Elsevier

Nurse Education Today

Volume 36, January 2016, Pages 310-317
Nurse Education Today

Qualifications for nurses for the care of patients with dementia and support to their caregivers: A pilot evaluation of the dementia care management curriculum

https://doi.org/10.1016/j.nedt.2015.07.024Get rights and content

Highlights

  • Nursing care for PwD requires a particular qualification of nurses.

  • Currently, the majority of nurses are not adequately qualified for caring of PwD.

  • The modular structure of the DCM curriculum allows to qualify nurses individually.

  • Nurses need to prepare for a cooperation of all stakeholders in the network.

  • The qualification should adequately prepare nurses to support caregivers.

Summary

Background

A substantial increase of people with dementia (PwD) is predicted for the future. Nurses are taking over important tasks to support PwD, which requires a specialized qualification.

Objectives

The aim was to identify points for revision and to further improve the Dementia Care Manager (DCM) curriculum as a basis for probable qualification of nurses caring for PwD.

Design

We conducted a summative evaluation study to revise the first version of the DCM curriculum.

Setting

The study was conducted in the primary health care setting.

Participants

Nurses and lecturers of the first theoretical and practical implementation were involved.

Methods

Questionnaire-based interviews with nurses and lecturers after every module during the theoretical qualification. Besides, nurses rated the curriculum after the end of the theoretical part and evaluated the DCM tasks and the usefulness of the curriculum contents after the practical phase in questionnaire-based interviews. Descriptive statistics were used for analysis.

Results

A total of five nurses and 33 lecturers participated in the first theoretical and practical implementation of the DCM qualification. Generally, nurses and lecturers assessed the curriculum contents as “very important” or “important.” In particular, the job-related issues, the variety of course topics and the close combination of theory and practice were highly valued. The practical implementation of the DCM was rated predominantly as “important” by nurses for the delivery of care for PwD. To optimize the theoretical DCM curriculum, participants suggested increasing the number of lessons for two of the modules (gerontopsychiatry, interdisciplinary case reviews). Furthermore, nurses preferred a longer practical phase, whereas some lecturers called for larger group sizes of participants.

Conclusions

The DCM qualification enhances nurses’ competencies to care for PwD. The curriculum regards an interprofessional, cooperative team approach as the potential to improve health care supply for demented people and to better support their caregivers.

Introduction

Due to the increasing number of elderly people, a substantial rise in the number of people with dementia (PwD) is predicted for the future. A high proportion of PwD require assistance in nursing care and support (Weyerer, 2005). Since many caregivers also need support in caring for their relatives with dementia, the role of the nursing profession in caring for PwD and their relatives will become ever more important. However, managing PwD in the primary health care setting requires a further, specialized qualification for nurses. In addition to their vocational training, nurses need to acquire skills for the specific field of work in the ambulatory, network-based care for PwD. This stresses the importance of advanced training options focused on dementia, with the aims to improve the care for the PwD and to support the caregivers. Currently, there are a range of advanced training options in dementia but the majority focused on specific aspects for caring of PwD (e.g., case management, communication, or nursing interventions). An advanced training option, which addresses all aspects of dementia care management in primary care (e.g., diagnostic, medical and non-medical therapy options, nursing interventions, case management, inter-professional cooperation), is still missing. Such training requires transparent cooperation of all stakeholders in the network, as well as close cooperation between nurses and the general practitioners. While general practitioners supervise diagnostic measures and treatment, nurses should take over a coordinating function. They analyze the nursing care, medical, and social needs and identify existing deficits. Primary tasks include (1) an assessment of the domestic care situation, (2) need assessment of PwD, (3) support needs of the caregivers, and (4) monitor PwD and their caregivers. Further tasks include prevention measures to delay the progression of dementia and to mitigate its consequences for the PwD’s daily life. Based on their specialized dementia competencies and detailed knowledge about regional care and support options, nurses should coordinate an individual care plan for PwD and their caregivers. Apart from general practitioners, the following professions need to be involved: specialists in neurology, specialists in psychiatry, outpatient care, physiotherapy, ergotherapy, but also social workers, care support points, and support groups.

Section snippets

Background

In industrial countries, dementia is the fourth most common cause of death after cardiovascular diseases, cancer, and cerebrovascular diseases. In 2008, more than 5.2 m people were living with dementia in the US. Caregivers provide care for an average of 16.6 h a day at home (Haupt et al., 2004). Furthermore, if only five percent of the current caregivers are no longer able to support their PwD in a primary health care setting in the US, a significant increase in nursing home places is expected (

Methods

In the evaluation, the following aspects were examined: (a) importance of the tasks of a DCM, (b) importance of the qualification contents, (c) identification of gaps, and (d) suggestions for improvement. The importance of the DCM tasks assessed in order to draw conclusions regarding the need of curriculum contents and qualification hours. The aim was to identify points for revision of the curriculum contents and to further develop the DCM qualification.

