Equipped to care: Training care home staff to meet the needs of people with dementia

It's a staff training day at Manton Heights Care Centre in Bedford, as people who support residents with dementia attend a course called 'Responding to distressed behaviours'.

Provided by Alzheimer's Society, the course helps staff to recognise when people at the care home are distressed, identify what might be triggering it and find better ways to support them. It also looks at how damage to the brain caused by dementia might affect someone's behaviour.

Attending today are care assistants, healthcare assistants and senior healthcare assistants, who all completed a more basic course the previous week with the same trainer, Caroline Hayden-Wright.

'There's the factual side of it, which we want people to understand, and then the skills about how to interact with residents,' she says.  

Interpreting behaviour

An early exercise sees staff in small groups ranking a list of behaviours – including spitting, making physical threats and using racist language – in order of which they would find most offensive. 

The groups come up with vastly different opinions, agreeing that it depends on the person with dementia, the staff member and the precise nature of the behaviour, among other factors.

Staff are then asked to consider the difficulties that people with dementia might have in communicating and expressing their physical and emotional needs.

Caroline links this back to the previous list of behaviours, explaining that people who behave in those ways are trying to communicate something.

'We're connecting with that person's emotional memory,' Caroline tells the group.

Staff are also asked to solve word puzzles, which underline the need for creativity when interpreting what people with dementia are trying to communicate. 

Caroline says that key skills include staying calm, picking up on emotional cues and looking for the true meaning of alternative words or sounds, which a person with dementia might use when trying to describe something.

She also talks about the need for validation and reassurance, rather than correcting someone with dementia.

'We're connecting with that person's emotional memory,' she tells the group.

Stressful situations

Asking group members how they would deal with various stressful scenarios in their personal lives provokes a discussion about the different ways in which they would react.

Caroline encourages staff to consider that a resident's response to a situation isn't always going to be because of their dementia – their personality, life history and environment can all play a part in someone feeling anger, anxiety or apathy.

Body language is also addressed, with Caroline explaining what stances might feel confrontational to a resident, then showing more appropriate alternatives.

In a practical activity about vision, staff experience what it's like to be surprised by someone when your peripheral vision is limited.

As the training draws to a close, staff members praise both Caroline and the course.

'I'm seeing care work differently to before,' says one. 'You boost our knowledge.'

Another says, 'I think every care worker should get this sort of training. It benefits the residents.'

Eye opening

To deliver a successful course, Caroline has to understand the needs of the group, as well as the personalities within it.

'My approach is to connect with them as people,' she says. 'You begin to understand their learning styles and the issues that are relevant to them.

'Although I do have to present facts, it's about being an equal, not a teacher, and giving them space to tell their stories.'

Tina Colley, Manton Heights' Deputy Home Manager, says the training is part of the home's efforts to become more dementia friendly.  

'Residents were showing some "challenging behaviour", so we wanted to give staff the knowledge of how best to deal with these issues, as some of them had only done more basic e-learning previously,' she says.

Tina was impressed with how the training was delivered.

'Staff have been talking about how much they've gained and how it's opened their eyes,' says Alex.

'I enjoyed it,' she says. 'There was a lot of group work and interaction.'

During the day, many of the staff spoke about their experiences of supporting people with dementia.

'The way they reflected on how they apply the training, even without realising it, has been really positive to see,' says Alex Peddar, Team Leader of the home's Advanced Dementia Unit.

'Away from the courses, staff have also been talking about how much they've gained and how it's opened their eyes.'

Quality of life

This course is one of many run by Alzheimer's Society for care home, home care, hospital and hospice staff, covering everything from basic dementia awareness through to end of life care.

The Society also provides training for businesses such as insurance firms and banks who want to better support customers with dementia.

'I want us to be recognised as the best for dementia training – we see ourselves as the experts, and we're passionate about that,' says Raj Kapoor, Head of External Training and Consultancy.

The courses are tied to the Society's latest five-year strategy, including our New Deal on Support, where we aim to train 20,000 health and social care professionals by 2022. Better quality care is also a focus of our Fix Dementia Care campaign.

'The most important thing is improving quality of life for a person with dementia,' says Raj. 'That's the ultimate outcome.'

Next steps

• Find out more about Alzheimer’s Society’s training and consultancy.
• Join our Fix Dementia Care campaign to demand change.
• Read more about Changes in behaviour.
• Read the next article from this issue of the magazine.