Dementia education for care home workers

Dementia education for care home workers

The Covid-19 crisis has had a disproportionate and devastating impact on care homes, including staff, residents and their families in the UK. Changes in care demands and staff shortages have had a negative impact on the 50% of care-home residents who have dementia and complex care needs. Care-home workers (CHWs), who are generally on low wages, can feel undervalued and have experienced higher levels of psychological distress during the pandemic.

Two adults holding hands
"The pandemic has laid bare long-standing structural deficiencies, including staff education." - Leah Macaden, Fellow

CHWs care for residents with a high prevalence of cognitive impairments in an environment where there is typically a high staff-to-resident ratio. In addition, they are now faced with the reallocation of roles, a reduction in the workforce and a need for ongoing learning to meet the changing demands of the pandemic. There is well-documented evidence suggesting gaps in dementia-specific knowledge amongst health and social care staff, which has intensified the need for an appropriately educated workforce. This need has been recognised as a key challenge throughout the UK, in a number of government reports and strategy documents. There is evidence that an appropriately trained workforce enhances confidence and competence, promoting positive care experiences for both staff and residents in care homes.

Loneliness and social isolation have been exacerbated during the pandemic, impacting on the social and emotional well-being of care-home residents in general. More importantly, for people living with dementia in these environments, opportunities to engage meaningfully with their established routines, including visits by family or friends, have not been possible. Structure, routine and familiarity are vital cognitive ramps that support people living with dementia to make sense of their world. Significant changes can be very difficult to process, resulting in disorientation, stress and distress for care-home residents living with dementia. The pandemic has laid bare long-standing structural deficiencies, including staff education and training affecting the care home sector, which is a vital public service.

Woman standing outside University of the Highlands & Islands Centre for Health Science in Inverness
Leah at University of the Highlands & Islands Centre for Health Science in Inverness, where she works Download 'Leah Macaden_Blog2.jpg'

I am currently developing a resource for blended learning and training of CHWs as trainers on Covid-19 related dementia care priorities. These will be delivered to care home workers, which draws upon my experience and expertise in developing award-winning dementia education and training programmes for nurse education. The Training of Trainers (TOT) Programme: Covid-19 Dementia Education for Care Homes (CODECH) is a project supported by the Churchill Fellowship’s Covid-19 Action Fund. Through my role as a senior lecturer in nursing at the University of the Highlands & Islands, I will be working with the Balhousie Care Group, one of the leading providers of care for older adults in Scotland, to develop CODECH.

Working in collaboration with Lindsay Dingwall, the Clinical Care Quality Manager and her colleagues at the Balhousie Care Group, I will be leading this project with a team of experts to:

  1. Set up an advisory group with stakeholder representation from health, social care, higher education, family carers, pedagogy and education technology. We have had recent expressions of interest from academics at the Faculty of Health Sciences, OsloMet University in Norway, and a colleague from the care-home sector in the north-east of England, to join our advisory group.
  2. Support the development of three web-based workbooks with a tailored approach to CODECH that is aligned to Scotland’s Promoting Excellence Framework.
  3. Adopt an integrated approach that uses both workbooks and virtual interactive sessions and gather feedback afterwards. Twenty CHWs from the Balhousie Care Group will be trained as trainers who will then cascade the training within their organisation.

This will require partnership, collaboration and commitment from everyone involved. Findings from this project will provide us with valuable insights on a blended approach that we will adopt for the first time and train a pool of trainers. The proposed training programme will include a comprehensive range of topics with relevant practical insights to support people across all stages of the dementia journey. Teaching and learning methods will include virtual training sessions supported by three web-based workbooks, reflections and peer supported discussions.

Empowering care-home staff with a systematic approach to dementia education and training that is transferrable to other aspects of care of older adults is perhaps the way forward to raise the profile of dementia care excellence in care homes. This needs to be built in as part of CHWs’ Continuing Professional Development (CPD) with mentoring and support as required.


The views and opinions expressed by any Fellow are those of the Fellow and not of the Churchill Fellowship or its partners, which have no responsibility or liability for any part of them.


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