Training Programs for Dementia Care

Overseen By Johanna Hickey, MSW

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of North Carolina, Chapel Hill

Disqualifiers: Under 18 years

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

Compensation: Varies

Number of Visits: 10

1764 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores two training programs to improve dementia care in assisted living facilities. It compares the essentiALZ training program alone with its combination with Project ECHO, which includes virtual mentorship sessions. The goal is to determine which approach better enhances staff knowledge and care practices, benefiting both caregivers and residents. It is ideal for assisted living staff who directly care for residents and seek to improve their skills in dementia care. As an unphased trial, this study provides a unique opportunity for staff to enhance their skills and directly contribute to improving dementia care practices.

Do I need to stop my current medications for this trial?

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

What prior data suggests that these training programs are safe for dementia care staff and residents?

Research has shown limited specific safety data for dementia care training programs like essentiALZ and Project ECHO. However, these programs are educational, aiming to boost caregivers' skills and confidence without involving medical treatments or drugs.

The essentiALZ program provides online training on Alzheimer's and dementia, person-centered care, and other key caregiving topics. As an online tool, it is generally well-tolerated with no known negative effects.

Project ECHO complements essentiALZ by offering virtual mentoring sessions. It enhances healthcare providers' knowledge and reduces obstacles through a team-based, interactive learning model. This educational method has been well-received in other areas and does not involve physical procedures, making it unlikely to pose safety risks.

Overall, both programs are educational and intended to improve care skills without causing harm. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the dementia care training programs, essentiALZ and Project ECHO, because they offer a fresh approach to improving care. Unlike traditional training methods, essentiALZ is fully web-based and self-paced, allowing care staff to learn in a flexible manner over four weeks. It covers key topics like person-centered care and communication, which are essential for effective dementia care. The addition of Project ECHO introduces a novel tele-mentoring model with interactive Zoom sessions, fostering case-based learning and discussion among caregivers. This combination aims to enhance the skills and confidence of caregivers more effectively than conventional standard care practices.

What evidence suggests that this trial's training programs could be effective for dementia care?

Research has shown that the essentiALZ training program, which participants in this trial may receive, can improve dementia care by enhancing care delivery and patient outcomes. Studies have found that it increases knowledge and boosts confidence in caring for people with dementia. The program covers important topics such as the basics of Alzheimer's, personalized care, and effective communication.

Another arm of this trial will receive both the essentiALZ training and Project ECHO. Adding Project ECHO to the essentiALZ training might enhance its effectiveness. Project ECHO uses online sessions to improve learning and build confidence in dementia care. It connects care teams, helping them learn more and overcome distance challenges. This combined approach could lead to better care and improved well-being for both residents and staff. ^{2 4 5 6 7}

Who Is on the Research Team?

Sheryl Zimmerman, PhD

Principal Investigator

University of North Carolina, Chapel Hill

Are You a Good Fit for This Trial?

This trial is for direct care staff in assisted living facilities. It aims to improve dementia care by enhancing staff knowledge and practices, as well as the wellbeing of staff, residents, and their families. Participants will be involved in data collection over a 6-month period.

Inclusion Criteria

Family: At follow-up, resident lived in AL community at least one month during the three months prior to interview date

I work in assisted living, providing direct care to residents.

I am over 18 and can read and speak English fluently.

Exclusion Criteria

I am under 18 years old.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Training

Participants receive essentiALZ training, a web-based program with five modules, over four weeks. In the ECHO arm, additional weekly sessions are conducted via Zoom.

4 weeks

6 virtual sessions (ECHO arm only)

Post-Training Assessment

Staff complete questionnaires and participate in interviews to assess training impact at baseline, post-training, 3-months, and 6-months.

6 months

4 assessment points (baseline, post-training, 3-months, 6-months)

Follow-up

Participants are monitored for changes in knowledge, attitudes, and care practices over an additional 6 months after the intervention ends.

6 months

What Are the Treatments Tested in This Trial?

Interventions

• essentiALZ
• Project ECHO

Trial Overview The study compares two training models: essentiALZ alone, and essentiALZ combined with Project ECHO against a waitlist control group. The goal is to see which model better improves dementia care workforce skills.

