Caregiver Theme Group Update March 2011

March 15, 2011

We are happy to report that the national study of the e-Learning program for Nursing Assistants has been launched.  We have 15 participating institutions – at least one from each province and we have tried to obtain a mix of rural and urban long term care homes.  Colleagues at participating institutions have been very enthusiastic about the project and are facilitating completion of the program by ten Nursing Assistants and one nursing supervisor at each facility.  We expect to have data by the end of April and hopefully can provide a summary of the results at out thme group meeting at the NICE conference May 19th.

The Caregiver Calendars were printed for 2011 and continue to be requested by both clinicians and caregivers.

The dementia Caregiver Assessment Tool has been digitized (can be completed via the Internet) and is in the process of being evaluated at two participating clinics – Baycrest Brain Health Clinic and Peel Alzheimer’s Society.  We will have some feedback to share with our theme group at May meeting.

As you know NICE is undergoing a transformation with regard to funding but the vision remains – that is, each theme group is committed to continue to develop and disseminate information tools.  For our group these will be  for caregivers – formal and informal.  With that in mind, our theme group will need to think about submitting grant proposals to support our ongoing initiatives – will discuss at meeting in May.

All the best

Elsa

Caregiver Theme Group Projects 2010-2011

June 12, 2010
  1. Caregiver Calendar
  2. Nursing Assistant (NA) e-Learning Tool
  3. 2. Dementia Caregiver Assessment Tool
  4. 3. Caregiver Services Information Tool

Project 1:  Caregiver Calendar

Introduction:

As per the Caregiver Theme Group blog we did not receive sufficient responses from the caregivers to determine the impact of the calendar information segments on caregiver caring practices.  However, we believe that the calendar has useful information.  We had discussed previously partnering with Shoppers Drugmart in the annual printing and distribution of the calendar rather than distribute annually as a NICE information tool.

Objective 2010-2011:

We plan to approach Shoppers to engage them in this partnership.

Above: NICE Caregiver Calendar

Methods:

Peter Donahue is in the process of preparing a funding application to Shoppers with regard to their participation in this project.  If they agree to support the calendar project we will design a method for obtaining ongoing feedback from caregivers who receive the calendar from Shoppers.

Implications:

If we are successful in gaining Shopper’s support this would result in distribution of the Calendar through all of their stores across Canada and hopefully increase number of responses to our follow up survey.

Project 2: Nursing Assistant (NA) e-Learning Tool

Introduction:

This past year we developed an e-learning tool for nursing assistants working in long term care institutions.  The e-learning program is in process of being pilot tested with NAs and nursing supervisors at two long term care institutions (Waterloo, Peter Donahue; Winnipeg, Corey McKenzie).  The results of the pilot test will be presented to the Caregiver Theme Group at the June, 2010 NICE meeting.

Objective 2010-2011:

Following analysis of the pilot study data we will use the feedback to revise the NA e-learning program preparatory to conducting a national study of the impact of the program on NA clinical practice in long term care institutions.

Methods:

We plan to invite participation of two long term care institutions in each province; one rural and one urban.  With the support of institution CEOs/manager we will implement the program at each institution, including REB applications for approval.  We will develop metrics for assessing efficacy of the e-learning tool with regard to NA knowledge gained, NA caregiving attitudes, NA stress, NA coping, NA self-efficacy, NA physical and mental health status.  Where possible we will compare outcome responses of NAs who engage in the e-learning program with responses of a waiting list control group of NAs.

Above: Screenshot of Nursing Assistant DVD

Implications:

The ultimate aim of the project is to be able to disseminate broadly an evidence-based e-learning tool that is readily accessible and has an impact on NA job performance and satisfaction reflected in optimal care of older adults living in long term care institutions.

Project 3: Dementia Caregiver Assessment Tool

Introduction:

The needs of informal dementia caregiver are rarely assessed by health and social services agencies; rather it is the assessed needs of the care recipient that determine service allocation. The stress of caregiving frequently results in deterioration in the health of the caregiver and premature institutionalization of the care recipient.  An easy to administer and interpret assessment tool would greatly assist service providers in identifying the needs of caregivers in conjunction with assessing the needs of care recipients resulting in individualized service allocation that benefit both caregiver-care and recipient.

Objective 2010-2011:

A validated dementia caregiver assessment tool will be digitized, made available via the Internet and tested in several health and social services agency settings.  The aim is to examine the ease of use, validity and utility of the information output for clinicians, and impact of services allocated on meeting the needs of caregivers.

Methods:

A pilot study will be implemented in one health care institution and one CCAC.  The dementia caregiver assessment questionnaires will be digitized that will include a scoring and interpretation algorithm.  Clinicians and dementia caregivers will be interviewed to obtain their reflections of using the assessment tool and whether it was effective in helping the clinician-caregiver pair determine services needed to meet the needs of both the caregiver and the care recipient.

Implications:

The ultimate aim of the project is to generate a Dementia Caregiver Assessment Tool that could be made available as an Apps for easy administration, scoring and interpretation of output.

Project 4: Caregiver Services Information Tool

Introduction:

The Caregiver Calendar produced and distributed annually for the past three years yielded little feedback as to the impact on caregivers’ knowledge/skill acquisition due to the very poor response to our evaluation questionnaires.  What we did learn from the feedback received is that caregivers need regional information regarding services within each province.  Considering the needs of caregivers an information tool that listed all services available, within each province for persons with chronic disease and their caregivers could be helpful. Immediately following diagnosis of a chronic disease (e.g. dementia, Parkinson, stroke) patients and caregivers need to know what services are available and they need to access information about the disease, its course and treatment.  The information tool would include regional information about services as well urls of web sites with authenticated information.

