Hearing Assessment and Rehabilitation for People Living With Dementia.

Hearing impairment commonly co-occurs with dementia. Audiologists, therefore, need to be prepared to address the specific needs of people living with dementia (PwD). PwD have needs in terms of dementia-friendly clinical settings, assessments, and rehabilitation strategies tailored to support individual requirements that depend on social context, personality, background, and health-related factors, as well as audiometric HL and experience with hearing assistance. Audiologists typically receive limited specialist training in assisting PwD and professional guidance for audiologists is scarce. The aim of this review was to outline best practice recommendations for the assessment and rehabilitation of hearing impairment for PwD with reference to the current evidence base. These recommendations, written by audiology, psychology, speech-language, and dementia nursing professionals, also highlight areas of research need. The review is aimed at hearing care professionals and includes practical recommendations for adapting audiological procedures and processes for the needs of PwD.

What are the perceptions of people living with dementia, family carers, professionals and other potential stakeholders to the use of global positioning systems to promote safer outdoor walking?: a qualitative literature review.

OBJECTIVE: Walking outdoors has many benefits which can improve quality of life for people living with dementia. However, due to the risk of getting lost, many people with dementia are denied the opportunity to be outdoors. There has been increased interest in using global positioning systems (GPS) to facilitate independent outdoor mobility for people with dementia, but this interest has been accompanied by ethical debate focussing on the rights of an individual with dementia to maintain privacy and autonomy. The objective was to establish what people, those with dementia, those who provide support for people with dementia and wider society perceive to be the issues around GPS use.Method: An adapted qualitative systematic review was conducted between November 2018 and December 2018. Medical, social and technological databases were searched for papers with no date restriction. Initial search terms displayed nine hundred and sixty citations. Titles and if necessary abstracts were read to determine which studies might be potentially relevant. Forty papers were identified as potentially relevant and their abstracts and references examined. This produced a further four potential studies. Following application of the exclusion criteria thirty papers were eliminated.Fourteen were accepted, appraised and thematically analyzed.Results: The ethical debate was reflected in the opinions of the study respondents. There was a willingness to relinquish some privacy for safety but people with dementia were not prepared to sacrifice their autonomy-believing they alone should decide whether GPS was appropriate.Conclusion: GPS was felt to have the potential to facilitate independent outdoor walking, but systems need to be tailored to the individual. There is also a need to contradict negative societal perceptions of the ability of people with dementia to live a fulfilled life which is in danger of diminishing GPS's potential to improve quality of life for people with dementia.Implications for RehabilitationWhilst dementia is a disabling and incurable disease, taking advantage of technological developments such as GPS can diminish its negative impact.Appropriate development and use of GPSs offers the potential to enable people with dementia to explore the outdoors independently with subsequent improvement in self-confidence, independence and autonomy.Professionals working with people with dementia need to be aware of the GPS technology available and the ethical issues involved to support the use of GPS.

Developing the evidence base for evaluating dementia training in NHS hospitals (DEMTRAIN): a mixed-methods study protocol.

INTRODUCTION: Around 70% of acute hospital beds in the UK are occupied by older people, approximately 40% of whom have dementia. Improving the quality of care in hospitals is a key priority within national dementia strategies. Limited research has been conducted to evaluate dementia training packages for staff, and evaluation of training often focuses on immediate, on-the-day training feedback and effects. OBJECTIVES: Our study aims to answer two research questions: (1) How do variations in content, implementation and intensity of staff dementia training in acute hospitals in England relate to health service outcome/process measures and staff outcomes? and (2) What components of staff dementia training are most strongly related to improved patient and staff outcomes? METHODS AND ANALYSIS: Using the principles of programme theory, a mixed-method study will be used to identify mechanisms and the interactions between them, as well as facilitators and barriers to dementia training in hospitals. We will use existing data, such as Hospital Episode Statistics, alongside two surveys (at hospital and staff level).We will recruit up to 193 acute hospitals in England to participate in the hospital level survey. We aim to recruit up to 30 staff members per hospital, from a random sample of 24 hospitals. In addition, we will explore the cost-effectiveness of dementia training packages and carry out an in-depth case study of up to six hospitals. ETHICS AND DISSEMINATION: The study has been reviewed and approved by the Faculty of Health and Medicine Research Ethics Committee (FHMREC 17056) and Health Research Authority (Integrated Research Approval System (IRAS) ID 242166: REC reference 18/HRA/1198). We plan to develop both standard (eg, academic publications, presentations at conferences) and innovative (eg, citizen scientist web portals, online fora, links with hospitals and third sector organisations) means of ensuring the study findings are accessible and disseminated regionally, nationally and internationally.

