Training in Dementia Care - Research Proposal Example

Training in Dementia Care Total Number of Words: 4,049 Aims/Purpose: To identify and discuss specific topics that should be included in the proposed online training program. Research Method: To identify and discuss specific topics that should be included in the proposed online training program, several peer-reviewed journals were gathered in this essay. Research Findings: The proposed online training program include topics related to the importance of early diagnosis, the need to identify all possible signs and symptoms of early-and late-stage dementia, clinical ways on how to effectively diganose dementia, the different stages in dementia, the need to use pharmacological intervention or medication, the need to use effective communication strategies when dealing with people with dementia and their family members, the principles and importance of person-centred care, the need to to treat people with dementia with respect and dignity, and the need to encourage people with dementia and their family members to join social support groups that were designed exclusively for people with dementia. Conclusion: The proposed online training program is effective in terms of increasing the training participants’ knowledge on dementia and ways on how to properly extend care for people with dementia without sacrificing their human rights and dignity. Basically, the proposed online training program is good in the sense that it can reach out various training participants despite the differences in location and time. 1. Introduction It is possible to improve the quality care given to people with dementia from early diagnosis up to the end-of-life stage by constantly subjecting all informal carers and family members of people with Dementia to participate in an online training program designed for effective diagnosis and dementia care. Through the provision of necessary training programs, the Home Care Manager can play a significant role in terms of increasing the knowledge and skills of professional healthcare staff and informal carers when managing people with dementia. Recently, dementia has been considered as one of the top most priorities based on the World Health Organization’s (WHO’s) Mental Health Gap Action Programme (WHO, 2012). Basically, a WebCT will be used as a platform for the proposed online training program (Innes, Mackay and McCabe, 2006). As such, this essay will focus on identifying specific topics that should be included in the proposed online training program. The process of conducting a training program can increase the confidence level of healthcare professionals when providing care for people with dementia (Lathren et al., 2013). In line with this, the proposed online training program includes the following: (1) the need to discuss the importance of early diagnosis; (2) the need to identify all possible signs and symptoms of early-and late-stage dementia; (3) clinical ways on how to effectively diganose dementia; (4) the different stages in dementia; (5) the need to use pharmacological intervention or medication; (6) the need to use effective communication strategies when dealing with people with dementia and their family members, (7) principles and importance of person-centred care; (8) the need to to treat people with dementia with respect and dignity; and (9) the need to encourage people with dementia and their family members to join social support groups that were designed exclusively for people with dementia (Fossey et al., 2014; Department of Health, Social Services and Public Safety, 2011, p. 32; Northern Ireland Executive, 2011; Standridge, 2004). Regardless of whether or not the person with dementia is suffering from severe memory loss, it is important to respect their privacy and confidentiality at all times (Kelly and Innes, 2013). (See Table I – Proposed Training Sessions on Dementia Care below) Table I – Proposed Training Sessions on Dementia Care Sessions Topic 1 Importance of early diagnosis and signs and symptoms of early- and late-stage dementia 2 Clinical ways on how to effectively diagnose dementia and the different stages of dementia 3 Pharmacological intervention and the need to use effective communication strategies when dealing with people with dementia and their family members 4 Principles and importance of person-centred care and the need to treat people with dementia with respect and dignity 5 Encourage people with dementia and their family members to join social support groups Each session will be tackled each week in order to give all training participants the chance to read, reflect, and learn more about each of the proposed training topics presented on Table 1. The online training program presented in this essay was designed base on my profession as a community home care manager. After discussing the rationale for selecting the topic covered in the proposed online training program, the drawbacks and opportunities of online learning and the significance of cross-national learning and policy transfer will be tackled in details followed by applying some aspects of adult education and learning theories when designing the online training session and the rationale behind the training materials used in the actual online training program. Prior to conclusion, suggestions on how I could encourage, motivate and support the online training participants to transfer the contents of the online training program into practice will be tackled in details. 