Learning lessons from dementia workforce education to develop general hospital dementia change agents for the future: A constructivist grounded theory study.

In recognition of the often poor experience of people living with dementia in general hospitals and the lack of dementia curricular content for health and social care professionals, the Scottish Government commissioned a dementia workforce development programme (Dementia Champions) for qualified health and social care professionals in 2011. This constructivist grounded theory study aimed to construct a theory of the learning experienced by the dementia champions before, during and after the programme. The reported experience of change in the champions' professional and personal perspectives about people with dementia was the focus of this study. The findings contribute to a deeper understanding of the long-term negative impact of knowledge and skills gaps in dementia education and on people living with dementia and health and social care professionals. This negative impact has implications for individual professionals, service leaders and health and social care systems internationally. Data was co-produced through intensive interviewing, a focus group and email interviewing with nineteen Dementia Champions. Construction of the theory emerged from direct engagement with the data using the constructivist grounded theory approach. The findings illuminate how, before the programme, professionals were educated, socialised and defined to fail people with dementia. On the programme, multiple learning interventions in which interacting with the lived experience of people living with dementia, their families and colleagues became the stimulators of change. These learning interventions stimulated a disrupted self-definition and actions to resolve this disruption. Once the self-definition was restored, the participants faced the complexity of working with people living with dementia with passion, pride and new thinking. These findings further illuminate the importance of expert facilitation and the inclusion of people with dementia and their families as peer educators in health and social care dementia education. Further research on the negative outcomes of gaps in initial professional education is important.

Championing Dementia Education: Adapting an Effective Scottish Dementia Education Program for Canadian Acute Health Care Providers.

With increasing numbers of persons living with dementia and their higher rates of hospitalizations, it is necessary to ensure they receive appropriate and effective acute care; yet, acute care environments are often harmful for persons with dementia. There is a lack of dementia education for acute health care providers in Canada. Scotland presently delivers a dementia education program for health care providers, known as the Scottish National Dementia Champions Programme. The objective of this Policy and Practice Note is to present the collaborative work of Scottish experts and Canadian stakeholders to adapt the Dementia Champions Programme for use in Canada. This work to date includes: (a) an environmental scan of Canadian dementia education for acute health care providers; (b) key informant interviews; and, (c) findings from a two-day planning meeting. The results of this collaborative work can and are being used to inform the next steps to develop and pilot a Canadian dementia education program.

Testing the sensitivity of two dementia knowledge instruments in dementia workforce education.

BACKGROUND: The importance of dementia education in improving the care and support that people living with dementia is well established. Previous research has shown ceiling effects in pre and post educational intervention measures of dementia knowledge using Knowledge in Dementia Scale (KIDE) on post-registered health and social care staff in Scotland. The aim was to test the sensitivity of two dementia knowledge instruments, namely the (KIDE) and the Dementia Knowledge Assessment Scale (DKAS). DESIGN: A pre and post evaluation comparison of two dementia knowledge scales. SETTING: The tenth cohort of Scotland's National Dementia Champions Education Programme, September 2019-March 2020. PARTICIPANTS: Post-registered Health and Social Care staff (n = 117). METHODS: Both the DKAS and KIDE scales were administered pre and post programme delivery. Wilcoxon signed-rank tests were performed to examine T1 - T2 differences in dementia knowledge for both validated measures. RESULTS: Ceiling effects continued to be present for the KIDE scale at T1 and T2. The DKAS responses showed a different score distribution than that achieved by the KIDE. Ceiling effects noted for KIDE at T1 were not present for the DKAS. Further, at T2, only 6% of respondents scored the maximum on the DKAS. CONCLUSIONS: The DKAS appears to be a more useful instrument for measuring knowledge in post-registered health and social care staff; however, there was some evidence of ceiling effects post-intervention. There is a need for both scales to be tested in more educationally diverse populations, so educators and researchers can make informed decisions about the instrument's target range. Additionally, further research is needed to develop new sets of dementia knowledge items suitable for use in trained health and social care staff.

