Efficacy of the CARES® Dementia 5-Step Method for Hospitals™ Online Training and Certification Program for hospital staff.

The main objective of the current study was to ascertain the efficacy of a newly developed online, video-based dementia training and certification program for hospital staff, the CARES® Dementia 5-Step Method for Hospitals™ Online Training and Certification Program. A parallel randomized waitlist control design was utilized. Participants (N = 272) completed online pre-evaluation measures. Forty-five days after completion of CARES® (treatment) or pre-evaluation measures (control), participants completed a post-evaluation online assessment. Analyses of variance found that participants in the treatment condition indicated greater and statistically significant (p < .001) increases in sense of competence, approaches to dementia, and patient care. The results implied that the CARES® Dementia 5-Step Method for Hospitals™ program could serve as a dynamic resource for hospitals nationwide to update training and share experiences, perspectives, and resources. The inherent scalability of the program regarding its acceptability, feasibility, and potential to incorporate seamlessly into routine workflows and staff training suggests high implementation potential.

Certified nursing assistants' perspectives of the CARES® activities of daily living dementia care program.

BACKGROUND: There has been a proliferation of online training programs for nursing home direct care staff related to dementia care, yet little is known about the effectiveness of the training. Some evidence exists that online training is effective in addressing problem behaviors of nursing home residents with dementia by enhancing self-efficacy, improving attitudes, and increasing knowledge of nursing home staff. STUDY AIM: The current study aim was to evaluate the implementation of an online training program consisting of ten, one-hour modules which applies the CARES® concepts and learning framework to activities of daily living (ADL) care for persons with dementia. METHODS: Responses from Likert-type items, and open-ended questions were analyzed in a sample of 48 certified nursing assistants (CNAs) from 10 nursing homes in six states (ME, MT, ND, WI, MN, MO) that were part of a National Institute of Aging funded intervention study (Grant #AG026210). RESULTS: The mixed-method study findings indicated that CNAs gained a better understanding, more knowledge, and more confidence in caring for persons with dementia. Recommendations were made regarding training length and technical issues, and some questioned the practicality of providing person-centered care when resident assignment was very high. CNAs expressed satisfaction with the online training, found it easy to use, and many said they would recommend the training. CARES® ADL Dementia Care online training appears to be a viable way of helping CNAs address the personal care needs of long-term care residents. Future CARES® ADL Dementia Care program research should include more racially diverse CNAs.

An evaluation of the CARES® Dementia Basics Program among caregivers.

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 w 2 = 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.

Impact of serious mental illness online training for certified nursing assistants in long term care.

Certified nurse assistants (CNAs) spend the most staff time with nursing home residents, yet they receive little training in addressing the mental health needs of residents with serious mental illness (SMI). Forty CNAs from four long-term-care facilities took the online interactive CARES-® Serious Mental Illness™ training consisting of two modules guided by the Recovery Movement philosophy of care. Responses from pre-post testing, Likert-type items, and open-ended questions indicated that CNAs gained information, changed their perspectives, and had more confidence in dealing with SMI. Although there were minor concerns regarding length, clarity of content, and technical issues, CNAs found the online format acceptable and easy to use, and many said they would recommend the training. CARES Serious Mental Illness online training appears to be a viable way of helping CNAs address the mental health needs of long term care residents. Additional testing on CARES Serious Mental Illness is planned.

CARES(®) Dementia Care for Families™: Effects of Online, Psychoeducational Training on Knowledge of Person-Centered Care and Satisfaction.

Challenges to intervention use among family caregivers of individuals with dementia include availability and timing of delivery. The current study sought to determine whether an online, psychoeducational intervention for dementia family caregivers, CARES(®) Dementia Care for Families™ (CARES for Families), improved and enhanced dementia caregivers' knowledge of person-centered care approaches. Forty-one family members completed pre- and posttest surveys that assessed improvement in dementia care knowledge, and multiple close- and open-ended items examined how the CARES for Families online modules benefited users at posttest. A paired t test demonstrated a significant and considerable increase in dementia care knowledge among family caregivers (p < 0.001); caregivers also indicated that CARES for Families' content, flexibility, and use of actual family caregivers and individuals with dementia in video care vignettes were strengths. The findings suggest that CARES for Families can offer an efficient supplement to holistic dementia care that gerontological nurses provide.

The CARES(®) Observational Tool: a valid and reliable instrument to assess person-centered dementia care.

The goal of the current study was to develop a valid and reliable tool to measure whether person-centered care is delivered by direct care workers to persons with dementia. Face validity was initially established through multiple revisions of the CARES(®) Observational Tool (COT™) by members of the study team. Afterward, content validity of the COT was established by piloting the tool on 31 observations across 7 nursing homes and review by an interdisciplinary panel of nine scientific experts. The final 16-item version of the COT was then tested for inter-rater reliability by 5 reviewers across 5 standardized dementia care videos. An intra-class coefficient of all possible Kappa coefficients resulted in an ICC of .77. The brief and easy-to-use COT has potential to assess person-centered care interactions between direct care workers and persons with dementia.