1.1 Aims and Objectives of the Training Program The main objective of this study is to help create public awareness about the necessary healthcare intervention for people with dementia. As such, this essay aims to design an online training program which can be use in educating all informal carers and family members of people with Dementia (i.e. how to effectively detect early signs of dementia and subsequently care for and address the needs of people with dementia). 1.2 Rationale for Selecting the Topic Covered in the Online Training Session There are several good reasons why Community Home Care Manager should include the need to educate people about the importance of early diagnosis and the need to identify all possible signs and symptoms of early-stage dementia. First of all, the provision of training programs can help both healthcare professionals and informal carers to learn more about the proper management of dementia. In the process of educating more people about the probable signs and symptoms of dementia, the Home Care Manager could somehow help more people know whether or not a person has dementia. Early intervention can help delay the onset of dementia for another five (5) years (Department of Health, Social Services and Public Safety, 2011). For instance, the use of pharmacological intervention or medication can help slow down the progress of cognitive decline (Standridge, 2004). By not knowing whether or not a person is suffering from early-stage dementia, there is a higher risks wherein the person will not be able to receive necessary pharmacological intervention or medication that can help slow down the progress of cognitive decline (Bradford et al., 2009; Standridge, 2004). Likewise, the person with early-stage dementia will not have the opportunity to receive necessary healthcare and social intervention. As a result, the person with early-stage dementia will not be able to effectively reverse the main origin of memory loss (Bradford et al., 2009). Other benefits of early diagnosis include having the opportunity to provide the person with dementia, including their loved ones, to have more time to seek for support groups as they prepare themselves mentally, psychologically, and financially for necessary future care or social service intervention (Bradford et al., 2009; Iliffe, Manthorpea and Eden, 2003). By learning more about the immediate and long-term effects of dementia, the family members of people with dementia can gradually learn to become more patient and understanding towards the person’s overall well-being. In fact, this particular pro-active approach to early diagnosis and healthcare intervention matters a lot in terms of improving the overall well-being of people with dementia and their loved ones (Moise, Schwarzinger and Um, 2004). As one of its most important strategies in improving the quality of life of people with dementia, everyone should consider the need to create public awareness about the importance of early diagnosis (Department of Health, Social Services and Public Safety, 2011; Northern Ireland Executive, 2011). The Home Care Manager should also identify and discuss different clinical techniques used to effectively diganose dementia. Including this particular topic in the training program can help inform the audiences about their option on how they can determine whether or not anyone in their family circle is suffering from dementia. To help informal carers and family members gain better understanding about the health and mental condition of people with dementia, it is necessary to discuss the different stages of dementia. People with dementia are known for having mild to severe cognitive decline or memory impairment (Mendez and Cummings, 2003, p. 6). Often times, having someone in the family circle having mild to severe dementia can be very tiring, frustrating or cause sadness on the part of the carers (Skaalvik, Normann and Henriksen, 2010). For this reason, it is necessary to remind the audiences about the need to to treat people with dementia with respect and dignity. Likewise, it is necessary to tackle issues related to the need to use effective communication strategies when dealing with people with dementia and their family members. To ensure that all people with dementia can have a better quality of life, the last part of the training session should talk about the need to encourage people with dementia and their family members to join social support groups that were designed exclusively for people with dementia (Department of Health, Social Services and Public Safety, 2011, p. 32; Northern Ireland Executive, 2011; Standridge, 2004). 