How Is the Trial Designed?

Group I: essentiALZ + ECHO Experimental Treatment 2 Interventions

Communities randomized to this arm will receive the essentiALZ training: a web-based training taken by AL staff that contains three hours of self-paced content separated into five modules, plus a final review. Modules include: 1) Alzheimer's disease and dementia; 2) person-centered care; 3) assessment and care planning; 4) activities of daily living; and 5) behaviors and communication. Staff will be encouraged to take the training over the course of four weeks. Additionally, they will receive access to Project ECHO. ECHO is a virtual tele-mentoring model grounded in case-based learning. It includes six weekly one-hour sessions of didactic and discussive learning. The first five sessions will reflect the content of the five essentiALZ modules, and the final session will address maintenance. ECHO sessions are group sessions that will be conducted via Zoom.

Group II: essentiALZ Experimental Treatment 1 Intervention

Communities randomized to this arm will receive the essentiALZ training: a web-based training taken by AL staff that contains three hours of self-paced content separated into five modules, plus a final review. Modules include: 1) Alzheimer's disease and dementia; 2) person-centered care; 3) assessment and care planning; 4) activities of daily living; and 5) behaviors and communication. Staff will be encouraged to take the training over the course of four weeks.

Group III: No Intervention Active Control 1 Intervention

Standard care will be provided.

essentiALZ is already approved in United States for the following indications:

Approved in United States as essentiALZ for:

• Dementia care training for assisted living staff

Who Is Running the Clinical Trial?

University of North Carolina, Chapel Hill

Lead Sponsor

Trials

1,588

Recruited

4,364,000+

Alzheimer's Association

Collaborator

Trials

103

Recruited

44,300+

National Institute on Aging (NIA)

Collaborator

Trials

1,841

Recruited

28,150,000+

Published Research Related to This Trial

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]

A consensus workshop with 31 healthcare professionals identified and ranked common adverse events in community care, highlighting the need for better understanding of how these events affect care quality.

The workshop emphasized the importance of further research to establish standardized definitions of adverse events and to prioritize research questions that can improve patient safety in community care settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adverse events in community care: developing a research agenda. Masotti, P., Green, M., Shortt, S., et al.[2022]

A training program for Family Health Teams (FHTs) significantly improved the knowledge, confidence, and ability of 124 health professionals in assessing and managing dementia, as evidenced by follow-up surveys conducted 6 months after the program.

After the training, nearly all participating FHTs established memory clinics, indicating a successful implementation of dementia care practices within primary care settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Developing memory clinics in primary care: an evidence-based interprofessional program of continuing professional development. Lee, L., Weston, WW., Hillier, LM.[2013]

The Project ECHO program successfully provided over 250 hours of dementia-related education to more than 50 primary care providers across 20 sites, improving their knowledge and confidence in diagnosing and managing dementia.

Post-session surveys indicated that two-thirds of providers planned to change their practice based on what they learned, highlighting the program's effectiveness in enhancing dementia care in rural and under-resourced settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

UW Project ECHO-Dementia: Implementation of a virtual clinic and telementoring program to improve dementia diagnosis and treatment in rural and under-resourced primary care settings. Rhoads, K., Isenberg, N., Schrier, A.[2022]

The CARES® Dementia-Friendly Hospital™ program significantly improved the knowledge of nursing assistants and allied hospital workers about dementia care, with a p-value of less than 0.001, indicating strong statistical significance.

The online training was perceived as feasible, useful, and efficient, suggesting that it could effectively enhance the quality of care for individuals with dementia in hospital settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feasibility and Utility of Online Dementia Care Training for Hospital Staff: The CARES® Dementia-Friendly Hospital™ Program. Hobday, JV., Gaugler, JE., Mittelman, MS.[2018]

Caregivers of individuals with Alzheimer's disease face significant challenges in managing home safety, highlighting the need for targeted interventions.

The transtheoretical model of health behavior change (TTM) can be useful in understanding caregivers' stages of adopting safety measures, suggesting that tailored strategies could enhance their ability to prevent accidents and injuries.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Caregiver perspectives on safety in home dementia care. Lach, HW., Chang, YP.[2015]

The CARES® Dementia Basics online program led to significant improvements in dementia caregivers' knowledge and sense of competency, with participants showing sustained knowledge retention even after 30 days.

