Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-20T06:57:28.112Z Has data issue: false hasContentIssue false
  • English
  • Français

An evaluation of the CARES® Dementia Basics Program among caregivers

Published online by Cambridge University Press:  03 October 2016

Michelle L. Pleasant ,
Victor Molinari ,
John V. Hobday ,
Sam Fazio ,
Nancy Cullen  and
Kathryn Hyer
Michelle L. Pleasant*
Affiliation:
Florida Policy Exchange Center on Aging/School of Aging Studies, University of South Florida, Tampa, Florida, USA
Victor Molinari
Affiliation:
Florida Policy Exchange Center on Aging/School of Aging Studies, University of South Florida, Tampa, Florida, USA
John V. Hobday
Affiliation:
Health Care Interactive, Minnesota, USA
Sam Fazio
Affiliation:
National Office of the Alzheimer's Association, Illinois, USA
Nancy Cullen
Affiliation:
National Office of the Alzheimer's Association, Illinois, USA
Kathryn Hyer
Affiliation:
Florida Policy Exchange Center on Aging/School of Aging Studies, University of South Florida, Tampa, Florida, USA
*
Correspondence should be addressed to: Michelle L. Pleasant, M.A., Florida Policy Exchange Center on Aging/School of Aging Studies, University of South Florida, Tampa, FL 33612, USA. Phone: 813-974-2414. Email: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

In 2014, the state of Oregon established Oregon Care Partners to provide high quality, free training to all dementia caregivers. This study evaluated participants’ changes in knowledge, sense of competency in dementia caregiving, and ability to identify person-centered caregiving techniques after completing CARES® Dementia Basics online program, one of the educational resources available through this initiative.

Methods:

A convenience sample of informal and formal caregivers (N = 51) provided data at three points in time; pre-test, post-test, and a follow-up test after an additional 30-day period to determine sustained changes in knowledge, sense of competency, and person-centered care.

Results:

From pre-test to post-test, modest improvements were detected in sense of competence in performing dementia care (ps < 0.01) and dementia-based knowledge, F(2, 150) = 7.71, p < 0.001, a multivariate effect size of w2 = 0.09. Even though improvements in sense of competency were not universal, three out of five individual items demonstrated positive growth from pre-test to post-test as well as four out of the five items from pre-test to follow-up test. Importantly, gains observed in dementia-based knowledge from pre-test to post-test were largely maintained at the 30-day follow-up. No significant changes were found in the correct identification of person-centered techniques after the training F(5, 150) = 1.63, p = 0.19.

Conclusions:

Future research should investigate how best to maintain educational interventions within the caregiving environment and to assess subsequent skill change.

