Dementia Education and Training in Hertfordshire and Bedfordshire : An organisational audit commissioned by Health Education England

This audit established the range of dementia education available to NHS staff, social care staff and GPs across the two counties. It reports on current uptake of training, course content, assessment and accreditation of training. Future commissioning for dementia education and training might need to consider i) who in the workforce needs to be targeted, ii) whether or not there should be different sets of competencies for various professional groups, iii) accreditation that leads to recognised steps of progression; iv) joint commissioning of health and social care to deliver dementia education and trainin

The prevalence and practice of self-injury: a sociological enquiry.

The widespread practice of non-suicidal self-injury suggests that it might no longer be reasonable to frame such behaviours as individual pathologies and highlights the need to understand such acts as sociological phenomena instead. This dissertation therefore explored the core elements of self-injury such as the self, the body, and meanings ascribed to acts of injuring the self/body, in relation to forms of sociation. Focusing on intent and aetiology, this qualitative enquiry used an interpretive mode of explanation, and collected data via indepth face-to-face interviews from a characteristically diverse community sample of fifteen participants. Findings indicated that respondents' aetiologies of self-injury were located in social interactions characterised by abuse, neglect, bullying, and invalidation. Individuals who perceived themselves as worthless and unlovable objects punished themselves, or branded themselves as failures. Paradoxically, sufficient castigation averted the complete annihilation of the existential self. Findings concur with previous studies which reported that, at its deepest level, self-injury is antithetical to suicide. This study also highlighted the body's communicative role in the symbolic expression of traumatic experiences, and emphasised its physiological role in (a) emotion regulation and (b) self-injury's propensity to become addictive. From a sociological perspective, instant emotion regulation via self-injury allowed individuals to avoid social stigma; well managed social performances in turn protected social bonds. Although self-injury constitutes a maladaptive coping mechanism, its reported physiological, psychological and social gains are significant and need to be considered in intervention programmes and policy. This dissertation therefore makes two recommendations: firstly, restorative practices should be reinstituted, particularly in schools; secondly, the growing and alarming trend of copycat behaviours reported in children and young teens needs to be researched further in relation to the mediation, ideation and imitation of self-injurious behaviours

Workforce development in dementia care through education and training: an audit of two counties

This is a pre-copyedited, author-produced PDF of an article accepted for publication in Journal of Mental Health Training, Education and Practice, following peer review. The version of record, Andrea Mayrhofer , Claire Goodman , (2016) "Workforce development in dementia care through education and training: an audit of two counties", The Journal of Mental Health Training, Education and Practice, Vol. 11(2): 112 - 121, is available on line at doi: http://dx.doi.org/10.1108/JMHTEP-04-2015-0015Abstract Purpose – People with dementia require care at home, in care homes and in hospitals, which has implications for the current and future workforce in health and social care. To inform regional workforce development planning in dementia care, Health Education East of England commissioned an organisational audit of current dementia training at NHS Trusts and in social care across Hertfordshire and Bedfordshire. The paper aims to discuss this issue. Design/methodology/approach – Qualitative methods and non-probability purposive sampling were used for recruitment and data collection. The audit included NHS Trusts, local authorities, clinical commissioning groups, and health and social care organisations involved in commissioning and providing dementia education and training in the two counties. Findings – Whilst there was considerable investment in dementia awareness training, learning was not targeted, assessed or structured to ensure on-going professional development. Practical implications – This has implications for workforce development and career-progression for staff responsible for the care of older people with dementia. Conclusion: if a future workforce is expected to lead, coordinate, support and provide dementia care across health and social care, a qualifying curriculum could play a critical part in ensuring quality and consistency of approach and provision. Originality/value – This paper makes a timely contribution to discussions on the skills and competencies needed to equip the future workforce for dementia care across health and social care. Keywords Education, Workforce development, Training, Ageing societies, Dementia care Paper type Research paperPeer reviewedFinal Accepted Versio

