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Challenges and Strategies for Implementing and Evaluating Dementia Care Staff Training in Long-term Care Settings

BEEBER, ANNA SONG PHD, RN; ZIMMERMAN, SHERYL PHD; FLETCHER, SUSAN MSW; MITCHELL, C. MADELINE MURP; GOULD, ELIZABETH MSW

doi: 10.1097/ACQ.0b013e3181cd1a52
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Evidence suggests that staff training in dementia care can improve the quality of care and the quality of life for older adults in nursing home (NH) and residential care/assisted living (RC/AL) settings. Although there is a great need for staff to be trained in dementia care, the long-term care setting poses challenges for training and uptake of new practices. This article provides a review of the published literature on dementia care staff training in NHs and RC/AL settings, the challenges faced when conducting training, and how these challenges influence the evaluation of its effectiveness. The authors examined this issue by reviewing 382 articles published between 1995 and 2009, with 25 articles meeting the review's inclusion criteria of provided staff training in dementia care, being conducted in an NH or RC/AL setting, focusing on changing overall dementia care practices (instead of single issues such as wandering or incontinence), or providing a review of relevant literature. Findings suggest that staff training is challenged by low staff attendance, lack of organizational support, and financial limitations. This review highlights the need for practical strategies to better focus and conduct staff training, such as involving community members and practitioners in the content and design of training.

Anna Song Beeber, PhD, RN, is Assistant Professor, School of Nursing, and Research Fellow, Program on Aging, Disability, and Long-Term Care, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill.

Sheryl Zimmerman, PhD, is Kenan Distinguished Professor and Director of Aging Research, School of Social Work, Adjunct Distinguished Professor, School of Public Health, and Co-Director, Program on Aging, Disability, and Long-Term Care, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill.

Susan Fletcher, MSW, is a doctoral candidate, School of Social Work; Hartford Doctoral Fellow; and 2009 recipient of the Gordon H. DeFriese Career Development in Aging Research Award, Institute on Aging, University of North Carolina at Chapel Hill.

C. Madeline Mitchell, MURP, is Research Associate, Program on Aging, Disability, and Long-Term Care, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill.

Elizabeth Gould, MSW, is Director, Quality Care Programs, Alzheimer's Association National Office, Chicago, Illinois.

Address correspondence to: Anna Song Beeber, PhD, RN, School of Nursing, University of North Carolina, CB 7460, Charington Hall, Chapel Hill, NC 27599 (asbeeber@email.unc.edu).

This research was supported by a grant from the National Alzheimer's Association Medical and Scientific Division (grant IIRG-05-14332) and the Building Interdisciplinary Research Careers in Women's Health (BIRCWH) Institutional K12 Program at the University of North Carolina at Chapel Hill.

© 2010 Lippincott Williams & Wilkins, Inc.