C.A.R.E.R. Tool for Responsive Behaviours: The development of an App and E-learning Modules for formal and informal caregivers
Quality Improvement & Outcomes
The Baycrest-Quick-Response Caregiver Tool (BQRCT) (formerly C.A.R.E.R Tool) was developed as an online educational tool to assist caregivers of persons with dementia (PWD) who exhibit responsive behaviours. A previous AFP project conducted in Year 9 demonstrated high utility of and satisfaction with the tool through both quantitative and qualitative feedback by family caregivers and healthcare providers. The purpose of the current project was to validate the findings of the previous study through increased recruitment of caregivers. A total of 33 family caregivers were recruited, of which 21 caregivers completed the study and provided feedback on BQRCT. Caregiver feedback validated the findings of the Year 9 AFP project and demonstrated that caregivers found the tool helpful, practical, and easy to navigate. The secondary purpose of the project was to make BQRCT public on the Baycrest website and to track usage metrics of the webpage. Usage metrics showed that the webpage received 5,649 views globally over a 36-month period. This project demonstrated that the BQRCT is a feasible educational tool and its presence on the Baycrest website ensures it is accessible to caregivers, healthcare providers, and individuals who need support in managing responsive behaviours.
The feedback from Behavioural Supports Ontario is that the tool is being used quite frequently with caregivers and there is consideration to make it part of the toolbox. The World Health Organization took interest in the BQRCT and the team was asked to submit it to the Global Dementia Observatory Knowledge Exchange Platform. Per the request, “The Platform was developed to support policy-makers and programme implementers in enhancing countries’ response to dementia by providing a space where they can find key resources that can be used to support the strengthening of policies, as well as health and social care systems, and evidence-based planning.” It is currently in the review process.
The online tool and videos have been translated into Spanish, Greek, Urdu, Bengali, Mandarin, and Cantonese. The results were published in the Canadian Geriatrics Journal and presented internationally.
The C.A.R.E.R tool was re-named to The Baycrest-Quick-Response Caregiver Tool (BQRCT). This tool was developed as an online educational tool to assist caregivers of persons with dementia who exhibit responsive behaviours. BQRCT comprises four training videos, a pocket guide, and an instruction manual and focuses on the emotional and cognitive responses of caregivers to facilitate improved empathic interactions and manage responsive behaviours.
The purpose of the current study is to increase recruitment in order to validate the findings from the Year 9 AFP project. The second purpose of the study is to make the tool accessible to all caregivers and healthcare providers through an online platform and to collect usage metrics for the webpage.
In a previous AFP project, 25 caregivers were recruited and 14 completed the study. In addition, 18 healthcare providers were recruited and completed the study. In the current project, we increased caregiver recruitment numbers to 33, and 21 caregivers completed the study. Family caregivers were recruited and were asked to complete pre-post (4 weeks) surveys. Usage metrics for the public webpage were collected for three years, starting on March 10th, 2018 and ending on March 16th, 2021.
Out of 33 caregivers who were recruited, 21 completed the study. At pre and post, caregivers’ self-rated health outcomes on validated tools that measured depression, stress, burden, competence, distress, and perceived change remained stable. Overall, caregivers reported high feasibility scores for BQRCT, and that tool positively impacted their compassion towards the PWD. Between March 10th, 2018 and March 16th, 2021, the webpage received 5,649 visits, of which 2,459 were unique webpage views. Viewers accessed the webpage from around the world, including from Canada, the United States, India, Israel, Australia, the United Kingdom, and Finland. The four videos received 282 total views, with each video receiving between 59-80 views. The online tool and videos have been translated into Spanish, Greek, Urdu, Bengali, Mandarin, and Cantonese. The results were published in the Canadian Geriatrics Journal and presented internationally.
The BQRCT was found to be feasible and scalable. Caregivers with high levels of stress and burden found the training tool to be helpful. BQRCT can be used as an educational training tool to allow caregivers to access the tool as they need, and to build their capacity in managing responsive behaviours. Its accessible online platform is especially useful for caregivers who are unable to seek in-person help. Future studies could follow caregivers through a longitudinal study to explore the utility of BQRCT over time, and study the tool in long term care (in progress).
A Novel Instrument for Caregivers in Managing Neuropsychiatric Symptoms of Dementia: Baycrest Quick-Response Caregiver Tool TM. Canadian Geriatrics Journal CGJ.. 25(4):368-374, 2022 Dec. Madan R; Natadiria M; Berall A; Santiago AT; Schwartz K