Feasibility of Internet training for care staff of residents with dementia: the CARES program.

This study evaluated an Internet-based training module, CARES(®) (Connect with the resident; Assess behavior; Respond appropriately; Evaluate what works; Share with the team), to determine its feasibility for certified nursing assistants (CNAs) in three nursing homes and one assisted living facility. Pre- and posttest questionnaires were administered to 40 CNAs to determine improvements in dementia care knowledge and perceptions of competence in dementia care. Dementia care knowledge improved significantly after CARES training. More than 85% of the sample agreed or strongly agreed that the CARES protocol improved mastery, improved care competency, and reduced stress related to care of residents with dementia. Open-ended feedback indicated that CARES provided CNAs with new information and skills pertaining to dementia care. The results suggest that Internet-based programs such as CARES represent time- and cost-efficient methods to deliver dementia care training in long-term care settings.

An internet-based multimedia education prototype to enhance late-stage dementia care: formative research results.

The goal of this project was to develop a portable, Internet-based multimedia education program (IBME) to provide a more efficient training resource for direct care workers (DCWs) who care for nursing home residents suffering from late-stage dementia. Thirty-four DCWs from 8 nursing homes in 8 states completed 5 posttest open-ended questions and 20 Likert items on the feasibility, strengths, and weaknesses of the IBME prototype. Pre- and post-test surveys also examined whether late-stage dementia care knowledge changed significantly. More than 90% of DCWs "agreed" or "strongly agreed" that the IBME prototype improved DCWs' feelings of competency and everyday care delivery. Open-ended comments offered several suggestions for improvement, including group-based discussion of the modules. Results also indicate that DCWs' late-stage dementia care knowledge significantly increased (P < .001) following completion of the IBME modules. The IBME prototype offers an online, asynchronous training strategy to enhance dementia-pertinent knowledge and skills related to everyday care delivery in nursing homes.

Feasibility and Utility of Online Dementia Care Training for Hospital Staff: The CARES® Dementia-Friendly Hospital™ Program.

The current project tested the feasibility and utility of the CARES® Dementia-Friendly Hospital™ (CDFH) program, a 4-module, online training program for nursing assistants (NAs) and allied hospital workers (AHWs) who provide care to individuals with dementia. A single group pretest/posttest design was used for 25 hospital NAs/AHWs, and quantitative and qualitative data were collected to determine whether NAs'/AHWs' knowledge of hospital-based dementia care significantly increased, and if CDFH was perceived as useful and acceptable. Dementia care knowledge increased significantly (p < 0.001). Open- and closed-ended data suggested that the delivery of online training to NAs/AHWs to enhance dementia care is feasible, useful, and efficient. Ongoing gaps in care exist for individuals with dementia in hospitals, and delivering robust training for NAs/AHWs may serve as an effective modality to enhance quality of dementia care in such settings. [Res Gerontol Nurs. 2017; 10(2):58-65.].

Direct Care Worker Training to Respond to the Behavior of Individuals With Dementia: The CARES® Dementia-Related Behavior™ Online Program.

Only a handful of online training programs are available for direct care workers (DCWs) to acquire the strategic skills needed to improve dementia care in instances of challenging or inappropriate behavior. Utilizing pre- and post-test data from a convenience sample of 40 DCWs, the present study sought to determine (a) whether DCWs' knowledge of responding to dementia-related behavior increased following participation in the CARES® Dementia-Related Behavior™ Online Training Program (or CARES® Behavior) and (b) if CARES® Behavior was acceptable and useful. The average number of correct scores on a dementia care knowledge measure was significantly higher among DCWs after viewing the online modules when compared with pre-test scores (p < .01). Descriptive empirical and open-ended data also suggested that the interactive, "real-world" content of CARES® Behavior was feasibly delivered online, acceptable, and may influence how DCWs deliver clinical care to individuals with dementia-related behavior.

Internet-based program for dementia caregivers.

The overall goal of the Internet-Based Savvy Caregiver (IBSC) program was to develop and bring to market an Internet-based psycho-educational program designed to provide dementia caregivers the knowledge, skills, and outlook they need to undertake and succeed in the caregiving role they have assumed. The IBSC program's concept is based on a face-to-face caregiver-training program and curriculum, the previously validated Savvy Caregiver Program (SCP). The project used an iterative design with expert and consumer input to develop the initial prototype. Forty-seven participants completed the IBSC program and follow-up questionnaire. Results of the formative evaluation showed that participants found the program educational, convenient, useful, and interesting. Participants endorsed feeling more confident in caregiving skills and communication with their family members. The evidence points to the feasibility of an Internet-based program to strengthen family caregivers' confidence in caring for persons with dementia.