Caregiver Education and Service Utilization in African American Families Dealing with Dementia

For more than a decade attention has been focused on Alzheimer’s family caregivers in African American communities. The Fourth Report of the Advisory Panel on Alzheimer’s Disease to the U. S. Congress and the U.S. Department of Health and Human Services calls for “…public education and outreach efforts specifically targeted to ethnic elders and their families and communities through the development and dissemination of culturally relevant materials emphasizing both the established facts about [Alzheimer’s Disease and Related Disorders] and the efficacy of seeking treatment.” (Advisory Panel on Alzheimer’s Disease, 1993, p. 50). While federal financing and state initiatives have addressed some of the inequities, minority family caregivers remain underserved

Screening and Brief Intervention for Alcohol Misuse in Older Adults: Training Outcomes Among Physicians and Other Healthcare Practitioners in Community-Based Settings

Screening and brief intervention (SBI) is increasingly available to older adults who engage in at-risk drinking. This study examined the extent to which SBI training influenced the willingness of healthcare providers in a community-based hospital and other clinical settings to promote the implementation of SBI. Ninety-three healthcare practitioners (primarily physicians, nurses, and social workers) who attended SBI training were asked about their intentions to apply the information in their professional practice, as well as their enthusiasm about recommending the training to others in their profession. Although there were no differences among the professions in terms of commitment to apply the information or level of comfort using the techniques, physicians were less interested in promoting SBI training among their colleagues. Although it may be more difficult to promote SBI in locations that don’t primarily provide mental health services, results suggest that primary care settings are precisely where training may be most useful

ELDER-CAREGIVING AMONG UNIVERSITY EMPLOYEES: RESPONSIBILITIES AND NEEDS

Although many institutions of higher education often house the researchers who study eldercare, few have documented the need for information and services among their estimated 460,000 employees who face the difficult task of effectively balancing work and eldercare responsibilities. Even fewer have established programs to address this need. Drs. Constance Coogle and Edward Ansello have recently completed an exhaustive survey of VCU employees (N = 11,430) to determine the extent to which they provide care to disabled parents or spouses.[1] A longer, more detailed survey was sent to those who indicated that they were eldercaregivers to measure their perceived sense of burden , job-related effects of eldercare, and need for eldercare assistance. Approximately 35% of VCU employees provide some kind of eldercare. The typical eldercaregiving employee at VCU is a 42 year-old, white, married, college-educated female working in a classified position and caring for a mother or mother-in-law. The typical eldercare recipient is a 75 year-old, white, female in fair physical health with occasional memory difficulty and dependent in at least one activity of daily living. More than one-third of the eldercaregivers experience mild to moderate levels of burden and another 20% experience even greater levels of strain. About half of the respondents felt that their eldercare responsibilities interfered with their work responsibilities to some extent. More than half of the eldercaregiving employees suffer from stress on the job and about half feel exhausted at times. The majority of caregivers leave work early in order to tend to their eldercare duties and more than half miss work altogether. About half say that their work productivity is negatively affected, and more than one-third say that the quality of their work is compromised. In general, caregiving employees would like information about the availability of community resources, dealing with caregiver stress, choosing long-term care facilities, selecting public or private insurance, and communicating effectively with health or social service professionals. Institutional programs or policies, such as caregiver seminars, resource fairs, and a family care leave policy would also be helpful. This study documents the pressing need for programs and policies which provide information and services for employees who care for elderly relatives. The need is especially great among those who have the dual responsibility of child care and eldercare, and those who are not married. With the recent creation of the Dependent Care Services office, VCU is beginning to address this problem through the provision of lunchtime seminars, a video discussion series, and the establishment of an Alzheimer\u27s support group. In this effort, VCU serves as an example to other institutions of higher education interested in improving job performance and worker satisfaction by helping their employees more effectively balance their work and eldercare responsibilities. [1] The research was supported in part by the Grants-In-Aid Program for Faculty of Virginia Commonwealth University