Navigating and negotiating: Social processes to describe and explain the student experience of undertaking part-time, taught study on a Master's level degree course in dementia care.

Post graduate education in dementia care is delivered by a number of academic institutions worldwide. Aimed primarily at people in advanced and specialised roles in health and social care, it is designed to develop the knowledge and skills to advance practice and lead to positive changes and benefits to people living with dementia and their social networks. However, undertaking Master's level education can be challenging, particularly when this is undertaken alongside full-time work and family/domestic commitments. To illuminate this student experience further, this paper takes a case study approach to explore the experiences of three students who have successfully completed a Master's programme in dementia care in the North West of England. Their individual and collective experiences highlight the challenges of juggling competing demands and the dynamic processes of navigating the student journey and continually negotiating supports in order to successfully complete the course. The study highlights important implications for the design and supportive structures within post graduate Master's education in dementia care/studies, and potentially in other subject areas also, in order to support students' transition to post graduate study.

Academic reawakening: Situated experiences of undertaking a post graduate masters course in dementia.

Master's level education can play important function in developing the knowledge and skills for nurses and allied professionals working in advanced roles in dementia care. However, little is known about the challenges experienced by professionals when making the transition to post-graduate study. This was a qualitative study comprising individual interviews with 15 graduates, nine of whom were nurses, who had experience of attending a part-time Master's in Dementia Care in the Northwest of England. Four sequential themes emerged from the data: 'Deciding what to do', 'Taking it on', 'Keeping going' and 'Endings and New beginnings'. Findings confirmed that Master's education for nurses and other professionals is significant in developing knowledge and instilling confidence in changing practice. Nevertheless, professionals experienced challenges in juggling the competing demands of education, family and work and were seen to navigate and negotiate their student journey by drawing on internal resources and external supports. The study adds to evidence that Master's level study is likely to benefit practice in dementia care; however, employers and Higher Education Institutions need to develop effective and flexible supports to enable nurses and allied professionals to engage effectively in part-time taught post graduate education.

'Getting to Know Me': The second phase roll-out of a staff training programme for supporting people with dementia in general hospitals.

Objectives The aims were to evaluate a second phase roll-out of a dementia care training programme for general hospital staff and to further develop two outcome scales: the Confidence in Dementia scale for measuring confidence in working with people with dementia and the Knowledge in Dementia scale for measuring knowledge in dementia. Method Following a 'training the trainers' phase, the study involved the delivery of the 'Getting to Know Me' training programme to a large number of staff (n = 517) across three National Health Service (NHS) Trusts situated in North-West England. The impact of the programme was evaluated using a pre-post design which explored: (i) changes in confidence in dementia, (ii) changes in knowledge in dementia, and (iii) changes in beliefs about behaviours that challenge. Results Statistically significant change was identified between pre-post training on all outcome measures (Confidence in Dementia: eight point increase, p < 0.001; Knowledge in Dementia: two point increase p < 0.001; controllability beliefs scale: four point decrease, p < 0.001). Medium to large effect sizes were demonstrated on all outcome measures. The psychometric properties of the Confidence in Dementia and Knowledge in Dementia scales are reported. Conclusion Staff knowledge in dementia and confidence in working with people with dementia significantly increased following attendance at the training sessions. The findings are consistent with preliminary findings and strengthen current knowledge about the impact of dementia care training in general hospitals. The Confidence in Dementia and Knowledge in Dementia scales continue to demonstrate psychometrically sound properties and demonstrate utility in the field of dementia research.

