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PHI Trains Home Care Workers in Dementia Care

December 21, 2013

Anyone who has ever cared for a loved one living with dementia knows what a struggle it can be, both emotionally and physically. Home care workers, too, feel the range of emotions of caring for elders living with dementia.

In recent months, PHI, in collaboration with The Harry and Jeanette Weinberg Foundation and the UJA-Federation of New York, has been piloting a two-day specialty training for home care workers that focuses on caring for clients with dementia.

At a training held in early December in the Bronx offices of PHI affiliate Cooperative Home Care Associates, 16 home care workers from three local agencies learned valuable skills that will help them to better respond to the unique challenges that dementia clients can present. (All told, approximately 1,000 home care workers will receive entry-level or specialty training through the project.)

The training was designed for home care workers of all skill levels. Not all of the participants in the adult learner-centered training had ever cared for people living with dementia, while others had done so many times. In this particular training, learners’ on-the-job experience ranged from four months to nearly four decades.

One of the major themes of the training as a whole was that home care workers must learn to separate the condition from the person. That is, they must constantly be aware that people living with dementia may say or do things that they are not accustomed to hearing or seeing — for example, they may unexpectedly lash out at their caregivers, either verbally or physically (or both). It is vital to remember that people living dementia still have teh same basic human needs that must be fulfilled regardless of the path of the disease.

Co-trainer Florence DeVore, an RN and consultant, told learners that caring for people with dementia is “not always about you — it’s about dementia and the impact it’s having on your client.”

At that point, a learner asked, “Most of the time you shouldn’t take things personally?” Florence was emphatic with her response: “Don’t take it personally.”

Later, co-trainer P. Afeefa Murray, a PHI Organizational Change Consultant, detailed several approaches that learners can use if they find themselves challenged by a particular client. For example, she explained the importance of “validation.” With validation, home care workers honor clients’ choices, even if they do not seem to make objective sense. If a client with dementia wants to go outside to look for her lost cat, her care worker can take her for a walk around the block — even if the worker knows that her cat died years ago.

These approaches do not constitute some sort of “magic formula” that will somehow undo the effects of dementia, Afeefa emphasizes. Rather, they should be looked at as tools to work with — if one approach isn’t working out, try a different one.

“You have a difficult job,” Afeefa told the learners. Methods such as validation present “a way of shifting your thinking toward what’s possible, rather than saying ‘I’m stuck.'”

Learners were also taught that they have a responsibility to observe different behaviors in their clients and report them to the proper people (e.g. their nurse, doctor, and/or family members). “Basically, you’re the detective and you’re passing that information on,” Florence said.

Florence and Afeefa also taught learners the importance of empathy when caring for people living with dementia. “Put yourself in their place — how would you feel?” Afeefa said. “Forcing” clients living with dementia to do something they don’t want to do — even if it’s an activity of daily living (ADL) — can feel like abuse to the client. Home care workers must be aware of that aspect of living with dementia, and must listen to the cues the client is offering.

“It’s not about you. It’s all about the person,” Afeefa said. “What they’re feeling, thinking, experiencing. And you can’t change the person: You can only change how you respond to them.”

The dementia training is part of the Homecare Aide Workforce Initiative (HAWI), a $3 million training and workforce development project that will run through the end of 2014. In addition to the 16-hour dementia training, PHI will design and conduct three other specialty trainings as part of HAWI.

More information about HAWI is available at the PHI Direct-Care Workforce News blog.

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