This article reports on the results of a nested cohort group-randomized trial of 6 training sessions of Foundations of Dementia Care, a national training curriculum for nursing home and residential care/assisted living staff. Staff from 9 nursing homes and 7 residential care/assisted living settings in 4 states, including 491 direct care staff and 171 supervisors, participated in the project. Entire facilities were randomly assigned to receive either the 6-week training or not. Primary findings included improved knowledge in 2 of 6 areas immediately posttraining and in 1 area 3 months posttraining, an increase in supervisors' reported likelihood to work with other staff (the key teaching of another of the 6 sessions) but also a perception of less support from their own supervisors, and an increase in work stress.
Sheryl Zimmerman, PhD, 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.
C. Madeline Mitchell, MURP, 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.
David Reed, PhD, Senior Analyst, Program on Aging, Disability, and Long-Term Care, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill.
John S. Preisser, PhD, Research Professor of Biostatistics, Gillings School of Global Public Health and Fellow of the Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill.
Susan Fletcher, PhD, Hartford Doctoral Fellow, University of North Carolina at Chapel Hill.
Anna Song Beeber, PhD, RN, Assistant Professor, School of Nursing and Research Fellow, the Program on Aging, Disability, and Long-term Care, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill.
Peter S. Reed, PhD, MPH, President and CEO, the Center for Health Improvement, Sacramento, California.
Elizabeth Gould, MSW, Director, Quality Care Programs, the Alzheimer's Association, National Office, Chicago, Illinois.
Stephanie Hughes, MPP, Associate Director, Performance Improvement, Chapter Relations, Alzheimer's Association, National Office, Chicago, Illinois.
Eleanor S. McConnell, PhD, RN, GCNS, BC, Associate Professor, Duke University School of Nursing; Clinical Nurse Researcher, Durham Veterans Affairs Medical Center Geriatric Research Education and Clinical Center; and Senior Fellow, Duke University Center for the Study of Aging and Human Development, Durham, North Carolina.
Kirsten N. Corazzini, PhD, Assistant Professor, Duke University School of Nursing, and Senior Fellow, Duke University Center for the Study of Aging and Human Development, Durham, North Carolina.
Deborah Lekan, MSN, RN, C, Clinical Associate, Duke University School of Nursing, Durham, North Carolina.
Philip D. Sloane, MD, MPH, Elizabeth and Oscar Goodwin Distinguished Professor of Family Medicine, the University of North Carolina at Chapel Hill.
Address correspondence to: Sheryl Zimmerman, PhD, Cecil G. Sheps Center for Health Services Research, University of North Carolina, 725 Martin Luther King Jr Blvd, Campus Box 7590, Chapel Hill, NC 27599 (Sheryl_Zimmerman@unc.edu).
This research was supported by grants from the Alzheimer's Association Medical and Scientific Division (grant IIRG-05–14332), the RAND/John A. Hartford Foundation Building Interdisciplinary Geriatric Healthcare Research Centers Initiative, and the Hartford Doctoral Fellowship in Geriatric Social Work.
The authors thank the long-term care staff and trainers who participated in this project. It is because of their efforts and collaboration that the quality of dementia care in residential care/assisted living settings and nursing homes may be better understood and improved. Thanks also are extended to Diane Cash, Jessica Blanc, and Britney Wiggins, the data collectors who worked long and varied hours to assiduously obtain the information reported in this article.
