All care staff need hands-on training in order to effectively provide person-centred care, says a consultant who delivered ‘experiential’ workshops to a provider’s 580 frontline staff.

Aged care organisations need to invest in whole-of-workforce training delivered directly to all frontline workers, rather than sending individual staff members off on education courses, providers have been told.

Catherine Brown, a nurse practitioner, consultant and trainer, said that if providers were serious about truly person-centred care they needed to consider “the impact of a critical mass approach” to their staff training.

Ms Brown, who was recently engaged by Catholic Community Services NSW/ACT to deliver “dementia experiential workshops” to 580 of its frontline staff, said that sending a care coordinator or manager off for a short course is “just not going to cut it.”

“I’m a bit tired of people pontificating about person centred care models when we know frontline staff are still illness focused, task focussed and inflexible,” Ms Brown told the Australian Association of Gerontology (AAG) national conference last week during a presentation on the experiential learning.

“If you really seek change to organisational culture, please reconsider the impact of a critical mass approach, using your staff as change agents but also taking along the leaders on the journey,” she said.

CCS was committed to ensuring care staff were equipped to provide person-centred care for people living with dementia, said Ms Brown, who developed an evidence-based framework to guide the provider.

The framework got underway with the series of mandatory, three-hour workshops delivered to all community care and support staff, including frontline care workers, bus drivers, administration staff, policy officers as well as managers and senior managers. In total 38 workshops were delivered across NSW, with 10 to 24 staff per session, Ms Brown said.

The workshops, which Ms Brown described as “very confronting and intimidating”, included an experiential simulation session.

The goals were for staff to experience the feelings of living with dementia, describe the emotions a person may have, identify work practices that enabled people with dementia, and learn how to respond to reduce distress.

During the sessions, staff members were given multiple tasks that were largely unachievable, they wore large labels around their necks, and they were rushed and harassed, Ms Brown said.

“For an individual, stepping into the shoes and the skin of someone living with dementia really does turn a light bulb on; we see it happening right there.”

During a debriefing session, which followed the simulation, staff discussed their feelings – commonly using words such as violated, degraded and belittled – as well as their behaviours – often hiding away from the group or simply agreeing or complying.

“Labelling was a huge part of the training sessions; using the large labels to hang around their necks instigates a lot of discussion during the debriefing session,” said Ms Brown.

She referred to one staff member who during the debriefing said he would rather have had the ‘incontinent’ label as it carried less stigma than dementia.

Follow-up evaluations with participants found that the majority described the experiential session as having a useful impact, even if they felt negatively about the experience itself, Ms Brown said.

“They said it was really tough, they didn’t enjoy parts of it, but they really get it now – that was the takeaway message,” she said.

Importantly, she said that CCS had committed to ongoing training as part of the framework, with further education sessions, mentoring and the development of tools and resources to maintain the learnings from the workshops.

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1 Comment

  1. BRAVO! Mrs Brown.

    I too recently was engaged by the CCS NSW/ACT to do the exact same training program to all direct care staff in a different subject. It is wonderful to have an organisation that has focused on frontline staff and in my case combined face to face with flexible online learning to ensure all staff were engaged and competent at the outcome.

    Learning and Development is not just TRAINING! it includes multiple delivery modes and contextualised contents, and it includes mixed classes and multi disciplined teams learning together with holistic knowledge that builds teams, cohesion and communication.

    Aged care and community services has a long way to go before it actually gets the strategy right when it comes to educating its people. Part of this is the fact that many organisations are busy trying to create their own courses and materials and deliver the outcome their own way and different to everyone else and trying to achieve this goal as cheap as humanly possible.

    Another issue is trying to educate competency in critical learning such as behaviours, ADL’s, Medications, continence etc etc and not being able to use real clients/patients or people.

    We are told to invest in SIM labs and SIM Dummies that replicate the scenario. To which we do at great cost and at a cost that the industry is not prepared to meet given that much of this “training” s for care workers.

    We are not able to film real scenarios or the elderly that are frail and vulnerable due to (abuse, neglect, dignity etc), but I can not get a SIM Dummy to act and create the situations that carers and staff face every day. I can not demonstrate what is disinhibition, object agnosia or apraxia condition and many other behaviours that challenge the care staff daily.

    We really have to examine what it is that makes the best practice of training people who work very closely with people in very complex scenarios. What is the best mechanism, what is the best solution, what is the impact of cost.

    Currently it costs an organisation the time off the floor to attend, the time for someone to be replaced on the floor , the time for allocated training, and the cost for educators experts and equipment. There are better ways to deliver high quality learning and development, learning pathways and their specific contents, and there are aged care learning and development experts in the industry.

    Perhaps a round table and open discussion should be undertaken by the NACA, so they can drive some more changes needed in the sector.

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