2. Drawbacks and Opportunities of Online Learning The demand for online dementia education is expected to increase as the global number of people with dementia increases each year (Innes, Mackay and McCabe, 2006). As explained by Innes, Mackay and McCabe (2006), one of the possible reasons why online learning has become more effective as compared to traditional teachings is because of the fact that the market prices of computers, software, and Internet access has become more affordable over the past few years. For this reason, the Internet has become one of the best and most economical tool when it comes to eduacting people about the issue on dementia. Based on my personal experience studying online distance learning, there are quite a lot of advantages using the Internet and WebCT. First of all, the use of online learning tool is known its flexibility when it comes to meeting a wide-range of learning styles and techniques (Carroll-Barefield and Murdoch, 2003; Mobbs, 2003). To be able to maximize the benefits of online teaching and learning method, several studies support the idea that the online training program should not be limited to online teaching and learning process but also offer the audiences the chance to participate in a face-to-face group introductory session and at the same time provide them with opportunity to ask complex questions using the telephone (Lu, Yu and Liu, 2002; Ribbens, 1998). Likewise, it is necessary for the online training website to offer added features such as the use of chat rooms, discussion boards, and free access to other related videos, online books and peer-reviewed journals (Innes, Mackay and McCabe, 2006). Aside from being able to offer more flexibility in teaching and learning process, the use of online training option can create more opportunity for wider access amongst the target audiences (Innes, Mackay and McCabe, 2006). Using WebCT in the proposed training program, the Community Home Care Manager can create a collaborative and interactive teaching and learning environment (Ke and Kwak, 2013; Kennedy and Duffy, 2004; Lu et al., 2002, p. 3) for all healthcare professionals and informal carers of people with dementia. Using chat rooms or discussion boards, the proposed WebCT can provide all healthcare professionals and informal carers of people with dementia the opportunity to participate in real-time or non-real time online discussion (Kaiden, 2002, p. 2) about the importance of early diagnosis, the common signs and symptoms of early-and late-stage dementia, ways on how to effectively diganose dementia, the different stages in dementia, and effective pharmacological intervention among many others (Fossey et al., 2014; Department of Health, Social Services and Public Safety, 2011, p. 32; Northern Ireland Executive, 2011; Standridge, 2004). Despite the benefits of using online tools in training programs, there are also some drawbacks when it comes to the use of online learning method. For instance, Debande (2004) argued that online courses can only become more effective when there is a good support coming from the target audiences and the availability of good quality course content. It means that one of the best strategies to ensure that the proposed online training program could work effectively in terms of meeting its main goal and objective is to carefully plan the entire process starting from the design of the training program contents down to the different learning styles of the target audiences (Innes, Mackay and McCabe, 2006; Sutton, 2004). Furthermore, several studies have noted that the huge cost associated with the need to create an official online training website is one of the main disadvantages behind the proposed online training program (Kruse, 2004; Curran, 2001). 3. Significance of Cross-National Learning and Policy Transfer in the Design of Training Program The health and social policies related to dementia can take place in different levels such as “international, national, regional, local, and individual” (Banerjee et al., 2010, p. 250). Whether internationally or nationally, most of the policies related to dementia were mostly designed in order to improve the care quality given to people with dementia (Russell et al., 2013; NAO, 2007; Department of Health, 2005). As such, Schicktanz et al. (2014) revealed that it is common for most public policies on dementia to give more importance to early diagnosis of the said mental health illness. Due to the presence of gap in diagnosis, a lot of diagnosis occurs when a person is already experiencing severe or chronic dementia (Russell et al., 2013). All these explain why a lot of people with dementia do not have the opportunity to improve their quality of life. Therefore, a large part of the training program should focus on ways to effectively diagnose early signs of dementia. It is given that each country, whether developed or underdeveloped, has its own healthcare policies on dementia. For instance, the Netherlands has implemented a policy for general practitioners when it comes to caring for people with dementia before and after the actual diagnosis (Alzheimer Europe, 2009a). As such, the GP policy strictly requires all general practitioners in Netherlands to acknowledge the signs and symptoms of dementia and either perform the diagnosis on his own or refer the person suspected of having dementia to a specialist (Alzheimer Europe, 2009a). Aside from focusing on signs of memory impairment, behavioural impairment, or cognitive impairment; general practitioners in Netherlands are required to discuss with the carers on how they can effective provide necessary care to the patient (Alzheimer Europe, 2009a). On the other hand, a significant part of Greece’s national policy on dementia focuses on “research and education” (Alzheimer Europe, 2015). In UK, policy statements as provided in the “Our NHS, Our Future”, the “NHS’s Next Stage Review”, the “End of Life Care Strategy”, the “National Dementia Strategy”, or the guidelines set by the National Institute for Health and Clinical Excellence (NICE) when it comes to assessing a person’s memory function can also be used when determining the best ways to care for people with dementia (Tsaroucha et al., 2011; Department of Health, 2009). The study of Tsaroucha et