Building Interprofessional Teams through Evidence Based Practice Training in Falls Prevention

Objectives 1. Analyze an Evidence Based Practice (EBP) program on falls prevention as a vehicle for successful interprofessional team-building. 2. Examine ways that organizational characteristics can affect team functioning. 3. Compare interprofessional teambuilding in two sites. 4. Discuss elements of interprofessional teams that contributed to practice changes

Enhanced Care Assistant Training to Address the Workforce Crisis in Home Care: Changes Related to Job Satisfaction and Career Commitment

Changes in job satisfaction and career commitment were observed as a consequence of a geriatric case management training program focusing on skills development among personal care attendants in home care. A comparison of pretraining and posttraining scores uncovered a statistically signifi cant increase in Intrinsic Job Satisfaction scores for participants 18–39 years of age, whereas levels declined among the group of middle aged participants and no change was observed among participants age 52 and older. On the other hand, a statistically signifi cant decline in Extrinsic Job Satisfaction was documented over all participants, but this was found to be primarily due to declines among participants 40–51 years of age. When contacted 6–12 months after the training series had concluded, participants indicated that the training substantially increased the likelihood that they would stay in their current jobs and improved their job satisfaction to some extent. A comparison of pretraining and posttraining scores among participants providing follow-up data revealed a statistically signifi cant improvement in levels of Career Resilience. These results are discussed as they relate to similar training models and national data sets, and recommendations are offered for targeting future educational programs designed to address the long-term care workforce shortage

Facilitating Lewin\u27s change model with collaborative evaluation in promoting evidence based practices of health professionals

Evidence based practices (EBPs) in clinical settings interact with and adapt to host organizational characteristics. The contextual factors themselves, surrounding health professions’ practices, also adapt as practices become sustained. The authors assert the need for better planning models toward these contextual factors, the influence of which undergird a well-documented science to practice gap in literature on EBPs. The mechanism for EBP planners to anticipate contextual effects as programs Unfreeze their host settings, create Movement, and become Refrozen (Lewin, 1951) is present in Lewin\u27s 3-step change model. Planning for contextual change appears equally important as planning for the actual practice outcomes among providers and patients. Two case studies from a Geriatric Education Center network will illustrate the synthesis of Lewin\u27s three steps with collaborative evaluation principles. The use of the model may become an important tool for continuing education evaluators or organizations beginning a journey toward EBP demonstration projects in clinical settings

Creating Interprofessional Readiness to Advance Age-Friendly U.S. Healthcare

A successful interprofessional faculty development program was transformed into a more clinically focused professional development opportunity for both faculty and clinicians. Discipline-specific geriatric competencies and the Interprofessional Education Collaborative (IPEC) competencies were aligned to the 4Ms framework. The goal of the resulting program, Creating Interprofessional Readiness for Complex and Aging Adults (CIRCAA), was to advance an age-friendly practice using evidence-based strategies to support wellness and improve health outcomes while also addressing the social determinants of health (SDOH). An interprofessional team employed a multidimensional approach to create age-friendly, person-centered practitioners. In this mixed methods study, questionnaires were disseminated and focus groups were conducted with two cohorts of CIRCAA scholars to determine their ability to incorporate learned evidence-based strategies into their own practice environments. Themes and patterns were identified among transcribed interview recordings. Multiple coders were used to identify themes and patterns and inter-coder reliability was assessed. The findings indicate that participants successfully incorporated age-friendly principles and best practices into their own work environments and escaped the silos of their disciplines through the implementation of their capstone projects. Quantitative data supported qualitative themes and revealed gains in knowledge of critical components of age-friendly healthcare and perceptions of interprofessional collaborative care. These results are discussed within a new conceptual framework for studying the multidimensional complexity of what it means to be age-friendly. Our findings suggest that programs such as CIRCAA have the potential to improve older adults’ health by addressing SDOH, advancing age-friendly and patient-centered care, and promoting an interprofessional model of evidence-based practice