Objective 2010-2011:

A services information tool that includes local information as to services as well as urls for authenticated information web sites will be developed and pilot tested.

Methods:

In collaboration with Caregiver Theme team members from across Canada we will develop province-specific caregiver information tools that will include urls for authenticated web sites for disease-specific information.  Both print copy and digital copy of the tool will be made available to a sample of GPs and health service organizations in each province.  Telephone follow up interviews will be conducted to gain feedback as to the utility of the tool for both clinicians and caregivers.

Implications:

The ultimate aim of the project is to generate a Caregiver Services Information Tool that would be available in print copy and could be made available as an Apps to practitioners and caregivers.

A History in Brief

May 1, 2010

2006-2007

June 2006 – Caregiving Theme Team met  for the first time in Calgary, Alberta

Dr. Sandra Hirst (Faculty of Nursing, University of Calgary) and Dr. Peter Donahue (Faculty of Social Work, University of Calgary and inaugural Network Manager for NICE) were the founding co-chairs of the Team.

Priorities set at that meeting included the development of two information transfer tools: a caregiving calendar for community dwelling family caregivers and a caregiving poster for professional caregivers in long term care facilities.

The calendar was targeted to family members providing care to older adults with some form of dementia. Each month was organized around a particular issue of relevance to caregivers, as for example, nutrition, communication, exercise, etc.  The calendar was distributed to over 100 caregivers with a request for feedback as to the format of the calendar and the usefulness of the information.

The poster was targeted to personal service workers in long-term care facilities to assist them in providing care to older adults with dementia. The acronym “RESPECT ALL” was used to identify 10 tips for the caregivers, supporting an underlying message that respecting the older adult is at the core of all care provided. The poster was distributed nationally to several long-term care facilities with a request for feedback as to the usefulness of the information.

2007-2008

In year two, the calendar was revised to include a caregiver stress inventory and was also made available in French.  The poster was re-printed in its original format.  Both information transfer tools were presented at the Annual NICE Knowledge Exchange held in Toronto, Ontario.  Subsequently, the calendars and posters were distributed nationally with a questionnaire attached requesting feedback from the users.  Dr. Ellen Sue Mesbur (School  of Social Work, Renison University College) joined Dr. Hirst as Co-Chair of the team.  Satmoi Yoshino joined the team through the NICE mentorship program.

Above: NICE Caring Calendar

Above: NICE Program Poster

2008-2009

In year three, the team revised the caregiving calendar based on feedback collected from the previous year and was again produced in French and English. This year, one of our International partners in India translated and distributed the calendar in Hindi.

Of note is the poor response rate to the questionnaires sent with the calendars for feedback ; 10 responses to over several hundred distributed nationally.  Over a two year period we received 24 responses to the calendar feedback questionnaires.  Fifty-four percent found the calendars ‘very helpful’; 42% found them ‘moderately helpful’ and one respondent indicated that the calendar was ‘not helpful’.  Several respondents provided suggestions for improvement as follows: a) provide the information on calendar in a pocket-sized booklet; b) need more information for managing finances of person with disability; c) need information regarding services by region of country; e) need information for dealing with uncomfortable feelings.  This feedback will be considered when deciding on projects for 2010-2011.

During this year a set of information transfer tools for grandparents raising grandchildren was developed under the leadership of Dr. Esme Fuller-Thomson.  The grand parenting tools were well received.   At the annual team meeting, Mr. Frank Wagner, Bioethicist, Toronto Central CCAC and University of Toronto Joint Centre for Bioethics was the guest speaker, presenting on a toolkit for ethical decision making with regard to the community dwelling older adults.

Link to Tools for Grandparents:  Legal Information and Financial Resources for Ontario Grandparents’ Raising their Grandchildren

Dr. Elsa Marziali (Baycrest Centre for Geriatric Care) joined Dr. Mesbur as Co-Chair of the Caregiving Team.  By September 2009 Dr. Mesbur resigned as co-chair.  The Team was also fortunate to have students Sienna Caspar,  Julie Colgate, Katie Kennel and Beanne John  join the Team through the NICE Mentorship program.

2009-2010

Under the leadership of the Caregiving Theme Team Chair, Dr. Elsa Marziali and with the collaboration of Dr. Cory MacKenzie (Department of Psychology, University of Manitoba) Dr. Peter Donahue (School of Social Work, Renison University College) and Dr. Laura Wagner, (Nursing Scientist, Baycrest ) and approved by the team members an e-learning program for nursing assistants working in long term care facilities was developed. The e-learning program includes a series of e-learning DVD’s focused on helping nursing assistants working in long-term care facilities communicate more effectively with their clients, the clients’ families and their co-workers.  The initial version of the e-learning program was reviewed by a small group of nursing assistants and their supervisor at Baycrest.  On the basis of their feedback, the learning modules have been modified preparatory to their being evaluated in a pilot study located at two long-term care facilities; one in Kitchener, Ontario and one in Winnipeg Manitoba.  Results of the pilot study will be reported at the NICE annual meeting in June 2010.

Above: Nursing Assistant DVD cover.

Above: Screenshots from the Nursing Assistant e-learning DVD.

Above: Scene from animation showing Nursing Assistant interaction with residents.

Above: Scene from animation showing Nursing Assistant coworker interactions.

Above: Scene from animation showing Nursing Assistant interacting family members.

Welcome to the NICE Caregiver Theme Group Blog!

March 23, 2010

Launched on March 23, 2010.