Dementia Care Training for Dementia

(CfAA Trial)

Overseen By Cerelia Liu

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Massachusetts General Hospital

Disqualifiers: Palliative care, Moderate dementia, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 22

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if additional training for home health aides can improve the behavior and overall well-being of people with dementia and their caregivers. It compares regular training with an enhanced version that includes more lessons on managing dementia behaviors. The study seeks participants within the Mass General Brigham system who have mild cognitive impairment or mild to moderate dementia and plan to receive home care. As an unphased trial, participants can contribute to innovative research that may enhance dementia care practices.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this enhanced home health aide training is safe for persons living with dementia or cognitive impairment?

Research has shown that improved training for home health aides is safe and well-received. Studies on similar programs reveal that caregivers gain more knowledge about dementia without negative effects. They also feel more confident in managing dementia symptoms. This indicates that the enhanced training safely boosts skills without causing harm. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores a new way to enhance dementia care through specialized training for home health aides. Unlike the standard 100-hour curriculum, the enhanced training includes an additional 8 hours focused specifically on dementia, with both classroom learning and hands-on practice. This approach aims to equip aides with better skills to recognize and manage dementia-related behaviors, potentially improving the quality of care for those with dementia. By increasing the instructional time by just 10%, this training could significantly impact how effectively aides support patients, offering a promising improvement over current methods.

What evidence suggests that this enhanced home health aide training is effective for improving behavioral symptoms and quality of life in persons living with dementia?

Research has shown that training programs for dementia care greatly improve caregivers' knowledge and confidence. One study found that after training, home care workers had a better understanding of dementia and felt more capable of handling patients' symptoms. In this trial, some home health aides will receive enhanced curriculum training, which includes advanced instruction that goes beyond basic lessons to provide more detailed guidance on dementia care. This approach is believed to help manage behavioral symptoms and improve the quality of life for both patients and their caregivers. These findings suggest that advanced training effectively improves dementia care. ^{2 3 6 7 8}

Who Is on the Research Team?

Olivia I Okereke, MD, MS

Principal Investigator

Massachusetts General Hospital

Are You a Good Fit for This Trial?

This trial is for individuals aged 60 or above with mild to moderate dementia or cognitive impairment, who are part of the Mass General Brigham healthcare system and have a care partner. They must be referred to home care services after hospital discharge and able to read English. Those with severe dementia, without a care partner, in palliative care, or unable to consent due to cognitive issues cannot participate.

Inclusion Criteria

My cognitive issues are mild to moderate.

My discharge plan includes getting home care services.

All surveys have been validated in English, so participation is limited to potential participants able to read English

Exclusion Criteria

You do not have someone to help take care of you during the study.

Your Montreal Cognitive Assessment (MoCA) score is below a certain level.

I am being discharged to a Medicare-approved short-term rehab.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Training Intervention

Home health aides receive either enhanced or standard curriculum training

Approximately 4 weeks

20 instructional days for standard curriculum, 22 instructional days for enhanced curriculum

Follow-up

Participants are monitored for behavioral symptoms and quality of life outcomes

6 months

Questionnaires every 2 weeks, occasional phone calls

What Are the Treatments Tested in This Trial?

Interventions

• Enhanced home health aide training

Trial Overview The study tests if special training for home health aides on how to handle dementia can improve behavior symptoms in older adults with dementia/cognitive impairment and enhance life quality for them and their caregivers. Participants will be randomly assigned into groups receiving either enhanced training or standard practices.

How Is the Trial Designed?

Group I: Home Health Aides with Enhanced Curriculum Training Experimental Treatment 1 Intervention

The enhanced curriculum of 108 hours of home health aide (HHA) training will constitute the Experimental arm. This arm consists of the 100 hours of the standard curriculum plus an 8-hour enhanced curriculum that includes additional didactic content and a skills practicum on dementia and recognizing and responding to dementia-related behaviors. As with the standard curriculum, the enhanced curriculum will be delivered by the training entity, CCHERS (Center for Community Health Education, Research and Service, Inc.). The enhanced component is delivered over an additional 2 instructional days (10% increase in instructional days from the standard curriculum).

Group II: Home Health Aides with Standard Curriculum Training Active Control 1 Intervention

The standard curriculum of 100 hours of home health aide (HHA) training will constitute the No Intervention arm. This 100-hour training is the standard curriculum that has been used by the training entity, CCHERS (Center for Community Health Education, Research and Service, Inc.), for many years to qualify HHAs to receive certificates from the Massachusetts Home Care Aide Council. The standard curriculum includes 75 hours of basic instruction ("ABC's for Direct Care Workers") and 25 hours of additional content on mental health and dementia topics. The standard curriculum is delivered over approximately on month, or 20 instructional days.

Who Is Running the Clinical Trial?

