Care Transitins Prgram t Imprve Outcmes fr Peple with Alzheimer s Disease and Related Dementias CARE TRANSITIONS COACHES ALZHEIMER S TRAINING FACILITATOR GUIDE This publicatin has been created by Alzheimer s Greater Ls Angeles. We wuld like t acknwledge the UCLA Health Services Research Prgram in Neurlgy and Partners in Care Fundatin fr their multi-year partnership and engagement in develping, implementing, and evaluating the Care Transitins Prgram fr Peple with Alzheimer s Disease and Related Dementias after Hspitalizatin, supprted by a grant frm UniHealth Fundatin, a nn-prfit philanthrpic rganizatin whse missin is t supprt and facilitate activities that significantly imprve the health and well-being f individuals and cmmunities within its service area. We als acknwledge Jewish Family Services, wh participated in this training prgram. Cpying f this facilitatr guide, in its entirety, is nt permitted withut the permissin f Alzheimer s Greater Ls Angeles. Revisin date: February 2016 1
2016 Alzheimer s Greater Ls Angeles Special thanks t: UCLA Department f Neurlgy Barbara Vickrey, MD, MPH Karen Cnnr, PhD, RN, MBA Michael McGwan, MA Frances Barry, MS, MA, MA Sage Kim, BA, BS Raquel Carbne, MSW Ariga Mvsesia, BS Carline Cntreras, BS Partners in Care Fundatin Jdy Dunn, BS Ester Sefilyan, MSG Care Transitins Caches Alzheimer s Greater Ls Angeles Jennifer Schlesinger, MPH, CHES Debra Cherry, PhD 2
Care Transitins Caches Alzheimer s Training Overview The Care Transitins Caches Alzheimer s Training is a five-hur wrkshp designed t assist care transitins caches as they wrk with caregivers f peple with Alzheimer s disease t help with pst-hspitalizatin transitins. The gal f the training is t increase caregivers knwledge abut the impact f Alzheimer s disease and related dementias n the transitin frm hspital t the cmmunity. The training prvides tls t help care transitins caches as they wrk with family members and ther caregivers wh care fr a persn with Alzheimer s and related dementias. The training includes lecture, vides, activities, and facilitated prmpts. Central t the training is the accmpanying use f the Care Transitins Ntebk: Caring fr Smene with Memry Lss r Alzheimer s After a Hspitalizatin. The training prvides care transitins caches with infrmatin n: Alzheimer s disease Cgnitive, behaviral, and functinal changes that ccur with Alzheimer s Stages f the disease Understanding baseline and when t call the dctr Transitining frm hspital t hme Challenging behavirs IDEA! A strategy t manage challenging behavirs Caring fr the caregiver Alzheimer s Greater Ls Angeles resurces The learning bjectives fr the training are: Distinguish between the stages f Alzheimer s disease Identify red flags f behavir changes that indicate risk fr hspital readmissin Increase knwledge f effective management f behaviral symptms f Alzheimer s disease Utilize cmmunicatin strategies t effectively cach caregivers abut Alzheimer s 3
Materials/Supplies The fllwing materials/supplies will be needed fr the training: Audivisual Supplies General Supplies Participant Materials Cmputer Name badges Sign-in sheet Prjectr Markers (t write n bard PwerPint slides and pads) Speakers Pens Care Transitins Ntebk Easel & easel pads Index cards Pst-training evaluatin Certificates f cmpletin/cntinuing Educatin Hrs (CEs) Trainers are encuraged t review all training materials and activities t be able t set up the activities and materials that supprt the training. It is imprtant t cnsider the unique characteristics f the class cmpsitin prir t the training t best supprt cach learning. 4
Symbls The fllwing symbls are used thrughut the Care Transitins Caches Alzheimer s Training presentatin. Crrespnding clrs are used in the training utline t differentiate direct instructin frm ther frms f learning. VIDEO Vides/vignettes help illustrate, prvide insight, and put a face t training tpics; immediately fllwing a vide, it is helpful t debrief main ideas, relevant tpics, r areas that merit further attentin. During the training, refer back t vides/vignettes s that cncepts can be applied t what was seen. TRY SAYING PROMPT Try Saying prmpts help care transitins caches brach sensitive tpics with family members. Trainers shuld encurage participants t practice saying the prmpts and t find alternative prmpts that are helpful in guiding cnversatins and discussins with families. ACTIVITY Activities help participants apply what they are learning and build team learning. Activities encurage active participatin and prblem slving. Activities shift the fcus f the training frm being didactic t participatry and interactive. 5
Care Transitins Caches Alzheimer s Training Mdificatins/Cnsideratins The training has been designed as a five-hur training, which can ccur in ne day r in tw 2.5 hur segments. If an rganizatin allcates additinal time t the training, mre in-depth discussins can take place, mre thrugh review f activities can ccur, and the trainer will be able t prvide mre detailed examples thrughut the training. If an rganizatin allcates additinal time t the training, case scenaris (vignettes) can be reviewed and discussed at the end f the training. Vignettes are ptinal. Trainers are encuraged t incrprate examples, stries, and vignettes int the training. This helps bring tpics t life, increases relevance, and prmtes applicatin f cncepts. Thrughut the training, reference the Care Transitins Ntebk: Caring fr Smene with Memry Lss r Alzheimer s After a Hspitalizatin. It is imprtant that training participants use the ntebk thrughut the training s they are familiar with the cntent. It