INNOVATION FUND Innovation, Integration, & Implementation Chronic Care and Patient Centred Care SHOWCASE 2016 INNOVATION FUND Innovation, Integration, & Implementation Chronic Care and Patient Centred Care SHOWCASE 2016

Training Health Professionals to Deliver an Intervention Based on Problem Solving Techniques to Informal Caregivers of Clients with Dementia Living in the Community

Chronic Care and Patient-Centred Care

virginia_wesson

Virginia Wesson

vwesson@mtsinai.on.ca

416-586-4800 x 6159

mchiu@mtsinai.on.ca

Sinai Health System, University of Toronto

Highlights

Community based care coordinators can be taught Problem Solving Techniques that they can then apply in their work with carers of family members with dementia. Carers learned to more effectively manage dementia care, experienced reduction in burden and increased capacity to care for their family members at home. Improving carers’ skills may reduce reliance on primary care, psychiatric services and long term care

Abstract

Family carers of individuals with dementia experience high levels of stress and burden. They are a population at risk requiring formal preventive and supportive interventions designed to meet their specific needs. However, the needs of family carers are often overlooked due to a lack of training for health care providers and little evidence to guide practice. Care Coordinators (CCs) of the Toronto Central Community Care Access Centres deliver care directly to clients and carers at home. Visits are often focused on completing a task but it was recognized that CCs could leverage their visits to deliver structured interventions fostering self-care and problem solving skills among carers. Methods: CCs were taught Problem Solving Technique (PST), a tested, structured intervention in which problems are examined systematically, defined explicitly and solutions found. CCs used PST to assist carers in identifying and managing unique caregiving challenges and developing dementia management skills. The use of PST, which involves a collaborative interaction between CC and carer, also might help create a stronger working therapeutic relationship.  Results: The PST grounded care visits were more effective than usual home visits by CCs in improving carers’ sense of caregiving competence and task and emotional coping and in reducing their burden and stress. Conclusions: The project demonstrated that CCs who received advanced training in PST could effectively deliver a PST intervention to carers at home thereby equipping carers to more effectively manage dementia care, decreasing their burden and enhancing their capacity to care for their family members in the community. Improving carers’ skills in dementia care may reduce their reliance on primary care and psychiatric services and prevent premature dependence on institutional care

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