Most aged care operators can show that staff have completed training. The harder question is what happens when that training is needed at 7pm, when a resident is distressed, does not want to change their clothes or becomes upset by something a staff member has said.
There can be quite a gap between understanding person-centred dementia care in a training module and recognising how to respond when that situation is happening in front of you.
A recent New Zealand pilot is looking at whether practising those interactions could help close that gap.
The Dementia Learning Centre, part of Alzheimers New Zealand, recently completed a pilot of CarePlay, an app-based game developed by Mentia Health. Rather than simply giving staff information to read or watch, it puts them into everyday dementia-care scenarios, asks them to decide how they would respond and lets them explore what happens next.
The eight-week pilot involved three New Zealand organisations, including two residential aged care homes and one home-based support provider. All participants reported finding CarePlay useful, with 62.5 percent describing it as very or extremely useful. Staff also reported changing aspects of their own practice, including slowing conversations, offering simpler choices and listening more closely.
Those results are encouraging, but they need to be kept in perspective. This was a pilot and the reported changes came from participants themselves. It was not a study showing measurable improvements in resident outcomes.
What it does offer is another way to look at how dementia training is delivered.
A staff member can know that they should not embarrass or confront someone living with dementia and still struggle with what words to use when that person refuses care. Practising the conversation, getting it wrong and trying another approach is quite different from answering a multiple-choice question correctly.
It is a discussion already happening more widely in New Zealand training. When Careerforce refreshed its Dementia Care Level 4 programme earlier this year, feedback from employers and learners called for stronger links between assessment and day-to-day practice. Careerforce said the updated programme was intended to make the connection between learning and what workers actually encounter on the job much clearer.
There is another consideration for operators, however. More interactive training still has to fit around a working care environment.
Research published this year into VR-based dementia communication training in Canada found managers became more positive about the approach after using it, but practical issues remained. Protected training time, fitting sessions around rosters, starting with small groups and having people within the organisation who could support the training all helped. The researchers were also careful to point out that reported changes in staff communication were managers' observations rather than independently measured evidence of effectiveness.
That is probably where the discussion becomes useful for New Zealand providers.
There will always be mandatory learning, qualifications and information staff need to know. But dementia care also involves hundreds of small interactions where the words used, the choices offered and the decision to slow down rather than push ahead can change what happens next.
As providers review training, perhaps one question is worth adding: after somebody has completed this, what should they actually be able to do differently when they go back on shift?
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