Implementing Gentle Persuasive Approaches dementia education for staff on in-patient medicine units: A program evaluation

Abstract

Older adults with dementia, when hospitalised, frequently experience responsive behaviours. Staff struggle to manage responsive behaviours without specific education. We aimed to enhance staff knowledge and confidence with care for older adults with dementia and responsive behaviours on medicine units at a Canadian hospital. An online dementia education program was disseminated to staff as part of a broader quality improvement project. Gentle Persuasive Approaches (GPA) encourages staff to reframe responsive behaviours as self-protective expressions of unmet needs and learn to assess their meaning. Participants completed online quantitative and qualitative measures of self-efficacy, competence and knowledge in dementia care at three times: immediate pre-, immediate post- and six to eight weeks post-GPA eLearning. Immediately post-GPA, participants showed significant increases relative to baseline in dementia care self-efficacy, competence and knowledge. Self-efficacy scores increased further eight weeks post-GPA. Before GPA, few participants described dementia-specific strategies for de-escalating a patient’s agitation. Eight weeks post-GPA, participants described application of tailored, person-centred, non-pharmacological interventions and successful application of GPA strategies. GPA eLearning strengthened staff preparedness to interact with older adults experiencing responsive behaviours, thus enhancing their care.

Barriers and Facilitators to Providing Rehabilitation for Long-Term Care Residents with Dementia: A Qualitative Study

“…Our participants identi ed the GPA training as one of the effective programs for this purpose. The GPA has been shown to improve dementia care self-e cacy, competence, and knowledge among the staff of in-patient medical units (29). Policy regulation could be used to set such training as a requirement for all providers with direct access to residents with dementia.…”

“…They indicated that the communication strategies should be clear, concise, loud, and illustrated with pictures, gestures, or supported by assistive tools (e.g., walker). Our participants recommended the Gentle Persuasive Approach (29) as an important training for care providers working with people living with dementia, which emphasizes encouragement and functional activities to improve care providers' understanding of dementia and strategies for effective engagement of residents.…”

Exploring Antipsychotic Use for Delirium Management in Adults in Hospital, Sub-Acute Rehabilitation and Aged Care Settings: A Systematic Literature Review

“…These behavioural manifestations [ 9 ] can interfere with provision of care to people with delirium in hospitals and residential aged care [ 11 ], especially if staff lack the requisite knowledge, skills and resources to prevent and de-escalate behaviours [ 12 ]. A recent qualitative descriptive study that examined doctors’ and nurses’ experiences ( n = 42) of antipsychotic use for people with delirium in Australia [ 13 ] identified that concerns for safety of nurses and the patient with delirium were the most common reasons antipsychotics were administered.…”