al. (2011) presented a compilation of competency framekwork in UK which can be applied when caring for people with dementia. Therefore, in the process of conducting cross-national research, it is possible to strengthen each country’s existing national policy on dementia by carefully reviewing the national policies of other more developed countries such as the United Kingdom (Hendriks et al., 2008; Kumpers et al., 2006). Likewise, it is possible to improve the health and social care policies of each country by reviewing the existing international dementia policies (Nakanishi, 2014). Often times, the process of conducting a cross-national research study can be considered as one of the best ways to increase our cross-national learning or knowledge with regards to the nature and probable causes of dementia. For instance, Larson et al. (1998) conducted a cross-national study which aims to evaluate clinical diagnoses of dementia and its subtypes in Japan (i.e. Tokyo and Hiroshima) and the United States (i.e. Seattle and Honolulu). Based on DSM-III-R criteria, Larson et al. (1998) found out dementia subtypes such as the vascular dementia and Alzheimer’s disease scored the highest in all four (4) sites (i.e. Seattle, Honolulu, Tokyo, and Hiroshima). In another study, Ganguli et al. (2000) conducted U.S. and India cross-national study on dementia which aims to examine the significance of APOE*E4 allele of apolipoprotein E gene and the risks of developing Alzheimer’s disease. Based on the research findings, Ganguli et al. (2000) found out that the frequency of APOE*E4 was signficantly higher in Monongahela Valley as compared to Ballabgarh and that the probability of developing Alzheimer’s disease amongst people between 70 to 79 years old is 0.7% in India and 3.1% in U.S. Amonst people more than 80 years of age, the probability of developing Alzheimer’s disease was 4% in India as compared to 15.7% in U.S. (Ganguli et al., 2000). A cross-national research study can also be conducted to learn more about the differences in the care given to people with dementia. For instance, Prince (2004) purposely examined the care arrangements of people with dementia in South-East Asian countries, Latin America, the Caribbean, China, India, and Nigeria. As such, Prince (2004) found out that most of the caregivers in Nigeria (95%), China and South-East Asian countries (59%) were female and that most of the female caregivers were either spouse (40%) or daughter-in-laws (11%). Racial factors can also affect the quality of care given to people with dementia. As compared to the white Americans, Pyke and Bengston (1996) revealed that most African-Americans are the ones who usually provide care based on their traditional values and “cultural justifications” when providing a collectivist type of care to the patients. As a result of the cross-cultural study that was conducted by Knight et al. (2002), the authors revealed that cultural values such as ‘familism’ varies in different group of caregivers depending on their individual exposure and practice of ‘individualism’1 (i.e. African American, Korean, Korean American, Japanese American, and Latino caregivers). A cross-national research study can also be conducted to explore ways on how to assess the quality of life of people with dementia. For instance, Banerjee et al. (2010) conducted a cross-national population-level study as a way to assess the quality of life of people with dementia and their family carers, as a result of policies and services they receive from healthcare professionals. In the case of Prince et al. (2012), the authors conducted a 10/66 dementia research group population-based survey study in order to determine the correlation between the people who provide care for people with dementia in both low- and middle-income countries. 4. Application of Adult Education and Learning Theories when Designing the Training Program and Rationale behind the Training Materials Used in the Actual Training Session When designing effective training program for dementia care, it is necessary to consider the application of different adult education and learning theories (i.e. Kolb’s learning cycle theory, learning through reflection, activists or learning by doing, theorists or logical thinking, and pragmatists or practical learning approach, problem-based learning, etc.) (Merriam and Bierema, 2014; Innes, 2001). By examining each existing learning theories, the Community Home Care Manager can gain better understanding on how the adult learners could easily absorb useful information from the list of proposed training context. When designing a training program for adult learners, the Community Home Care Manager considered the fact that each person has their own preferred learning style and that each of the training participant has their own unique approach to learning (Innes, 2001). Based on Kolb’s learning cycle of experiential learning, a person could learn from their own individual experiences by reflecting on their experience, thinking and developing new strategies for future action, and experimenting with their newly developed strategies (Innes, 2001). Likewise, it is possible for the adult learners to learn from different stories or real-life experiences when taking care of people with dementia (Clark and Rossiter, 2008, p. 65). For this reason, a large part of the training course materials will make use of true-to-life stories about caring for people with dementia and how the carers can possibly