Dementia Care

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Research Focus

The Research Focus section of the

Australian Journal of Dementia Care

aims to keep readers up to date with the fast expanding field of social, psychological and nursing research

in dementia care. By this we mean every aspect of person-to-person communication, nursing and care practice and organisation, and the influence of all aspects of the

environment. The aim is to provide a channel of two-way communication between researchers and practitioners, to ensure that research findings influence practice and that

practitioners’ concerns are fed into the research agenda. We would like to hear from you, specifically with:

notice of the publication (recent or imminent) of peer reviewed papers with practical relevance to dementia care;

research reports available for interested readers;

requests or offers for sharing information and experience in particular fields of interest.

This section aims to provide a channel of two-way communication between researchers and practitioners in the expanding field of social,

psychological and nursing research in dementia care, including all aspects of nursing and care practice, communication and the environment.

Australian Journal of Dementia Care

October/November 2016 Vol 5 No 5

BPSD: getting good practices

into everyday practice

sing medications to

manage behavioural and

psychological symptoms

of dementia (BPSD)* for

residents in aged care can be

risky, with antipsychotics

especially problematic

(Banerjee 2009; Hollis

et al

2007). Despite evidence of

increased risk of stroke,

cognitive decline and death,

and minimal evidence

supporting their effectiveness

to manage symptoms (see

article p40), these medications

continue to be prescribed

inappropriately.

There are alternatives, with

research highlighting a range

of psychosocial and

environmental interventions

that direct care staff can use

(Spector

et al

2013). However,

in our team’s experience a

working knowledge of these

strategies among care staff

varies, and it can sometimes be

a challenge for teams or

organisations to change their

approach to BPSD

management.

BPSD education program

Knowledge translation (KT) is

about bridging the gap in any

field between what we know

and what we do. It is more

than just giving out

information; from a research

perspective we are also trying

to improve our understanding

of how organisations change –

and the challenges for staff to

deliver care that is the right

mix of clinical experience,

intuition, and science (CIHR

2010; Phillipson

et al

2016).

Direct care staff have an

integral role to play in moving

the KT field forward, yet they

frequently lack a voice and the

power to implement change.

Since 2015 Kim Burns has led

a team of DCRC-based experts

in delivering KT BPSD

workshops around Australia

for direct care staff and health

professionals, based on the

evidence-based document

Behaviour Management – a Guide

to Good Practice: Managing

Behavioural And Psychological

Symptoms of Dementia (BPSD

Guide)

(Burns

et al 2012

) and

associated resources (see box

p62). The workshop content

reflected a review of research-

based knowledge about

managing BPSD to improve the

quality of care for people with

dementia (Spector

et al

2013).

The BPSD education

program partnered with the

NSW/ACT Dementia Training

Study Centre’s (DTSCs)

Knowledge Translation

Program to undertake a pilot

study to evaluate the

effectiveness of the workshops

in remote and regional areas of

NSW and Tasmania and gather

feedback from staff about their

experiences in putting new

learnings into practice. The

free two-hour workshops were

funded by the NSW/ACT

DTSC with the aim of

increasing participants’

understanding of:

• Evidence-based resources

available to assist in the

management of BPSD.

• Potential challenges to

changing practice in

response to evidence and

learnings.

• Evidence-informed

recommendations for more

effective management of

BPSD.

This article summarises the

feedback from 258 workshop

participants, in particular their

experiences in transferring

knowledge of evidence-based

interventions into practice to

better manage BPSD.

Care staff experiences

The workshops were attended

by a participants from a range

of professional roles including,

nursing (27.1%: registered,

enrolled), assistant in nursing/

personal care worker (57.9%),

recreational officer/

diversional therapist (4.6%),

general services (4.6%) and

other, eg allied health,

management (5.8%).

Small group activities

conducted during the

workshops asked attendees to

identify and discuss barriers

and enablers to translating

evidence-based knowledge of

BPSD management into

everyday practice, and

potential ways to overcome

these challenges. Small groups

of four to five were chosen for

the activities to encourage

participants to report their

experiences openly and

honestly. Anonymous

demographic and evaluation

data were collected after each

of the workshops.

Feedback on

workplace changes

Factors discussed below and

summarised in Figure 1 (next

page) outline feedback from

participants indicating that

they frequently found it

difficult to suggest and

implement changes in their

workplace in relation to BPSD

management. While some

participants reported that they

did have opportunities to

suggest changes, they still

found implementation difficult

for similar reasons.

DCRC SPEC I AL I SSUE : THE B I G P I CTURE I N DEMENT I A RESEARCH

KimBurns

Ranmalie Jayasinha

Belinda Goodenough

and

Henry Brodaty

report the experiences of

dementia care staff in putting into practice knowledge of evidence-based interventions for better managing BPSD