Keywords

dementiaeducationtrainingcompetency
Type
Research Article
Information
International Psychogeriatrics , Volume 29 , Issue 1 , January 2017 , pp. 45 - 56
Copyright
Copyright © International Psychogeriatric Association 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Algase, D. L. et al. (1996). Need-drive dementia-compromised behavior: an alternative view of disruptive behavior. American Journal of Alzheimer's Disease and Other Dementias, 11, 10–19.CrossRefGoogle Scholar
Alzheimer's Association (2014). Alzheimer's association report 2014 Alzheimer's disease facts and figures. Alzheimer's & Dementia, 10, e47–e92. doi:10.1016/j.jalz.2014.02.001.Google Scholar
Assistant Secretary for Planning and Evaluation (ASPE) (2014). Informal Caregiving for Older Americans: An Analysis of the 2011 National Health and Aging Trends Study. Washington, DC: US Department of Health and Human Services. Available at: https://aspe.hhs.gov/report/informal-caregiving-older-americans-analysis-2011-national-health-and-aging-trends-study; last accessed 14 July 2016.Google Scholar
Blom, M. M., Zarit, S. H., Groot Zwaaftink, R. B., Cuijpers, P. and Pot, A. M. (2015). Effectiveness of an internet intervention for family caregivers of people with dementia: results of a randomized controlled trial. PLOS One, 10. doi:10.1371/journal.pone.0116622.Google Scholar
Bonner, A. (2013). Improving Dementia Care and Reducing Unnecessary use of Antipsychotic Medications in Nursing Homes. Baltimore, MD: Centers for Medicare & Medicaid Services. Available at: https://www.cms.gov/outreach-and-education/outreach/npc/downloads/2013-01-31-dementia-care-presentation.pdf; last accessed 25 July 2016.Google Scholar
Bonner, A. et al. (2015). Rationales that providers and family members cited for the use of antipsychotic medications in nursing home residents with dementia. Journal of the American Geriatrics Society, 63, 302–308. doi:10.1111/jps.13230.Google Scholar
Brodaty, H. and Arasaratnam, C. (2012). Meta-analysis of nonpharmacological interventions for neuropsychiatric symptoms of dementia. American Journal of Psychiatry, 169, 946–953. doi:10.1176/appi.ajp.2012.11101529.Google Scholar
Brodaty, H. and Donkin, M. (2009). Family caregivers for people with dementia. Dialogues in Clinical Neuroscience, 11, 271–228.Google Scholar
Centers for Disease Control (CDC). (2013). The Healthy Brain Initiative: The Public Health Road Map for State and National Partnership, 2013–2018. Chicago, IL: Alzheimer's Association.Google Scholar
Coogle, C. L., Head, C. A. and Parham, I. A. (2006). The long-term care workforce crisis: dementia-care training influences on job satisfaction and career commitment. Educational Gerontology, 32, 611–312. doi:10.1080/0360120500494147.Google Scholar
Cristancho-Lacroix, V., Wrobel, J., Cantegreil-Kallen, I., Dub, T., Rouquette, A. and Rigaud, A. S. (2015). A web-based psychoeducational program for informal caregivers of patients with Alzheimer's disease: a pilot randomized controlled trial. Journal of Medical Internet Research, 17. doi:10.2196/jmir.3717.Google Scholar
Ducharme, F., Dube, V., Levesque, L., Saulnier, D. and Giroux, F. (2011). An online stress management training program as a supportive nursing intervention for family caregivers of an elderly person. Canadian Journal of Nursing Informatics, 6, 1–19.Google Scholar
Gitlin, L. N. et al. (2003). Effect of multicomponent interventions on caregiver burden and depression: the reach multisite initiative at 6-month follow-up. Psychology and Aging, 18, 361–374. doi:10.1037//0882-7974.18.3.361.Google Scholar
Government Accountability Office (GAO) (2015). Antipsychotic Drug Use: HHS has Initiatives to Reduce use Among Older Adults in Nursing Homes, but Should Expand Efforts to Other Settings (GAO-15-211). Washington, DC: US Government Accountability Office. Available at: http://www.gao.gov/assets/670/668221.pdf; last accessed 5 March 2016.Google Scholar
