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There are currently 35.6 million people with dementia worldwide1 and this is expected to increase to 115.4 million by 2050. The increasing demand on public health highlights the need for education and training to support dementia care staff. The provision of training to health workers is essential to provide the knowledge and skills required for high quality dementia care2-6. Numerous national and regional policy initiatives have emphasized the knowledge and skills gaps for both dementia specialist and non-specialist staff4-10. The government of Scotland has introduced a target for the National Health Service to make improvements to the early diagnosis and management of patients with dementia. Subsequently, a National Dementia Strategy was introduced, making dementia a national public health priority6.
To address specific dementia-care training needs in the rural Scottish Highlands, a one-day tailor-made workshop for health and social-care staff was organised to:
- raise awareness about the importance of recognising and diagnosing dementia
- give staff an opportunity to discuss their role in recognising and managing dementia
- promote better understanding of current service delivery issues and staff training needs.
An open email invitation was issued to approximately 1140 health and social staff in the rural area where the training took place. Few staff have a dementia-specific remit; however, all staff who may offer services to persons with dementia were encouraged to participate. The training was attended by 18 staff, 10 of whom provided dementia care. Only three of these participants had attended any dementia training previously. This suggests there is a need for basic information and awareness raising among staff working in rural areas.
The workshop program included speakers specialising in differing areas of dementia care, including service improvement, provision of services, and rural dementia research. Group exercises were introduced to stimulate active participation and facilitate peer learning. The exercises included a case study analysis, a problem solving task, and a discussion of what it might mean to live with dementia.
The key training needs identified in the pre- and post-training evaluation included:
- improved understanding of dementia-related issues
- better knowledge about services and ways to provide help to people with dementia and their carers
- an update on current initiatives available and future changes in service provision.
Specific issues included nutrition, managing behaviour that challenges, and communication with people with dementia.
The anonymous post-training evaluation questionnaire sought information on the respondent's satisfaction with the course information and content, how they thought the course would influence their practice, and suggestions for future training needs. Fifteen of the 18 participants were able to identify the influence of the training on their practice. The key areas that were expected to change as the result of participating in the workshop included early recognition and diagnosis of dementia, and improved knowledge of available services. These findings demonstrate that participants were able to make the connection between acquired learning and their practice.
This training evaluation must be interpreted carefully due to the small sample size. However the analysis of participants' views allows for a better understanding of current knowledge about dementia-related issues among rural health and social-care staff. In addition, staff identified specific areas where further information and training support were required, including how to recognise dementia, what the diagnostic process entails, and the management of challenging behaviour.
Numerous barriers to implementing learning were also identified, such as issues with GPs and other colleagues, and a lack of resources. Despite these barriers the workshop received an overall high satisfaction rating from participants. Finally, the evaluation provided information to assist in developing successful models of training for health and social-care staff in rural areas of Scotland that would enable them to be confident in the diagnostic process and delivery of post-diagnostic dementia services.
Acknowledgements
The workshop reported in this paper was organised as part of a Knowledge Transfer Partnership Project, funded by Momenta, between NHS Highland and the Dementia Services Development Centre. Lynda Forrest and Kim Tewnion from NHS Highland also contributed to the organisation of the training workshop. Financial support for the training (venue and catering) was provided by the Highland Region Mental Health Collaborative, which is part of Scotland wide National Improvement Programme. Staff from the local Alzheimer Scotland branch contributed a session in the training workshop.
References
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