified qualitatively to enhance practice were advanced communication skills, supervised practice, resources to frame conversations and a guide and template for advance care planning. Conclusion: Although Admiral Nurses are specialists in dementia, several educational initiatives could be employed to better enable them to support advance care planning for families affected by dementia. This training needs analysis is contributed towards developing an educational intervention for Admiral Nurses to improve advance care planning support.

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Improving advance care planning for care home residents with dementia: Evaluation of simulation training for care home workers

Cited by 8 publications

References 5 publications

Challenges of Agitation in Dementia: A Plea for Early Discussion

Challenges of Agitation in Dementia: A Plea for Early Discussion

Advance Care Planning in Neurodegenerative Disorders: A Scoping Review

A training needs analysis of admiral nurses to facilitate advance care planning in dementia

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