Griffiths, P. C., Whitney, M. K., Kovaleva, M. and Hepburn, K. W. (2016). Development and implementation of Tele-Savvy for dementia caregivers: a department of veterans affairs clinical demonstration project. Gerontologist, 56, 145–154. doi:10.1093/geront/gnv123.Google Scholar
Harahan, M. F. and Stone, R. I. (2007). The long-term care workforce: can the crisis be fixed?. Retrieved from Report prepared for the National Commission for Quality Long-Term Care, Washington, DC. Available at: http://www.leadingage.org/uploadedFiles/Content/About/Center_for_Applied_Research/Center_for_Applied_Research_Initiatives/LTC_Workforce_Commission_Report.pdf; last accessed 15 June 2016.Google Scholar
Hattink, B. et al. (2015). Web-based STAR e-learning course increases empathy and understanding in dementia caregivers: results from a randomized controlled trial in the Netherlands and the United Kingdom. Journal of Medical Internet Research, 17. doi:10.2196/jmir.4025.Google Scholar
Health Resources and Services Administration (HRSA) (2004). Nursing Aides, Home Health Aides, and Related Health Care Occupations: National and Local Workforce Shortages and Associated Data Needs. Washington, DC: US Department of Health and Human Services.Google Scholar
Hobday, J. V., Savik, K., Smith, S. and Gaugler, J. E. (2010a). Feasibility of Internet training for care staff of residents with dementia: the CARES program. Journal of Gerontological Nursing, 36, 13–21. doi:10.3928/00989134-20100302-01.Google Scholar
Hobday, J. V., Savik, M. S. and Gaugler, J. E. (2010b). An internet-based multimedia education prototype to enhance late-stage dementia care: formative research results. Geriatric Nursing, 31, 402–411. doi:10.1016/j/gerinurse.2010.06.011.Google Scholar
Hoffman, D. (2014). Alzheimer's disease legislation and policy–now and in the future. Health Affairs, 33, 451–465. doi:10.1377/hlthaff.2013.1223.Google Scholar
Institute of Medicine (IOM) (2008). Retooling for an Aging America: Building the Health Care Workforce. Washington, DC: National Academic Press.Google Scholar
Irvine, A. B., Beaty, J. A., Seeley, J. R. and Bourgeois, M. (2012a). Use of a dementia training designed for nurse aids to train other staff. Journal of Applied Gerontology, 32, 936–951. doi:10.1177/0733464812446021.Google Scholar
Irvine, A. B., Billow, M., Bourgeois, M. and Seeley, J. R. (2012b). Mental illness training for long term care staff. Journal of the American Medical Directors Association, 13, 81.e87–81.e13. doi:10.1016/j.jamda.2011.01.015.Google Scholar
Irvine, A. B., Billow, M. B., Gates, D. M., Fitzwater, E. L., Seeley, J. R. and Bourgeois, M. (2012). An internet training to reduce assaults in long-term care. Geriatric Nursing, 33, 28–40. doi:10.1016/j.gerinurse.2011.10.004.Google Scholar
Irvine, A. B., Billow, M. B., McMahon, E., Eberhage, M. G., Seeley, J. R. and Bourgeois, M. (2013). Mental illness training on the Internet for nurse aides: a replication study. Journal of Psychiatric and Mental Health Nursing, 20, 902–912. doi:10.1111/jpm.12035.CrossRefGoogle ScholarPubMed
Irvine, A. B., Bourgeois, M., Billow, M. and Seeley, J. R. (2007). Internet training for nurse aides to prevent resident aggression. Journal of the American Medical Directors Association, 8, 519–526.Google Scholar
Kajiyama, B. et al. (2013). Exploring the effectiveness of an internet-based program for reducing caregiver distress using the iCare stress management e-training program. Aging & Mental Health, 17, 544–554. doi:10.1080/13607863.2013.775641.Google Scholar
Kales, H. C., Gitlin, L. N. and Lyketsos, C. G. (2014). Management of neuropsychiatric symptoms of dementia in clinical settings: recommendations from a multidisciplinary expert panel. Journal of the American Geriatrics Society, 62, 762–769. doi:10.1111/jgs.12730.Google Scholar