Evaluation of the End of Life Care Train the Trainer (TTT) Education Model

Final Published versio

Establishing a community of practice for dementia champions (innovative practice)

Andrea Mayfhofer, Claire Goodman & Cheryl Holman, 'Establishing a community of practice for dementia champions (innovative practice), Dementia, Vol. 14 (2): 259-266, first published online 14 July 2014, available at doi:10.1177/1471301214542534 Published by Sage. © The Author(s) 2014.This discussion paper considers the currently evolving roles of dementia champions and describes an initiative designed to support their activities. The aim of this initiative was to establish a county-wide group that has a shared group identity and sufficient critical mass that is able to identify and implement dementia training and development needs for the health and social care workforce. The approach used to achieve this aim was a Dementia Champion Community of Practice Project, which involved dementia leads in various NHS Trusts. Whilst this approach might be effective at practitioner level, the Dementia Champion Community of Practice Project experience suggests that if such initiatives are to be sustainable they need to be strategically placed within networks that can bring together service providers, educators and commissionersPeer reviewe

The role, remit and training needs of Dementia Champions : Results from an online survey

Background: Dementia Champions play a critical role in implementing the goals of the National Dementia Strategy. Whilst there is no common definition of what a Dementia Champion is, their role is often to act as change agents in improving the experience, care, treatment and outcomes for people with dementia, their families and carers. This can be in general hospitals, community and long term care settings and at the interface between hospital and community services. Professionals and clinicians across Health and Social Care have taken up the role of Dementia Champion in addition to their existing responsibilities. Aim: The first part of the Project was completed in 2014. In its second phase the Project focused on exploring how Dementia Champions perceived their role, its remit, and which training they thought they would need in order to meet the needs of people living with dementia and to co-ordinate their care in various clinical contexts. Methods: An online survey was conducted. Findings: Most perceived dementia awareness training as useful, but limited. Areas for further development were context specific skills training, education programmes that were formally recognised, and clarification around the expectations of the role. Conclusion: Expectations of ‘champion roles’ in dementia need to be re-visited, specifically in relation to the remit of the role and the level of education, preparation and support required for DCs to become change agents in dementia care.Final Published versio

Living with young onset dementia: Reflections on recent developments, current discourse, and implications for policy and practice

© The Author(s) 2020. Published by Cambridge University Press. This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.Recent research on young onset dementia (formal diagnosis at age <65) evidences emerging work around pre-diagnosis, diagnosis and the need to improve post-diagnostic support for this group. An increased awareness of young onset dementia has led to the establishment of peer-support groups, support networks and the involvement of people affected by dementia in research. However, the need to join up services at the systems level persists. Third-sector organisations that offer post-diagnostic support at the communitylevel rely heavily on volunteers. Implications for policy and practice are that community-based commissioning of integrated services between health care, social care and the third sector would go a long way to providing the continuity and stability required in dementia support and care along the illness trajectory. This discussion document was written in collaboration with diagnostic services, the charity sector and conversations with people living with, and affected by, dementia.Peer reviewedFinal Published versio

