New Workforce Development in Dementia Care: Screening for “Caring”: Preliminary Data

Abstract

The United States has a significant shortage of trained geriatricians and of nurses, social workers, and paraprofessionals educated to care for elderly adults. As the aging population continues to grow, providing high-quality care will require new models that better address the many needs of aging individuals and their caregivers, using cost-effective strategies. Responding to this need, the Indiana University Center for Aging Research implementation scientists developed, tested, and are now scaling up a successful collaborative care coordination model for older adults with dementia, depression, or both: the Aging Brain Care program. This model now includes a newly created frontline care provider position, the Care Coordinator Assistant. The Care Coordinator Assistant works with individuals and caregivers to monitor biopsychosocial needs and deliver evidence-based and individualized care protocols, with close supervision from the registered nurse Care Coordinator. Recognizing that current hiring practices for frontline providers were insufficient to screen for critical abilities expected in this new position, including the ability to express "caring" and empathy, a new screening process was created building on the Multiple Mini Interview (MMI) format. The Care Coordinator Assistant MMI comprised six stations, each created to simulate challenging scenarios that will be frequently encountered and to assess important candidate abilities. Overall, the six-station MMI, with two to three items per station, provided factorially valid measures and good predictive ability. The process did not appear to be overly burdensome for candidates, and interviewers noted that it was helpful in discriminating between candidates.

Workforce development to provide person-centered care

“…The Training Core for the CMMI award, charged with recruiting, hiring, and training the new CCAs, realized that current hiring practices for older adult direct care workers were insufficient to meet the requirements of person-centered care (Lindquist et al, 2012) and chose to develop a new, rigorous, and innovative screening process to ensure that CCAs possessed the core interpersonal and analytical qualities required to provide excellent person-centered care (Cottingham et al, 2014). For a detailed description of how CCAs were hired utilizing an innovative interviewing and recruitment process and then participated in a six-station Multiple Mini Interview process, developed to simulate challenging scenarios likely to be encountered in real home visits, see Cottingham et al (2014).…”

“…For a detailed description of how CCAs were hired utilizing an innovative interviewing and recruitment process and then participated in a six-station Multiple Mini Interview process, developed to simulate challenging scenarios likely to be encountered in real home visits, see Cottingham et al (2014).…”

“…CCAs work in teams led by an RN and social worker care coordinators (CCs) who both supervise and support the CCAs in every aspect of care delivery. CCAs are responsible for assisting CCs in scheduling and performing patient and caregiver visits, administering the biopsychosocial needs assessment, delivering care protocols, monitoring medication adherence, and managing data entry (Cottingham et al, 2014). To carry out these responsibilities CCAs are provided with a mobile office, enhanced medical record-ABC (eMR-ABC) software, information on community resources and team member support.…”

“…To carry out these responsibilities CCAs are provided with a mobile office, enhanced medical record-ABC (eMR-ABC) software, information on community resources and team member support. Details of the intervention and its tools, including care protocols have been previously published (Alder et al, 2015; Boustani et al, 2011; Callahan et al, 2011, 2014; Cottingham et al, 2014; Frame, LaMantia, Bynagari, Dexter, & Boustani, 2013; French et al, 2014; Guerriero Austrom et al, 2004, 2005, 2006; LaMantia et al, 2015; Monahan et al, 2012); therefore, we provide only a brief description of this here. The use of the ‘mobile office’ in the CCAs day-to-day work allows them to meet patients at their homes, their primary care doctor’s office, or any other safe location of their choosing.…”

Enhancing the prospects for palliative care at the end of life: A statewide educational demonstration project to improve advance care planning

“…R. Counsell et al, 2007;Department of Health, 2008;Steven R Counsell, Callahan, Tu, Stump, & Arling, 2009;Glaser & Strauss, 2009;Baughman et al, 2012;Working Group on Health Outcomes for Older Persons with Multiple Chronic Conditions, 2012;Cottingham AH, 2014;Kirolos et al, 2014).…”