Increased training needed for staff caring for dementia patients
MedWire News: Quality of life for care-home residents with behavioral and psychologic symptoms of dementia (BPSD) and those caring for them can be improved by developing assisted living facilities (ALFs) skills, suggest study findings.
The study shows that depression-related behaviors are associated with increased feelings of bother and upset for unlicensed staff. Care for this patient population is mostly provided by unlicensed staff, "who may be particularly vulnerable and ill-prepared for depression-related behaviors in residents with dementia," say Glenise McKenzie (Oregon Health and Science University, Ashland, USA) and colleagues.
For the study, the researchers used standardized measures to assess the type and frequency of BPSD in 87 patients residing in a total of 12 ALFs, and the reaction of their corresponding staff members. Information was also collected on the amount of staff training received for caring for patients with BPSD.
Self-reported hours of attendance at training sessions addressing cognitive impairment varied significantly (from 0 to 100 hours), with a median of 2 hours. Furthermore, 37% of carers reported receiving no on-the-job training specific to caring for individuals with cognitive impairment, and 44% reported no such training before starting their position.
In total, 94% of patients experienced at least one of the possible 24 BPSDs from the Revised Memory and Behavior Problems Checklist (RMBPC), with an average of 8.17 experienced per resident in the previous week.
The most frequently seen behaviors were memory related, occurring in 91% of patients, and included "forgetting what day it is" (61%) and "asking the same question over and over" (50%).
Depression-related behaviors were the second most commonly occurring symptom, and were reported in 77% of residents. Conversely, disruptive behaviors were the least frequent, occurring in 60% of residents.
When the team assessed staff reactions to resident behaviors, they found that 60% of staff reported some level of reaction, as measured on the RMBPC, to one or more of the behaviors.
Further analysis showed that a higher prevalence of BPSD in ALF residents was linked to increased levels of reaction (feelings of bother and upset) for the unlicensed staff who provided their care.
Indeed, depression-related behaviors elicited the highest level of staff reaction, followed by disruptive and memory-related behaviors. Staff were found to react most often to behaviors related to "threatening to harm self," "comments about death," and "feeling worthless."
Writing in Geriatric Nursing, the team concludes: "Improving coping and management skills of staff working with dementia residents with depression in ALFs may therefore serve a dual purpose of improving the quality of life for residents and improving the emotional well-being of unlicensed staff."
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By Ingrid Grasmo