Community Engagement Evidence Synthesis : A final report for Alzheimer’s Society

Goodman C, Buswell M, Russell B, Bunn F, Mayrhofer A (2016). Community Engagement Evidence Synthesis: A draft report for Alzheimer’s Society. Centre for Research in Primary and Community Care (CRIPACC), University of Hertfordshire, Hatfield, UK. © 2016. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.This report presents a review of the evidence that demonstrates where there is robust evidence for community engagement activities, what is important to think about and consider when planning new or revised activities and additionally outcomes that can inform current work and future service development. We wanted to understand, the dominant approaches to promoting community engagement with and awareness of dementia in the UK, the underlying assumptions/theories about how they work and how impact is assessed. The first phase provided an overview of what is known about community engagement activities specifically focussed on dementia. We found these clustered around the following activities: awareness raising to normalise living with dementia, co-ordination and integration of services to be dementia aware and responsive, promoting inclusion in culture and leisure activities to reduce social isolation, environmental adaptation and, digital technology to support orientation and involvement. We found three key motivations for community engagement that all need to be underpinned by awareness and understanding of dementia. Compassion: ‘we must do something’ driven by concern for the wellbeing of people affected by dementia Utilitarian: ‘we must do something’ driven by practical cost-benefit or utilitarian analysis Rights-based: ‘we should not be excluded’ driven by a social justice/disability rights/citizenship based perspective In phase two, we focused on the proposition that Community Engagement that is grounded in a rights based approach is likely to be more effective in achieving the short and long term goals of the inclusion of people with dementia in their local community and wider society. There is good evidence that empowerment approaches work and are the most sustainable. Participation is key, yet we must remember that presence does not necessarily equate to participation and measuring impact needs to account for this, (for example counting who attends an event or service does not tell you about a person’s involvement or if it is an activity they benefit from and want to do)

The feasibility of a train-the-trainer approach to end of life care training in care homes: an evaluation

This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://​creativecommons.​org/​licenses/​by/​4.​0/​), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://​creativecommons.​org/​publicdomain/​zero/​1.​0/​) applies to the data made available in this article, unless otherwise statedBackground: The ABC End of Life Education Programme trained approximately 3000 care home staff in End of Life (EoL) care. An evaluation that compared this programme with the Gold Standards Framework found that it achieved equivalent outcomes at a lower cost with higher levels of staff satisfaction. To consolidate this learning, a facilitated peer education model that used the ABC materials was piloted. The goal was to create a critical mass of trained staff, mitigate the impact of staff turnover and embed EoL care training within the organisations. The aim of the study was to evaluate the feasibility of using a train the trainer (TTT) model to support EoL care in care homes. Methods: A mixed method design involved 18 care homes with and without on-site nursing across the East of England. Data collection included a review of care home residents’ characteristics and service use (n=274), decedents’ notes n= 150), staff interviews (n=49), focus groups (n=3), audio diaries (n= 28) and observations of workshops (n= 3). Results: Seventeen care homes participated. At the end of the TTT programme 28 trainers and 114 learners (56 % of the targeted number of learners) had been trained (median per home 6, range 0–13). Three care homes achieved or exceeded the set target of training 12 learners. Trainers ranged from senior care staff to support workers and administrative staff. Results showed a positive association between care home stability, in terms of leadership and staff turnover, and uptake of the programme. Care home ownership, type of care home, size of care home, previous training in EoL care and resident characteristics were not associated with programme completion. Working with facilitators was important to trainers, but insufficient to compensate for organisational turbulence. Variability of uptake was also linked to management support, programme fit with the trainers’ roles and responsibilities and their opportunities to work with staff on a daily basis. Conclusion: When there is organisational stability, peer to peer approaches to skills training in end of life care can, with expert facilitation, cascade and sustain learning in care homesPeer reviewe

The role of Dementia Champion in dementia care : Its aspirations, development and training needs (innovative practice)

This document is the Accepted Manuscript version. The final, definitive version of this paper has been published in Dementia Vol. 15 Issue 5, February 2016, published by SAGE Publishing, all rights reserved.Background: The conceptualisation and development of the role of Dementia Champions in clinical practice is on-going, and dementia specific training has a significant impact on the scope of the role. Aim: This survey aimed to elicit Dementia Champions’ views on their role and associated training needs. Methods: Data were collected via an online survey. Findings: Of 188, 34 Dementia Champions (response rate 18%) participated. Most perceived dementia awareness training as useful, but limited. Areas suggested for further development were context specific skills training, education programmes that were formally recognised, and clarification around the expectations of the role. Conclusion: Expectations of ‘champion roles’ in dementia need to be re-visited, specifically in relation to the remit of the role and the level of education, preparation and support required for Dementia Champions to become change agents in dementia care.Peer reviewedFinal Accepted Versio