Dementia Care

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Vol 5 No 5 October/November 2016 Australian Journal of Dementia Care 59
Aged care policy in Australia
supports the delivery of services in
the community, reflecting the fact
that most people with dementia prefer to
live at home. Despite this, one-in-three
people with dementia in the community
do not access formal services (Access
Economics 2009; Brodaty et al 2005).
Reasons for a lack of engagement with
care services are varied but we do know
that unmet needs are associated with
negative outcomes including nursing
home placement (Gaugler et al 2005).
This illustrates the importance of
ensuring people with dementia and their
carers are connected with a service that is
appropriate to their specific needs and
circumstances.
In order to decide whether a service is
appropriate, you need to understand
what that service is capable of achieving.
However, while there is a need for
quality dementia services in the
community, there is a lack of evidence for
successful programs, suitable outcome
measures and evaluation frameworks in
community-based dementia services
(Low et al 2012). This leaves both carers
and service providers without reliable
and timely information about successful
programs and areas for improvement.
In 2013 our team from the Dementia
Collaborative Research Centres
developed the Dementia SPEAKE
(Service Providers’ Evaluation and
Knowledge Exchange) Program.
Dementia SPEAKE was designed to
address this evidence gap by helping
service providers develop evaluation
skills within their workforce. Dementia
SPEAKE aimed to build confidence with
evaluation design and procedures within
community sector staff.
Building capacity
Previous capacity building efforts such as
The Dementia Services Evaluation
Grants (DSEG) Program (funded by
Ageing, Disability and Home Care,
Department of Family and Community
Services NSW) have provided small
grants to support specific projects. This
approach to building research-related
skills is potentially unsustainable.
Dementia SPEAKE explored a different
approach. Instead of limiting skills
development to small external grants (a
traditional ‘research outcomes’ model)
we sought to directly improve the
evaluation skills and confidence of
frontline community care workers. We
reasoned this type of applied knowledge
would potentially:
• Increase the number of organisations
indicating an intention to routinely
evaluate their services.
• Help care workers identify areas of
interest and need that researchers not
working on the frontline may overlook.
• Enable organisations to evaluate and
answer specific questions about their
service.
Increasing evaluation skills
The Dementia SPEAKE program
included a face-to-face workshop,
written materials and ongoing support
(three months) from experienced
researchers.
A total of 19 care workers from NSW
took part in Dementia SPEAKE.
Organisations represented were mainly
metropolitan (74%), not-for-profit (74%)
and providers of dementia-specific
services (79%).
We assessed the change in participants’
evaluation knowledge and skills by
asking them to complete self-evaluations
before the workshop and then again one
week and three months after the
workshop. Over half of participants
found topics relevant and helpful, and
there was an increase in confidence in
conducting evaluations (58% to 75%).
Almost half (42%) said they anticipated
integrating evaluation into their
workplace.
Barriers to implementing evaluation
methods included other work taking
priority (64%) and lack of technical
support (27%).
The evaluation of Dementia SPEAKE
demonstrated that evaluation knowledge
and skills can be increased in a short
course. However, the ability to apply and
use this knowledge in a time-poor work
environment remains a strong barrier to
adoption of formal evaluation methods.
Accessing the resources
Care workers or organisations interested
in developing evaluation skills can access
the Dementia SPEAKE resources free of
charge in the form of e-Learning modules
from the DCRCs’ new DementiaKT Hub
website ,
under Education and Training).
The resources are designed for people
with little evaluation experience and can
serve as a starting point for those new to
the area or before moving onto more
comprehensive materials. Topics covered
include the evaluation process,
developing evaluation goals and
objectives and evaluation designs,
recruitment and sampling, ethical
considerations, analysing qualitative and
quantitative data, evaluation findings,
and the essentials of an evaluation report.
Through developing resources such as
Dementia SPEAKE we hope to improve
the ability of service providers to feel
more confident in partnering with
agencies like the DCRCs in evaluating
their services and impact. This approach
has the potential to be a cost-effective
way to gather important data about
which community-based services meet
consumers’ needs.
Acknowledgments
Dementia SPEAKE was funded by a grant from
the DCRC Knowledge Translation Small Grant
Scheme.
References
Access Economics (2009) Making choices:
future projections, problems and preferences.
Alzheimer’s Australia. Available at:
/access-economics-reports.
Brodaty H, Thomson C, Thomson C, Fine M
(2005) Why caregivers of people with dementia
and memory loss don’t use services.
International Journal of Geriatric Psychiatry
20(6) 537-546.
Gaugler JE, Kane RL, Kane RA, Newcomer R
(2005) Unmet care needs and key outcomes in
dementia. Journal of the American Geriatrics
Society 53(12) 2098-2105.
Low LF, White F, Jeon YH, Gresham M, Brodaty
H (2013) Desired characteristics and outcomes
of community care services for persons with
dementia: what is important according to
clients, service providers and policy?
Australasian Journal On Ageing 32(2) 91-96.
Dr Megan Heffernan is a Research Associate
with the Dementia Collaborative Research
Centre: Assessment and Better Care (DCRC:
ABC), UNSW Australia; Dr Tiffany Jessop is a
DCRC: ABC Project Coordinator; Ruby Tsang is
a research assistant with DCRC: ABC. To follow
up on this article contact Megan Heffernan at
DCRC SPEC I AL I SSUE : THE B I G P I CTURE I N DEMENT I A RESEARCH
Tools to build care workers’ evaluation skills
Dementia SPEAKE is a series of free online resources to help dementia care
workers develop the skills to formally evaluate their programs and services.
Megan Heffernan, Tiffany Jessop and Ruby Tsang explain