The impact of psychosocial training on staff attitudes towards people living with dementia: A systematic review

BACKGROUND

As the prevalence of dementia increases, the need for appropriately trained and skilled care teams also increases. Staff attitudes towards people living with dementia have a significant impact on caregiving behaviours and staff and resident outcomes. Training within care settings is a potential way of improving staff attitudes towards residents in their care.

OBJECTIVES

This review aimed to (i) assess the effectiveness of psychosocial training in improving care staff attitudes towards dementia; and (ii) examine the content and focus of training.

METHOD

The review was conducted following PRISMA guidance and the protocol was registered on PROSPERO prior to conducting the review. A comprehensive search of peer-reviewed literature was undertaken using CINAHL, Medline and PsycINFO from inception to March 2021. All papers were evaluated using a quality appraisal tool.

RESULTS

Ten studies met inclusion criteria and were of variable quality. However, six studies found significant improvements in staff attitudes towards dementia following staff training. The studies varied in terms of training focus and included behavioural, communication and cognitive-based approaches.

CONCLUSIONS

Staff training could be an effective method of improving staff attitudes towards dementia in care settings. Further research adopting high-quality randomised controlled designs to further explore staff attitudes following psychosocial training would make a valuable contribution to the literature base.

Reducing dementia-related aggression through a staff education intervention

This article presents findings from a research study that examined the impact of a staff education programme on aggression as displayed by people with dementia living in residential aged care. The staff education programme was designed to change staff attitudes and perceptions towards their care management of the person with dementia. A simple interrupted time series, with the resident acting as his/her own comparison, was used to measure residents' aggressive behaviour both before and after the education intervention — Emotional Responses as Quality Indicators (ERIC). Forty-three residents and 85 staff were involved in the study. Staff attitudes to their work were assessed before and six weeks after the education intervention using the Attitude to Elderly Severely Mentally Infirm Care Scale. Findings indicate that people with dementia display cues about impending physical aggression, but such cues are often ignored by staff, as they may not see or understand anger as a legitimate human emotion within the context of the disease process.

Characteristics of care and caregivers of Alzheimer's patients in elderly care homes: a qualitative research

BACKGROUND

Due to the increase in the number of Alzheimer's patients in Iran and also the limitation of cultural knowledge about caring of these patients, this study was designed to explore the perceptions of Iranian caregivers about caring Alzheimer patients in the elderly care homes.

METHODS

A qualitative content analysis method was conducted on two elderly care homes of Shiraz/Iran, during 2009-2011. Fourteen key informants (10 women and 4 men, between 25-35 years of age), who had been working in elderly care homes caring for the elderly with Alzheimer disease for about 1-11 years (Mean=30 months) were selected by purposive sampling method. The caring experience and ability of transferring their experience to others were the main criteria for selection of the participants. They were participated in 2 focus groups and 4 interviews.

RESULTS

Nearly, 800 initial codes were extracted and categorized into 3 groups of "multidimensional care", "going along with the patients" and "need to be professional" and 12 subcategories. Although several aspects of care were mentioned by the participants but the main aspect was physical care. Infantilizing the patients was the main feature of care and caring personality was an important characteristic of caregivers.

CONCLUSION

An appropriate schedule of care considering main categories and subcategories of this research based on cultural context should be prepared. Moreover, consistent promotion of the schedule, employment of trained staff and plans for continued education for them can improve the quality of care and patient's life in elderly care homes.

The staff's view on dementia and the care in three cultures: A qualitative study in France, Portugal and Sweden

This article discusses the staff's view on dementia and its impact on the care delivered arising out of a qualitative comparative study focusing on long-term care of older people in France, Portugal and Sweden. The aim was to explore the staff's view on the illness dementia; on older people suffering from dementia; the care provided and the impact of various views on the care. The care was studied through observations at 22 care settings in the three countries and the staff's attitudes were explored by means of interviews with 79 people. A relation-oriented phenomenological approach was used. Great differences appeared regarding the various staff groups’ views. The findings also indicated that the staff's view; the cultural context and the organizational environment might have an impact on the care provided. However the impact of professional affiliation and the way of collaborating seemed to be of greater significance than other similarities or differences. An interdisciplinary based starting point, with close collaboration between medical based health care and social care of older people suffering from dementia in integrative care models, is therefore of vital importance.