Continuing professional education: Motivations and experiences of health and social care professional's part-time study in higher education. A qualitative literature review.

OBJECTIVES: To understand the motivations and experiences of health and social care professionals undertaking part-time, accredited, continuing professional education in higher education. DESIGN: A review following systematic principles. DATA SOURCES: Systematic searches for literature published between January 2000 and December 2015 using the databases: SCOPUS, Web of Science, Medline, PsychINFO, Social Policy and Practice and CINAHL. REVIEW METHODS: Studies were included if they were published in the English language and were qualitative in design, focussing on the motivations and experiences of staff engaged in part-time, accredited, higher education study. Three reviewers appraised the quality of the selected studies. RESULTS: Thirteen qualitative studies were identified for the review. Motivating factors for staff to engage in part-time, accredited, continuing professional development study included: personal and professional drivers, influence of workplace/management and funding and availability. Key themes in relation to how staff experienced study included: the demands of adjusting to the academic requirements of higher education study; the experience of juggling competing demands of study, work and family; and the presence or absence of support for part-time study in the personal and professional arenas. CONCLUSIONS: Health and social care professionals experience a number of challenges when engaging in part-time, continuing professional education in higher education institutions. A significant challenge is the juggling of competing demands of study, work and family, and this may have a negative impact on learning. Research is needed to inform how higher education can address the specific learning needs of this population and develop pedagogic approaches that are both responsive to need and support of effective learning.

Life story resources in dementia care: a review.

PURPOSE: Life story work has a relatively long tradition in the caring sciences and is recognised as an important component of dementia care and practice. However, to date, there has not been a review of accessible life story resources. The paper aims to discuss these issues. DESIGN/METHODOLOGY/APPROACH: Following a systematic approach to identification and inclusion, 11 life story resources were reviewed to ascertain areas of commonality and divergence between the materials. FINDINGS: The authors were able to group the analysis under eight areas and at the end of this process, it was uncertain if life story work is a formal staff intervention or an informal activity that people with dementia and their families could engage in. Resources also varied in terms of whether the life story information was organised in a chronological way, or with topics of interest/discussion or with a combination of both. Life story evaluation and its impact on the life of the person with dementia is in need of development. PRACTICAL IMPLICATIONS: Across the resources the authors identified four reasons to do life story work which the authors have named as: emotional connections; interactional connections; building new connections and practical care connections. SOCIAL IMPLICATIONS: There was limited guidance aimed at helping people with dementia to develop and compile their own life story. ORIGINALITY/VALUE: This paper provides new insights into the usefulness, future directions and content of life story resources in dementia care. It will be of interest to those in health and social care as well as people living with dementia.

'Getting to Know Me': the development and evaluation of a training programme for enhancing skills in the care of people with dementia in general hospital settings.

OBJECTIVE: The aims of the study were to report on the development and evaluation of a staff training intervention in dementia care designed for use in the general hospital setting: the 'Getting to Know Me' training programme. The study also aimed to undertake initial psychometric analysis on two new outcome scales designed to measure knowledge and confidence in dementia care. METHODS: The study comprised two phases. The first phase comprised the design of two questionnaires which are shared within this paper: Confidence in Dementia (CODE) Scale and Knowledge in Dementia (KIDE) Scale. In phase two, staff undertook the 'Getting to Know Me' training programme (n=71). The impact of the programme was evaluated using a pre-post design which explored: (1) changes in confidence in dementia; (2) changes in knowledge in dementia; and (3) changes in beliefs about challenging behaviour. RESULTS: The psychometric properties of the CODE and KIDE scales are reported. Statistically significant change was identified pre-post training on all outcome measures. Clinically meaningful change was demonstrated on the CODE scale. CONCLUSIONS: The 'Getting to Know Me' programme was well received and had a significant impact on staff knowledge and confidence. Our findings add to a growing evidence base which will be strengthened by further robust studies, the exploration of the impact of staff training on direct patient outcomes, and further identification of ways in which to transfer principles of care from specialist dementia environments into general hospital settings.