cope with stress associated with their caring tasks. To encourage the training participants to reflect on each of the training topics, it is necessary to ask questions related to each of the training topics presented on Table 1. For instance, in relation to session 1 topic, questions such as “Why do you think it is important to conduct early diagnosis and regularly observe signs and symptoms of early- and late-stage dementia?” will be included at the end of each training session. By asking such question, the training participants will be encouraged to think on their own about why they need to detect the early signs of dementia or simply make use of the open forum discussion board or chat room to discuss this issue with the rest of the online training participants. The training participants can be classified as deep2, surface3, or strategic4 learners (Entwistle, 1997, p. 19). Through online live discussion, training participants can have the opportunity to learn from other people’s idea or personal experiences when managing the needs of people with dementia. Throughout the online training sessions, it is the surface learners who can learn more from the personal experiences of deep learners. Based on the visual, auditory, and kinaesthetic (VAK) learning styles, the adult learners can learn from their visual senses, hearing senses, or through physical movement (Gilakjani, 2012). With this in mind, the proposed online training session will be created using colourful visual aids, graphs, charts, pictures, and readable font size. To support the learning experience of people who learn more out of their hearing senses, some online videos related to dementia care and management will be uploaded in the proposed online training website. Since there are some adult learners who could learn more out of doing, all of the online training participants will be invited to a group meeting at least once a week in order to provide them the opportunity to learn more out of role playing and interactive discussion or brainstorming about the proposed weekly training topics (Spencer, Robinson and Curtin, n.d.). (See Appendix I – Learning Materials for the Proposed Online Training Program on page 21; Appendix II – List of Related Videos on page 30) 5. Suggestions on How I can Encourage, Motivate and Support the Training Participants to Transfer the Contents of the Training Program into Practice There is a huge difference between knowing and applying knowledge into practice. At the end of the training session, the Community Home Care Manager can easily test the knowledge of each training participants by giving them a simple “yes” or “no” type of questions and case studies related to the training topic of the week. However, increasing one’s knowledge on dementia care and management does not necessarily guarantee that the training participants would apply what they have learned into practice. To ensure that the training participants would be able to transfer the content of the training program into practice, I intend to closely monitor the way healthcare professionals and informal carers are communicating with people with dementia. Through the use of observation method, it is possible on the part of the Community Home Care Manager to determine whether or not the training participants are religiously applying the context of the training program into practice. Assuming that one of the training participants has failed to apply what he or she has learned from the training program, the Community Home Care Manager should immediately call their attention and remind them what they have learned from the training program. In the process of questioning the training participants about the training course context, the training participants can be reminded about the proper way of dealing and caring for people with dementia. Other ways to effectively encourage and motivate the training participants is to Acknowledge, respect, and give them praise for being able to apply the training course context into practice (Schulz et al., 2007). Often times, the use of intrinsic motivational strategy such as verbally giving praise or the use of public acknowledgement method can be very effective in terms of improving the training participants’ attitude and behaviour when caring for people with dementia. 6. Conclusion The proposed online training program is effective in terms of increasing the training participants’ knowledge on dementia and ways on how to properly extend care for people with dementia without sacrificing their human rights and dignity. Likewise, the proposed online training program is good in the sense that it can reach out various training participants despite the differences in location and time. However, the provision of online training session alone could limit the Community Home Care Manager from providing more learning experience by doing. For this reason, it is necessary to combine the use of online training platform with a weekly face-to-face meeting. By doing so, each of the training participants can have the opportunity to participate in group brainstorming and role playing activities. References Alzheimer Europe. (2009, May). Dutch: Guideline for Integrated Dementia Care [excerpt}. [Online] Available at: http://www.alzheimer-europe.org/Policy-in-Practice2/National-Dementia-Plans/Netherlands#fragment-1 [Accessed 7 April 2015]. Alzheimer Europe. (2015). Greece: National Dementia Plans. 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