Long term care staff beliefs about evidence based practices for the management of dementia and agitation

Abstract

SUMMARYContext Despite a growing literature on effective interventions for Alzheimer's disease (AD) and agitation, the management of these conditions in long term care (LTC) often is inadequate. The goals of the present study were: (a) to evaluate existing beliefs about evidence based practices (EBP) for the management of Alzheimer's disease and agitation among LTC staff; and (b) to evaluate the contribution of demographic and attitudinal variables to LTC staff beliefs about these EBP. Method A cross sectional study of 371 LTC staff members completed an EBP questionnaire, a short demographic questionnaire, and an attitudinal questionnaire about AD and agitation. Results Paraprofessional caregivers, those of lower educational level, and ethnic minorities were more likely to be in disagreement with the EBP views examined in this study. Those in disagreement with the EBP views also reported a preference towards not working with residents with AD and agitation and a sense of helplessness associated with such work. Disagreement with EBP views was associated with both normalization and stigmatization of AD and agitation. Conclusions Paraprofessional caregivers, ethnic minorities, and people of lower educational level are most at need for educational activities about AD and neuropsychiatric symptoms. Educational efforts geared towards changing the belief system of LTC staff should target not only EBP but also information about AD and agitation as conditions that are deviant from the normal aging process, yet non-stigmatizing. It is expected that following EBP will empower staff and improve staff motivation to work with residents with AD and agitation.

Prescribing pattern of psychotropic drugs in nursing home residents with dementia

“…Indeed, one study suggests that residents were treated to help the nursing staff (Lovheim et al, 2006). Recent insight into the motivational and attitudinal commitment of nursing staff to work with residents with AD and agitation might contribute to this argument (Marshall, 2001;Ayalon et al, 2009). Staff tend to have little motivation (Marshall, 2001) and report a sense of helplessness or a preference for not working with residents with AD and agitation (Ayalon et al, 2009).…”

“…Recent insight into the motivational and attitudinal commitment of nursing staff to work with residents with AD and agitation might contribute to this argument (Marshall, 2001;Ayalon et al, 2009). Staff tend to have little motivation (Marshall, 2001) and report a sense of helplessness or a preference for not working with residents with AD and agitation (Ayalon et al, 2009). Moreover, staff may disagree with the views of evidence-based practices for the management of AD and agitation (Ayalon et al, 2009) or even be unaware of recent thinking about dementia care (Marshall, 2001).…”

“…Staff tend to have little motivation (Marshall, 2001) and report a sense of helplessness or a preference for not working with residents with AD and agitation (Ayalon et al, 2009). Moreover, staff may disagree with the views of evidence-based practices for the management of AD and agitation (Ayalon et al, 2009) or even be unaware of recent thinking about dementia care (Marshall, 2001). As reported by nursing home physicians, the use of nonpharmacological methods is limited due to staff requests for medication and insufficient resources (Cohen-Mansfield and Jensen, 2008).…”

Stigma, the medical model and dementia care: Psychological growth in senior health professionals through moral and professional integrity

“…In fact, these paraprofessional carers have the greatest client contact yet the lowest dementia literacy (Ayalon et al, 2009). Regrettably these carers are the most in need of training and the least likely to receive it (Arendts, Reibel, Codde, & Frankel, 2010;Hyer & Ragan, 2002).…”

Distinguishing Between Knowledge Gaps And Misconceptions Of Alzheimer’s Disease Among Caregivers In The UK

“…With a growing global population, prevalence of dementia is increasing world-wide. It is estimated that approximately fifty percent of all residents in long-term care settings have dementia [1,2] and the resulting heterogeneity in behaviours of residents can challenge the demands on knowledge and skills of carers in residential care homes [3,4,5]. Knowledge of dementia and Alzheimer's disease (AD) has been shown to vary among caregivers in residential settings and among informal carers [6,7].…”