Originally published in AJDC April May 2018 Vol 7 No 2
In 2016, Dementia Training Australia (DTA) was charged with delivering a three-year, $28 million national Dementia Training Program to the dementia care workforce. DTA’s Directors* explain how the consortium’s training and education activities will reach a minimum of 23,000 staff and at least 500 care services over the next two years
“There comes a point where we need to stop just pulling people out of the river. We need to go upstream and find out why they’re falling in.” Desmond Tutu
This quote has been something of a guiding principle for Dementia Training Australia (DTA) since our early days as a national consortium. We know that today’s problem/task orientation to caring for people living with dementia and their families, deeply embedded by previous models of training, is not working for the benefit of residents, patients or staff.
So how can we change this? There is no easy answer, of course, but we are confident that we have developed a model of training delivery that improves the well-being of staff as well as people living with dementia.
Dementia Training Australia is working with aged care provider Scalabrini to provide a Tailored Training Package, including training for staff working at its new care community for people with dementia, The Village, in Sydney. Photo: Scalabrini
DTA is funded by the Federal Government to provide dementia education and training across Australia. We are combining the dementia expertise of five universities and Dementia Australia to deliver a coordinated national approach to dementia training for individuals and organisations.
We are keenly aware that our brief is not just about education and training; in a way, that’s the easy part. We are focused on knowledge translation; striving to move beyond increasing the knowledge base of staff through training, to grapple with the challenging issues around how to achieve adoption of new knowledge into practice in a sustainable way and improve delivery of care.
Earlier this year we submitted a strategic plan to the Department of Health outlining our vision, mission and strategy. The plan puts knowledge translation at the core of our offering. A combination of this commitment to knowledge translation and a ‘salutogenic’ approach – a focus on factors that support health and well-being, and opportunities for a person with dementia to live a full life – is what sets us apart.
Courses and resources
Over the next two years DTA training and education activities will reach a minimum of 10,000 professional staff and 13,000 vocational staff. We will work closely with the managers and staff of, conservatively estimated, 500 health, community and aged care services. Our publications, online courses and resources will be used by 25,000 people engaged in improving their dementia literacy and skills.
We deliver education and training across four streams: CPD training on dementia for GPs, nurses, pharmacists and other specialists, delivered via courses and workshops; vocational level training (Dementia Essentials); online training; and training that is tailored to the assessed needs of aged care providers who are willing to work with DTA for a period of time to implement practice changes and evaluate outcomes.
This last point captures the development and delivery of Tailored Training Packages (TTPs), which allow us to get alongside aged care organisations, really understand their needs and circumstances, and tailor training to meet their goals. The ultimate goal is for these organisations to adopt knowledge into practice in a sustainable way, with real improvements for people living with dementia and the staff who care for them.
This is where our work has, we believe, the most potential in allowing us to “go upstream”, in Desmond Tutu’s words, and find out why both these groups of people are so often falling into the river.
TTPs are a package of courses, services and resources developed to meet the unique needs of an organisation. TTPs incorporate environmental design and staff training, with structure and content being informed by an environmental audit carried out alongside a training needs analysis.
TTPs require substantial commitment on the part of organisations that are ready and willing to invest in systemic change. For some TTPs we offer Fellowships – a coaching partnership in which we work within an organisation to facilitate knowledge transfer and practice change, and develop the leadership skills of staff.
Knowledge into practice
Fellowships within several TTPs in Victoria have resulted in the successful translation of knowledge into practice in areas such as responsive behaviours, staffing models and supporting residents’ families.
The TTP model recognises that improving staff knowledge is not enough; there needs to be a corresponding attention to sustainable capacity building within an organisation to bring about practice improvements (real change). This may involve activities and tools that reinforce learning, and workplace review of systems and policies to ensure that staff can practise their new skills in a supportive work environment.
TTPs honour the principle that the delivery of best practice dementia care requires a commitment to systematic knowledge translation – bringing together the expertise of trainers and service deliverers who work together in close collaboration.
Already there are some great examples of what can be achieved when we come together with change-ready organisations.
Earlier this year, aged care provider Scalabrini opened a state-of-the-art, culturally specific community for people with dementia. We collaborated with the Scalabrini team on the environmental design principles of The Village and we are now working with them on the other vital component of a TTP – staff training.
Another example is Illawarra-based IRT which, as a very early adopter, is now rolling out TTPs across its 19 care centres. In Queensland, a TTP at Maryborough Hospital has resulted in a deeper understanding of dementia among interdisciplinary teams, and hospital staff taking a more person-centred approach to patients with dementia.
In Western Australia, Baptistcare is undertaking TTPs at a number of its sites.
All these organisations are willing to look beyond ‘tick the box’ training, and invest in systemic change. Because it is an investment. There are many more organisations willing to take this path as well; there are currently more than 200 TTPs in progress across Australia.
This work has potential for real and lasting change. While we are a long way from the aged care sector as a whole embracing the value of education and investing in training its people, there are stories of hope and evidence of a shifting paradigm. Change is possible, and it’s all around us.
*This article is co-authored by DTA Executive Director Professor Richard Fleming (University of Wollongong) and DTA Directors Professor Elizabeth Beattie (Queensland University of Technology), Dr Margaret Winbolt (La Trobe University), David Sykes (Dementia Australia), Dr Andrew Stafford (University of Western Australia) and Professor Andrew Robinson (University of Tasmania)