Participants

A total of five nurses (n = 3 female, n = 2 male) participated in the first theoretical and practical implementation of the DCM qualification. All participants had completed a vocational nursing training (n = 4 nursing care, n = 1 elderly care), and three nurses had an additional qualification as Nursing Home Managers. All participants had previously participated in advanced trainings related to dementia.

A total of 33 lecturers were involved in the first theoretical DCM qualification. The average age

Discussion

The evaluation study was planned as an integral part of the development of the DCM qualification from the very start. Its ultimate goal was to adequately prepare nurses to best support PwD in a primary health care setting. The summative evaluation concept allows for an overall assessment of the DCM qualification from the different perspective of nurses and lectures. Both nurses and lecturers assessed the curriculum structure and contents predominantly as positive.

This study does have some

Conclusion

The structured evaluation presented in this study renders a Germany-wide implementation of the DCM concept attractive. Currently, the DCM concept is prepared for a model project to implement DCM in routine care in Germany. Thereby, the competition of the DCM qualification will be a precondition for nurses to take over tasks as a DCM. By developing a DCM qualification for the nursing profession and the associated expansion of competencies for dementia care, the health care support for demented

Contributions

Development of the study design: AD, JRT, WH

Data collection: AD

Data management: AD

Data analysis: AD

Data interpretation: AD, JRT, WH

Drafting the manuscript: AD

Critical review of the manuscript: JRT, TE, WH

Funding Statement

The study is funded by the German Center for Neurodegenerative Diseases (DZNE) and the University Medicine Greifswald.

Trial Registration

NCT01401582

Acknowledgments

The developing process and pilot implementation of the DCM curriculum was accompanied and supported by several experts from different fields. These include listed in alphabetical order: Dirk Battermann, Georgia Böwing, Thomas Fiß, Axel Goepel, Siegfried Huhn, Doreen Köster, Andreas Krüger, Daniela Oertel, Christiane Reppenhagen, Andrea Richau, Micheline Richau, Hagen Rogalski, and Jan Erik Waschk.

References (36)

  • J. Lauterberg et al.

    IDA Study- concept und realization of a cluster-randomized study to supply patients with dementia in a primary care setting

    Z. Arztl. Fortbild. Qualitatssich.

    (2007)
  • L. Alushi et al.

    Evaluation of dementia education programs for pre-registration healthcare students—a review of the literature

    Nurse Educ. Today

    (2015)
  • Alzheimer Europe

    The Dementia Carer’s Survey

  • Alzheimer´s Association

    Alzheimer’s Disease—Facts and Figures

  • L.E. Beer et al.

    Communicating with patients who have advanced dementia: training nurse aide students

    Gerontol. Geriatr. Educ.

    (2012)
  • H. Bickel

    Dementia syndrome and Alzheimer disease: an estimation of cases and the annually incidences in Germany

    Gesundheitswesen

    (2000)
  • N. Bortz et al.

    Scientific methods and evaluation for human- and social scientist

    (2006)
  • M. Boustani et al.

    Screening for dementia in primary care: a summary of the evidence for the U.S. Preventive Services Task Force

    Ann. Intern. Med.

    (2003)
  • M. Boustani et al.

    Acceptance of dementia screening in continuous care retirement communities: a mailed survey

    Int. J. Geriatr. Psychiatry

    (2003)
  • M. Boustani et al.

    The challenge of supporting care for dementia in primary care

    Clin. Interv. Aging

    (2007)
  • M. Boustani et al.

    Can primary care meet the biopsychosocial needs of older adults with dementia?

    J. Gen. Intern. Med.

    (2007)
  • A. Bühl

    SPSS 20. Introduction in a modern data analyses

    (2012)
  • C.M. Callahan et al.

    Effectiveness of collaborative care for older adults with Alzheimer disease in primary care: a randomized controlled trial

    JAMA

    (2006)
  • A. Dreier et al.

    Translating task and demands in routine care into a qualification for a Dementia Care Manager

  • A. Dreier et al.

    Dementia Care Manager for patients with dementia: determination of the requirements specification and qualification contents for nurses in the DelpHi-MY study

    Bundesgesundheitsblatt

    (2013)
  • A. Dreier et al.

    Dementia Care Manager for supplying demented patients in a primary health care setting: development of an innovative qualification for nurses

    (2011)
  • T. Eichler et al.

    Dementia Care Management: going new ways in ambulant dementia care within a GP-based randomized controlled intervention trial

    Int. Psychogeriatr.

    (2014)
  • E. Gräßel

    Care giver counselling related to dementia: demands, designs, effects

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