Multi-species dementia studies: Contours, contributions and controversies.

Developed via an online collaborative writing project involving members of the Multi-species Dementia International Research Network, this article seeks to refocus "the lens of the dementia debate" (Bartlett & O'Connor, 2007) by bringing dementia's complicated relations with the more-than-human world into sharper relief. Specifically, the article explores four thematic areas (contours) within contemporary dementia studies (Care & Caring; Illness Experience & Disease Pathology; Environment, Self & Sustainability; Power, Rights & Social Justice) where the application of multi-species theories and concepts has potential to foster innovation and lead to new ways of thinking and working. Whilst incorporating multi-species perspectives within dementia studies can create new ways of responding and new spaces of response-ability, the potential for conflict and controversy remains high. It is imperative, therefore, that the field of dementia studies not only becomes a site within which multi-species perspectives can flourish, but that dementia studies also becomes a vehicle through which multi-species concepts may be refined.

Palliative and end of life care for people with advanced dementia.

Despite growing understanding in recent years of the biological, psychological, social, environmental and spiritual aspects of dementia, people with advanced dementia continue to experience inequalities in accessing healthcare capable of improving their lives. The complexities of advanced dementia challenge professional competence and demand the highest level of skilled, compassionate care. This article, the last in a series on living with advanced dementia, considers the status and direction of palliative care as it applies to people with dementia and explores contemporary issues regarding advanced dementia and end of life, with a focus on guidance for practitioners and support for best practice. It identifies that open communication, clear information and a person-centred approach adopted as early as possible in the syndrome can make this period less distressing. Crucially, people at the end of life should be offered care in line with best practice in palliative and end of life approaches.

Delivering personal care for people with advanced dementia.

This is the second article in a six-part series in Nursing Older People exploring the nursing care of people living with advanced dementia. This article considers the complexity of providing personal care, including the need for expert nursing practice to assess and lead the fundamentals of care: washing, dressing, continence care, nutrition and hydration. The contemporary evidence base for effective assessment, care planning, partnership working and evaluation of personal care for people with advanced dementia is presented, supported by sources of further information.

The provision of accredited higher education on dementia in six European countries: An exploratory study.

BACKGROUND: The World Health Organization has identified developing the knowledge and skills of healthcare professionals who are involved in dementia care as a priority. Most healthcare professionals lack the necessary knowledge, skills and understanding to provide high quality dementia care. While dementia education amongst most UK university health and social care programmes is inconsistent, we know little about the provision of dementia education in European universities. OBJECTIVES: To examine the provision of accredited higher education on dementia in European countries, to illustrate that it is highly variable despite universities being the major provider of education for healthcare professionals internationally. DESIGN: An exploratory research design was used. SETTINGS: The providers of higher education undergraduate and postgraduate programmes in the Czech Republic, Portugal, Scotland, Slovenia, Spain, Sweden. PARTICIPANTS: Higher Education Institutions who provide undergraduate and postgraduate education in the fields of nursing, medicine, psychology, social work, physiotherapy, occupational therapy, and gerontology in six European countries. METHODS: The data was collected using a structured questionnaire. Researchers in each country conducted an internet-based search using the websites of Higher Education Institutions to identify existing accredited dementia education. RESULTS: These searches revealed a lack of dementia education in undergraduate health and social care study programmes. Three of the six countries offered postgraduate study programmes on dementia. There was a significant variation amongst the countries in relation to the provision of dementia education at undergraduate, postgraduate and doctoral levels. CONCLUSIONS: Dementia is a global challenge and educating and upskilling the workforce is a policy imperative. To deliver the best dementia care, investment in interprofessional evidence-based education is required if we are to respond effectively and compassionately to the needs of people living with dementia and their families. Higher Education Institutions have an important role to play in equipping health and social care professionals with the knowledge, skills and understanding to respond to this imperative.