is imprtant that breaks are built int the training. Breaks are nt predetermined because each rganizatin will structure the training differently. The trainer needs t allw time fr participants t take breaks. This will facilitate learning and make the verall training mre prductive. The trainer shuld utilize cncepts f adult learning thrughut the training t maximize effectiveness. Principles f adult learning that shuld be integrated thrughut the training, include: Dialgue (facilitate sharing life experiences and insights; participants will benefit frm hearing frm their peers/clleagues) Respect (appreciate the cntributins and life experiences f participants; cnnect existing knwledge t learning bjectives) Relevance t previus experience (make cnnectins t what peple already knw r can d) Immediate relevance (participants shuld see hw they can immediately use and apply what they have learned; applicatin f knwledge t jbs is imprtant) Future relevance (participants need t realize the utility f what they are learning fr the future) Active participatin (prfessinals have a depth f knwledge and skills t cntribute t the training; they are nt passive recipients f knwledge) 6
Care Transitins Caches Alzheimer s Training Outline Day One I. Alzheimer s Disease II. Cgnitive, Behaviral, and Functinal Changes III. Stages f the Disease IV. Understanding Baseline and When t Call the Dctr Day Tw V. Transitining frm Hspital t Hme VI. Challenging Behavirs VII. IDEA!: A Strategy t Manage Challenging Behavirs VIII. Caring fr the Caregiver IX. Cmmunity Resurces X. Case Scenari/Vignette (ptinal) XI. Pst-Test Evaluatin 7
Case Scenari/Vignette (Optinal) Lupe is a 78 year-ld wman wh lives with her daughter. Abut tw and a half years ag, Lupe s daughter nticed that her mm was having prblems remembering things and was challenged with day-t-day activities like dressing and bathing. When dctrs asked Lupe hw she was getting alng, Lupe said that she was fine. Nw, Lupe cntinues t have wrsening memry and prblems with activities. She als has cmmunicatin difficulties. She ften has hard time understanding what peple say t her. Lupe generally has a pleasant persnality; she enjys humming tunes and ging fr walks. Hwever, Lupe s daughter sees that her mm smetimes gets mre cnfused and agitated in the afternn. Abut a mnth ag, Lupe started getting aggressive. She was shuting at her daughter and lashed ut physically. Overall, she seemed t be mre cnfused and disriented. Lupe s daughter was cncerned, but thught that her mm wuld imprve in a few days. When she realized that things were nt getting better, she called the dctr. Lupe ended up being hspitalized fr delirium. The underlying cause f the delirium was a urinary tract infectin. Once the infectin was under cntrl, she was discharged t hme with medicatin t treat the infectin. Once hme, Lupe was n lnger aggressive. She stpped lashing ut at her daughter and was less disriented. Discussin Questins Wrk with Lupe s daughter, using the Care Transitins Ntebk, t ensure that she: understands the stage f Alzheimer s Lupe is likely in (and hw this impacts care) takes care f Lupe s pst-hspitalizatin needs, accunting fr the Alzheimer s minimizes the need fr a future hspitalizatin (cach Lupe s daughter abut baseline & recgnizing sudden and unusual changes in thinking and behavir) accunts fr her wn persnal needs 8
Vide Clips (1) Alzheimer s Disease Latest Facts and Figures 2014 https://www.yutube.cm/watch?v=waeuks1-3z4 (2) What is Alzheimer s Disease https://www.yutube.cm/watch?v=9wv9jrk-gxc (3) HBO: The Alzheimer s Prject http://www.hb.cm/alzheimers/the-films.html Nte: Link des nt g t the vide clip; link is t entire vide (4) Department f Veterans Affairs: Delirium Quiet and Excited https://www.yutube.cm/watch?v=zv38u8snjfs 9
Training Evaluatin The Care Transitins Caches Alzheimer s Training includes a pst-training evaluatin (see next page). Evaluatins shuld be cmpleted prir t distributin f certificates f cmpletin/ces. 10
Care Transitins Caches Alzheimer s Training Pst Training Evaluatin Please indicate t what extent yu agree r disagree with the fllwing statements: Strngly Disagree Disagree Nt Sure Agree Strngly Agree 1. I can distinguish between the different stages f Alzheimer s disease. 2. I understand changes that ccur when smene has Alzheimer s disease. 3. I can identify red flag behavir changes that indicate risk fr hspitalizatin and readmissin. 4. I feel cnfident caching caregivers abut identifying red flags and calling the dctr if they see a sudden and unusual change. 5. I understand why transitining frm hspital t hme is unique fr a family dealing with Alzheimer s disease. 6. I feel cnfident caching caregivers abut medicatin management when smene has Alzheimer s disease. 7. I can identify pssible warning signs f pain in smene wh has Alzheimer s disease. 8. I feel cnfident caching families in hme safety when smene has Alzheimer s disease. 9. I understand hw t use IDEA! t manage challenging behavirs. 10. I feel cnfident talking t caregivers abut hw they can use IDEA! 11. I understand the imprtance f prviding supprt t caregivers wh are caring fr smene with Alzheimer s disease. 12. I can identify available resurces at Alzheimer s Greater Ls Angeles fr families. 11
Strngly Disagree Disagree Nt Sure Agree Strngly Agree 13. Overall, I was satisfied with the training. 14. I wuld recmmend this training t thers. 15. The presenter was effective. 16. I learned smething new. 17. I learned smething I can use. 18. What did yu like best abut this training? 19. Hw can this training be imprved? 20. Other cmments: 12