Increasing Dementia Training in Long-Term Care: A Person-Centered, Non-Pharmacological Approach

Background: Approximately 64% of residents living in long-term care (LTC) settings have a diagnosis of Alzheimer's disease or other forms of dementia. Many will exhibit challenging behavioral and psychological symptoms of dementia (BPSD) such as agitation, wandering, anxiety, and delusions. Highly trained frontline care providers (direct caregivers) are crucial for the successful management of residents with BPSD. Non-pharmacological interventions are preferred first-line treatment options in dementia care. Unfortunately, many care providers are ill-equipped to manage BPSD due to suboptimal or lacking dementia care training in non-pharmacological management strategies. This quality improvement project is intended to help frontline care providers become better equipped with person-centered, non-pharmacological management strategies to confidently care for residents with dementia. Methods: A dementia training program for frontline care providers was developed and implemented at two rural skilled nursing facilities. Four, two-hour educational training sessions were offered. The training focused on helping care providers identify residents with varying levels of cognitive/functional abilities and a 10-item, non-pharmacological dementia care toolkit. The training included didactic presentation, role play, and handouts. A pre-training, immediately post-training, and 30-day post-training survey was administered to assess changes in knowledge, self-efficacy, work-related stress, and attitude in delivering non-pharmacological dementia care. Results: Thirty-six frontline care providers attended the dementia training presentation and completed the pre-training and immediately post-training surveys. Eight, 30-day post-training surveys were collected. Overall mean survey scores for knowledge, self-efficacy, and attitude increased significantly from pre-training to post-training. No change was observed in overall mean survey scores for work-related stress. All participants expressed satisfaction with the quality and content of the training. Conclusion: The results of this project suggest that dementia training in LTC increases frontline care providers' knowledge, self-efficacy and attitude in providing non-pharmacological dementia care. The training was successful, participants reported they have increased their use of non-pharmacological methods when caring for residents with dementia. Ongoing dementia training will be imperative to improve caregiver outcomes as well as the quality of life for residents living with dementia in LTC.