Training improves Alzheimer’s care
Training improves Alzheimer’s care
Be sure you cover the basics
If your staff work with Alzheimer’s patients, you understand the necessity of Alzheimer’s training. And if it’s been a while since your last Alzheimer’s inservice, it’s probably time for an update.
"The depth of your training depends on the specific purpose it’s used for," notes Betsy Pegelow, RN, MSN, director of the Channeling Program, an Alzheimer’s caregiver support program of the Miami Jewish Home and Hospital for the Aged. "But whether we are training our dementia-specific case managers or support staff, there is some basic content that we always cover."
The basic information Pegelow suggests anyone working with Alzheimer’s patients receive includes the following:
• Characteristics of dementia. "We cover not only the definition of dementia and theories for the causes of dementia and diagnostic testing for dementia, but we also cover the impact of dementia on the caregiver and extended family. We want our case managers to understand not only the common problems they might encounter when working with the families of Alzheimer’s patients, but how coping with those problems affects families," she says.
• Stages of disease. "Alzheimer’s is a progressive disease. Case managers should understand how to stage the disease in order to help families plan and anticipate issues common to each stage," she says.
• Drug therapy. "There are drugs available to enhance memory and manage behavioral issues. Case managers should be updated regularly on the newest drug therapies," she says.
• Caregiver issues. "Case managers, aides, and home health providers must partner with caregivers when working with Alzheimer’s patients. Their relationship will be more with the caregiver than the patient."
• "Dementia-proofing" the house. "Living with an adult with dementia is very similar to living with a toddler," she notes. "Case managers should help caregivers evaluate safety issues in the home in order to limit the risk of accidents and injuries."
• Behavior management techniques. "There are so many behavioral issues involved in Alz heimer’s care. There is agitation and the potential for injury. There is aggressive, abusive behavior."
Pegelow teaches her case managers and caregivers communication and distraction techniques to help manage the behavior common to Alzheimer’s. "Some techniques can be used with any frail, elderly population. However, redirection, distraction, and cuing are specific to dementia clients."
• Legal and financial issues. "This is especially important for caregiver training," notes Pegelow. "The primary caregiver must have an emergency plan that clearly outlines what should happen if the caregiver becomes ill or injured. It’s the case manager’s responsibility to explain the importance of such a plan and help the caregiver develop it."
• Resources. Of course, case managers understand the value of information. Pegelow has a library of dementia-specific written materials and videos to which she refers regularly. She also has taken the handouts she has assembled through the years and placed them in a resource manual for her case managers. The manual has plastic pages that case managers can pull out and copy for families as appropriate. Many of the sheets discuss specific issues such as coping with incontinence.
However, no inservice replaces the need for professional meetings, she says. "We send our staff to an annual meeting every year. We are fortunate enough to have a one-day workshop in our local area that provides updates on Alzheimer’s and breakout sessions. It’s very important to keep current, and nothing is as effective as a professional meeting. Consumers are very sophisticated. They have access to the latest developments via the Internet. Case managers have to be knowledgeable enough to answer caregivers’ questions."
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