More than one-third of adults over the age of 65 receiving home health care has some form of cognitive impairment, but the number of caregivers qualified to properly serve this subset of patients doesn’t meet the demand, prompting a researcher at the New York University College of Nursing to develop a program aimed at narrowing that gap.
The Dementia Symptom Management at Home (DSM-H) program aims to help him health care agencies improve the quality of care they provide to patients living with dementia and reduce caregiver stress and burnout. It is the brainchild of Abraham Brody, Ph.D., RN, GNP-BC, an assistant professor at the NYU College of Nursing and an associate director at the Hartford Institute for Geriatric Nursing.
Additionally, researchers tested the program’s ability to boost knowledge, confidence and attitudes among home health workers and whether it’s a solid resource for agencies to use.
The program consists of inter-professional training programs that employ online education, offline mentoring and evidence-based assessment tools and care plans meant to provide a structured way for home health agencies to assess and manage pain and behavioral symptoms. The education modules ranged from 45 to 90 minutes for a total training time of four and a half hours, and incorporated a blend of imagery and text with narrative voiceovers alongside content-specific questions to reinforce learning objectives.
As part of the study, 191 participants were measured before and after they completed online training. Generally, the pre-assessment showed that clinicians tended to have limited initial knowledge and confidence around identifying and managing pain, depression and behavioral symptoms. Occupational therapists displayed the most knowledge, confidence and attitudes beforehand, and physical therapists the least.
Home health professionals experienced improvements across the different training areas, however. Pain knowledge and confidence increased by 5.9% and 26.5%, respectively; depression knowledge and confidence went up by 14.8% and 36.1%, respectively; and neoropsychiatric symptom general knowledge grew by 16.8%, with intervention knowledge up 20.9%.
Despite these positive results, the study didn’t evaluate how this increase in knowledge, confidence and attitudes might influence patient and caregiver outcomes, meaning further research on the program’s effectiveness is necessary.
“Our study shows this disseminable program proved to be implementable and improve clinician’s confidence and knowledge in caring for [patients living with dementia],” Brody said. “…There’s a significant need, and nothing out there for home health care in geriatrics, let alone dementia.”
The findings were published in Geriatric Nursing.
Written by Kourtney Liepelt