International perspectives on dementia education, training and knowledge transfer: Guest Editorial

Dementia is on the rise and, as a result, the aged care workforce has an increasing need for up-to-date information on how to care for people living with dementia. While dementia research continues to mushroom, any research findings that have practical implications also need to be passed on to those at the coalface of dementia care as quickly as possible. This Supplement brings together a number of papers that have addressed various perspectives on dementia education, training and knowledge transfer in the U.S.A., U.K. and Australia

What is the role of a case manager in community aged care? A qualitative study in Australia

This study aimed to explore the perceptions of case managers about their roles in providing community aged care in Australia. Purposeful sampling was used and 33 qualitative semi-structured interviews with 47 participants were conducted. Participants were drawn from a list of all case managers working in aged care organisations that provided publicly funded case-managed community aged care programmes in the State of Victoria, Australia. Participant selection criteria included age, gender, job titles, professional backgrounds, practice locations, organisational attributes and organisational size. Data collection was implemented between September 2012 and March 2013. Thematic analysis was performed. Participants believed that case managers performed diverse roles based on clients’ needs. They also articulated 16 important roles of case managers, including advisors, advocates, carers, communicators, co-ordinators, educators, empowering clients, engaging clients and families, liaising with people, managing budgets, navigators, negotiators, networking with people, facilitators, problem solvers and supporters. However, they were concerned about brokers, mediators and counsellors in terms of the terminology or case managers’ willingness to perform these roles. Moreover, they perceived that neither gatekeepers nor direct service provision was case managers’ role. The findings of this study suggest that case managers working in community aged care sectors may be more effective if they practised the 16 roles aforementioned. With the value of helping rather than obstructing clients to access services, they may not act as gatekeepers. In addition, they may not provide services directly as opposed to their peers working in medical care settings. The findings will also assist organisations to design job descriptions specifying case managers’ roles and associated job responsibilities. Clear job descriptions will further benefit the organisations in staff recruitment, orientation and ongoing development, as well as facilitate case managers to set professional boundaries in the delivery of case management interventions to their clients

The relationship between apathy and participation in therapeutic activities in nursing home residents with dementia: Evidence for an association and directions for further research

Apathy is one of the most frequent and early symptoms of dementia. Because apathy is characterised by lack of initiative and motivation, it leads to considerable burden being placed on carers to ensure that the person living with dementia has a reasonable quality of life. The aim of this study was to investigate the relationship between apathy and participation in therapeutic activities for older people with dementia living in nursing homes. Ninety residents were recruited into the study, and apathy was measured by nursing home staff using the Apathy Evaluation Scale Clinician version. Staff also compiled data on each resident’s involvement in therapeutic activities. Among this sample, the mean age was 84.8 years, and mean length of stay in the nursing home was 1.8 years. The mean apathy score was 50.4, indicating that on average the residents had a moderate level of apathy. Overall, residents participated in six activities per week and those residents who were involved in the most activities had the lowest levels of apathy. This paper provides evidence that residents involved in therapeutic activities have lower levels of apathy. Further research should be conducted on the direction of causality, whether apathy levels can be changed through participation in therapeutic activities, the relationship between dementia severity and modifiability of apathy, and the intensity of therapeutic activities required to maintain functioning

Victorian farmers' and other rural outdoor workers' skin cancer prevention knowledge and practices

Farmers and other rural outdoor workers are a high-risk group for skin cancer. This study aimed to describe the skin cancer prevention knowledge and practices of farmers and other rural outdoor workers in the Wimmera and Gippsland regions of Victoria. In total, 366 farmers and 140 other rural outdoor workers completed questionnaires at agricultural field days. Most respondents believed that they were at risk of developing skin cancer and had high levels of knowledge regarding the issue, yet farmers' prevention practices were less than optimal (particularly in terms of the low percentages reporting usually or always using sunscreen (21 %) and wearing long-sleeved shirts (20%)). A targeted campaign could focus on overcoming the barriers to using sun protection specific to the farming profession (in particular, to encourage farmers and other rural outdoor workers to wear sun protective clothing where it is practical and safe, and to incorporate sunscreen use into their daily routine)