Kamble, P., Chen, H., Sherer, J. and Aparasu, R. R. (2008). Antipsychotic drug use among elderly nursing home residents in the United States. The American Journal of Geriatric Pharmacotherapy, 6, 187–197. doi:10.1016/j.amjopharm.2008.10.002.Google Scholar
Katz, R. E. and Frank, R. G. (2011). A vision for the future: new care delivery models can play a vital role in building tomorrow's eldercare workforce. Generations-Journal of the American Society on Aging, 34, 82–88.Google Scholar
Koren, M. J. (2010). Person-centered care for nursing home residents: the culture change movement. Health Affairs, 29, 312–317. doi:10.1377/hlthaff.2009.0966.CrossRefGoogle ScholarPubMed
LaMascus, A. M., Bernard, M. A., Barry, P., Salerno, J. and Wesss, J. (2005). Bridging the workforce gap for our aging society: how to increase and improve knowledge and training. Journal of the American Geriatrics Society, 53, 343–347.Google Scholar
Lawton, M. P. and Nahemow, L. (1973). Ecology and the aging process. In Eisdorfer, C. and Lawton, M. P. (eds.), The Psychology of Adult Development and Aging (pp. 619–674). Washington, DC: American Psychological Association.Google Scholar
Lopoprabhu, S. and Molinari, V. (in press). Supporting the caregiver in dementia. In Calvano, K. and Burke, R. (eds.), The Sandwich Generation: Caring for Oneself and Others at Home and Work. UK: Edward Elger Publishers.Google Scholar
Lyketsos, C. G. et al. (2006). Position statement of the American association for geriatric psychiatry regarding principles of care for patients with dementia resulting from Alzheimer disease. American Journal of Geriatric Psychiatry, 14, 561–573.Google Scholar
Molinari, V. (2006). Caregiver burden. In Loboprabhu, S., Molinari, V. and Lomax, J. (eds.), Supporting the Caregiver in Dementia: A Guide for Health Care Providers (pp. 63–81). Washington DC: Johns Hopkins Press.Google Scholar
NAPA (2012). National Plan to Address Alzheimer's Disease. Washington, DC: Office of the Assistant Secretary for Planning and Evaluation. Available at: http://aspe.hhs.gov/daltcp/napa/natlplan.shtml; last accessed 15 June 2016.Google Scholar
Pinquart, M. and Sorensen, S. (2007). Correlates of physical health of informal caregivers: a meta-anaylsis. Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 62B, 126–137.Google Scholar
Prince, M., Prina, M. and Guerchet, M. (2013). World Alzheimer Report 2013: An Analysis of Long-Term Care for Dementia. London, Alzheimer's Disease International (ADI). Available at: https://www.alz.co.uk/research/WorldAlzheimerReport2013ExecutiveSummary.pdf; last accessed 1 August 2016.Google Scholar
Prince, M., Wimo, A., Guerchet, M., Ali, G. C., Wu, Y. T. and Prina, M. (2015). World Alzheimer report 2015: The Global Impact of Dementia. London, Alzheimer's Disease International (ADI). Available at: https://www.alz.co.uk/sites/default/files/pdfs/world-alzheimer-report-2015-executive-summary-english.pdf; last accessed 1 August 2016.Google Scholar
Rosen, J., Mulsant, B. H., Kastango, K. B., Mazumdar, S. and Fox, D. (2002). Mental health training for nursing home staff using computer-based interactive video: a 6-month randomized trial. Journal of the American Medical Directors Association, 3, 291–296. doi:10.1016/S1525-8610(05)70543-0.Google Scholar
Roth, D. L., Freedman, M. and Haley, W. E. (2015). Informal caregiving and its impact on health: a reappraisal from population-based studies. The Gerontologist, 55, 309–319. doi:10.1093/geront/gnu177.CrossRefGoogle Scholar
Schepers, A. K., Orrell, M., Shanahan, N. and Spector, A. (2012). Sense of competence in dementia care staff (SCIDS) scale: development, reliability, and validity. International Psychogeriatrics, 24, 1153–1162. doi:10.1017/S104161021100247x.Google Scholar
