Communication skills for professionals caring for persons with dementia (initial study)
Funded by the National Institute on Aging
Scientist(s):
Blair Irvine, PhD
With such a large percentage of nursing home residents suffering from dementia-related illnesses, certified nursing assistants (CNAs) must contend daily with difficult behaviors, accusations, and emotional outbursts. Training can help reduce the frequency of these disruptions and can help employees better cope with the stresses of their day. But maintaining a trained staff can be difficult, especially when employee turnover is high.
With no need for managerial supervision, Strategies for Dementia: Communication Skills for Professional Caregivers offers self-paced, individualized multimedia training in the skills required to work positively with confused residents. Employees log onto the system and are presented with four modules: Speaking Skills, Reacting Skills, Redirection Skills, and Communication Cards. The program also offers an Information Center with articles about dementia-related topics (e.g., types of dementia, appropriate exercise activities). Video peers (i.e., CNAs) guide the trainee through the program, describing the challenges they have faced and how they have overcome them. Dramatizations model application of the techniques presented.
At the end of each module, the trainee is presented with a video dramatization of an interchange and is asked to identify correct and incorrect usage of the skills. Those who pass the quiz are given credit and advanced to the next module. Those who need help are routed through a remediation loop until they answer the questions correctly. This self-paced program allows trainees to complete the program at their own convenience—all at one sitting or through several sessions as time permits. Certificates of completion can be printed to verify for managers that the trainee has mastered the material.
Of 88 experienced care providers who participated in the evaluation of Strategies for Dementia, 86% were paid professionals and 14% were nursing-home volunteers. In this randomized control trial, half the participants watched the multimedia training program, and the other half watched a linear videotape of a standard lecture inservice with no video or audiovisual aids. All participants began by watching videos of simulated interchanges between CNAs and nursing home residents and were asked to rate the various responses of the video CNA. After watching their assigned programs (multimedia or videotape), participants were asked to view the same video simulations and then rate the responses of the onscreen CNAs.
Those who watched Strategies for Dementia showed significant improvement. They had greater gains in the number of correct answers than did those who saw only the videotaped inservice. In addition, those who saw the multimedia program expressed a significantly greater intention to use the skills taught and reported more self confidence in their ability to do so. Interestingly, although program evaluators were not highly educated (only 14% had graduated from college), they all found the computer program very easy to use (rating it a 6 on a scale of 1 to 7) and were very positive in their feedback.
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