Massachusetts General Hospital

Lead Sponsor

Trials

3,066

Recruited

13,430,000+

Published Research Related to This Trial

The VOICE Dementia Care Training Program significantly improved knowledge and self-efficacy among care managers and nurses, with a large effect size (d = 1.8) in these areas, indicating enhanced confidence in managing behavioral symptoms of dementia.

This evidence-informed training program demonstrates the feasibility and effectiveness of nonpharmacological approaches in dementia care, addressing the training needs of caregivers and promoting better management of dementia-related behaviors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Empowering the dementia care workforce to manage behavioral symptoms of dementia: Development and training outcomes from the VOICE Dementia Care Program. Karlin, BE., Young, D., Dash, K.[2018]

The IHSS + ADRD Training Project is a 10-week online training program designed to improve dementia care knowledge among IHSS caregivers in Alameda County.

Preliminary results show that caregivers who completed the training experienced significant increases in their knowledge about dementia and their confidence in providing care, highlighting the need for ongoing training initiatives.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Enhancing Dementia Knowledge and Self-Efficacy of In-Home Supportive Services Caregivers Through Online Training. Yeh, J., Pond, B., Beld, M., et al.[2023]

The Dementia Care Skills for Aged Care Workers program aims to train 17,000 aged care staff in Australia over three years, providing essential skills for dementia care and resulting in a nationally recognized qualification.

Despite challenges in training delivery, such as geographical distances and staffing issues, the program is on track to meet its goals, with positive feedback indicating it is effectively improving care practices, including a notable participation rate of 9% from registered nurses.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Large-scale training in the essentials of dementia care in Australia: Dementia Care Skills for Aged Care Workers project. Fleming, R., Fitzgerald, D.[2016]

The Home Safety Toolkit (HST) significantly improved caregiver competence in creating safer home environments for individuals with dementia, as evidenced by reduced caregiver strain and increased self-efficacy, with results showing statistical significance (P ≤ 0.001 for home safety and P = 0.002 for self-efficacy).

The intervention also led to a notable decrease in risky behaviors and accidents among care receivers, highlighting the effectiveness of the HST in enhancing safety for individuals with dementia living at home.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Clinical trial of a home safety toolkit for Alzheimer's disease. Horvath, KJ., Trudeau, SA., Rudolph, JL., et al.[2021]

A training program developed by a consortium of home care agencies significantly reduces staff turnover and improves care for patients with Alzheimer's disease and dementia.

The program emphasizes knowledge-based care and highlights the importance of self-esteem for both home care aides and patients, suggesting that boosting confidence can lead to better outcomes in caregiving.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

New directions for care of Alzheimer's disease and dementia. Gang, V.[2018]

Citations

1. withpower.com withpower.com/trial/phase-cognitive-dysfunction-7-2023-dc2ab

Dementia Care Training for Dementia (CfAA Trial) What data supports the effectiveness of the treatment Enhanced home health aide training for dementia care? Research shows that training programs for dementia ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12179336/

Competency‐based training boosts dementia knowledge ... This study evaluated a multi‐week, competency‐based, online training for caregivers in California's Medicaid‐funded In‐Home Supportive Services (IHSS) program.

3. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/40538020/

Competency-based training boosts dementia knowledge ... Home care workers' dementia knowledge improved significantly post-training. Self-efficacy to manage care recipients' dementia symptoms improved significantly.

4. researchgate.net researchgate.net/publication/232698659_Training_of_Home_Health_Aides_and_Nurse_Aides_Findings_From_National_Data

(PDF) Training of Home Health Aides and Nurse Aides Training and satisfaction with training were examined using data from nationally representative samples of 2,897 certified nursing assistants ( ...

5. ovid.com ovid.com/journals/gern/fulltext/10.1016/j.gerinurse.2021.10.017~home-health-aide-perceived-information-needs-for

Home health aide perceived information needs for... Findings from this research can guide efforts to develop dementia-specific care plans, and training to support the HHA workforce caring for the growing ...

6. advancingstates.org advancingstates.org/sites/default/files/State_Sponsored_Home_Care_Aide_Training_Approaches.pdf

An Exploration of State-Sponsored Home Care Aide ... Trained home care aides receive a portable certificate that allows them to work in a variety of settings. The training also can be applied toward CNA training ...

7. mcknights.com mcknights.com/news/dementia-training-program-significantly-improves-home-care-worker-skills-study-finds/

Dementia training program significantly improves home ... Participants showed significant improvements in their understanding of Alzheimer's disease and related dementias, with knowledge scores jumping ...

8. in.gov in.gov/health/reports/QAMIS/hharpt/6455a-h2_2567.pdf

This was a Post-Condition Revisit survey for a Federal ... Any significant changes to policy all home health aides will receive training and education within 14 days of implementation. Clinical director ...