Selbaek, G., Engedal, K. and Bergh, S. (2013). The prevalence and course of neuropsychiatric symptoms in nursing home patients with dementia: a systematic review. Journal of the American Medical Directors Association, 14, 161–169. doi:10.1016/j.jamda.2012.09.027.Google Scholar
Sengupta, M., Harris-Kojetin, L. D. and Ejaz, F. K. (2010). A national overview of the training received by certified nursing assistants working in U.S. nursing homes. Gerontology and Geriatrics Education, 31, 201–219. doi:10.80/02701960.2010.503122.Google Scholar
Sloane, P. D. et al. (2004). Effect of person-centered showering and the towel bath on bathing-associated aggression, agitation, and discomfort in nursing home residents with dementia: a randomized, controlled trial. Journal of the American Geriatrics Society, 52, 1795–1804.CrossRefGoogle ScholarPubMed
SPADO Task Force (2012). State Plan for Alzheimer's Disease and Related Dementias in Oregon. Oregon, Oregon Department of Health and Human Services. Available at: http://www.alz.org/oregon/documents/spado_report.pdf; last accessed 6 July 2016.Google Scholar
Squillace, M. R., Remsburg, R. E., Harris-Kojetin, L. D., Bercovitz, A., Rosenoff, E. and Han, B. (2009). The national nursing assistant survey: improving the evidence base for policy initiative to strengthen the certified nursing assistant workforce. The Gerontologist, 49, 185–197. doi:10.1093/geront/gnp024.Google Scholar
Stevenson, D. G. et al. (2010). Antipsychotic and benzodiazepine use among nursing home residents: findings from the 2004 national nursing home survey. American Journal of Geriatric Psychiatry, 18, 1078–1092.Google Scholar
Stone, R. I. (2007). The role of training and education in solving the direct care workforce crisis. Gerontology and Geriatrics Education, 28, 5–16. doi:10.1300/J021v28n02_02.Google Scholar
Stone, R. I. and Bryant, R. A. (2012). The impact of health care reform on the workforce caring for older adults. Aging & Social Policy, 24, 188–205. doi:10.1080/08959420.2012.659144.Google Scholar
Stone, R. I. and Wiener, J. M. (2001). Who Will Care for Us? Addressing the Long-Term Care Workforce Crisis. Washington, DC: The Urban Institute. Available at: http://www.urban.org/sites/default/files/alfresco/publication-pdfs/310304-Who-Will-Care-For-Us-Addressing-the-Long-Term-Care-Workforce-Crisis.PDF; last accessed 20 June 2016.Google Scholar
Tritz, K., Laughman, M. and Bonner, A. (2014). Report on the CMS National Partnership to Improve Dementia Care in Nursing Homes: Q4 2011- Q1 2014. Baltimore, MD: US Department of Health and Human Services.Google Scholar
van der Roest, H. G., Meiland, F. J., Jonker, C. and Droes, R. M. (2010). User evaluation of the DEMentia-specific digital interactive social chart (DEM-DISC). A pilot study among informal carers on its impact, user friendliness and, usefulness. Aging & Mental Health, 14, 461–470. doi:10.1080/13607860903311741.Google Scholar
Vasse, M. et al. (2012). Guidelines for psychosocial interventions in dementia care: a European survey and comparison. International Journal of Geriatric Psychiatry, 27, 40–48.Google Scholar
Vitaliano, P. P., Zhang, J. and Scanlan, J. M. (2003). Is caregiving hazardous to one's physical health? A meta-analysis. Psychological Bulletin, 129, 946–972. doi:10.1037/0033-2909.129.6.946.Google Scholar
Winzelberg, G. S., Williams, C. S., Preisser, J. S., Zimmerman, S. and Sloane, P. D. (2005). Factors associated with nursing assistant quality-of-life ratings for residents with dementia in long-term care facilities. The Gerontologist, 45, 106–114.Google Scholar
Yeatts, D. E. and Cready, C. M. (2007). Consquences of empowered CNA teams in nursing home settings: a longitudinal assessment. The Gerontologist, 47, 323–339.Google Scholar
Zimmerman, S. et al. (2005). Attitudes, stress, and satisfaction of staff who care for residents with dementia. The Gerontologist, 45, 96–105.Google Scholar