While caregivers felt more competent in their roles after the training, there was no significant improvement in their ability to identify person-centered caregiving techniques, indicating a need for further training in this area.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An evaluation of the CARES® Dementia Basics Program among caregivers. Pleasant, ML., Molinari, V., Hobday, JV., et al.[2019]

Participation in Project ECHO-AGE significantly reduced the use of physical restraints in nursing homes, with residents being 75% less likely to be physically restrained compared to control facilities over an 18-month period.

There was also a trend towards reduced prescription of antipsychotic medications, with ECHO-AGE residents being 17% less likely to receive these medications, indicating potential improvements in managing dementia-related behaviors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Impact of a Videoconference Educational Intervention on Physical Restraint and Antipsychotic Use in Nursing Homes: Results From the ECHO-AGE Pilot Study. Gordon, SE., Dufour, AB., Monti, SM., et al.[2022]

In a study of 123 patients treated with donepezil for Alzheimer's dementia, 21% discontinued treatment due to adverse events (AEs), highlighting the need for careful monitoring during the initial months of therapy.

The most common AEs leading to discontinuation were nausea/vomiting, diarrhea, and loss of appetite, indicating that these side effects are significant considerations in the management of patients on donepezil.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Adverse events causing discontinuation of donepezil for Alzheimer's dementia]. Carøe, TK., Moe, C.[2018]

Project ECHO is an innovative educational model designed to enhance dementia care in primary care settings, emphasizing the importance of ongoing education for clinicians managing dementia.

The mixed-methods evaluation of the program revealed valuable insights into primary care providers' motivations for participating, which can inform the development of future ECHO courses and improve geriatrics education in dementia care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Beyond knowledge and confidence: a mixed methods evaluation of a Project ECHO course on dementia for primary care. Waters, L., Sohmer, D., Goldman, RE., et al.[2023]

In a pilot study involving 47 participants aged 60 and over with dementia, person-centered care (PCC) significantly improved behavioral and neuropsychiatric symptoms and care quality compared to usual care after 4-5 days.

Sustained improvements in care quality were observed for patients with longer hospital stays, indicating that PCC can be beneficial for enhancing the overall care experience for individuals with dementia in acute hospital settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Outcomes of Person-centered Care for Persons with Dementia in the Acute Care Setting: A Pilot Study. Chenoweth, L., Williams, A., Fry, M., et al.[2022]

The DementiaNet program, which lasted for 2 years, significantly improved collaboration among 35 primary care networks and enhanced the quality of dementia care, with measurable increases in both areas during the program.

These improvements in collaboration and care quality were sustained even after the program ended, suggesting that DementiaNet successfully facilitated a lasting transition to integrated primary dementia care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

DementiaNet facilitates a sustainable transition toward integrated primary dementia care: A long-term evaluation. Oostra, DL., Nieuwboer, MS., Melis, RJF., et al.[2023]

Participation in the Basic Care I training course significantly improved dementia knowledge, with 76.4% of participants showing increased scores.

While the effects on stress levels and work-related self-esteem were inconclusive, the study highlights the need for further research in these areas.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Basic care I: the effect of dementia-specific training on certified nursing assistants and other staff. Peterson, D., Berg-Weger, MS., McGillick, J., et al.[2019]

Citations

1. reporter.nih.gov reporter.nih.gov/search/WJmc5v0UM06S35Uy8CFFMQ/project-details/10900576

Project Details The Alzheimer's Association is the national leader in dementia care training, and ... It is possible that essentiALZ is effective in changing care and outcomes ...

2. centerwatch.com centerwatch.com/clinical-trials/listings/NCT06239688/evaluating-a-national-person-centered-training-program-to-strengthen-the-dementia-care-workforce

Evaluating a National Person-Centered Training Program ... It is possible that essentiALZ is effective in changing care and outcomes ... dementia training might provide a necessary boost to achieve care ...

3. alz.org alz.org/professionals/professional-providers/dementia-care-training-certification/essentialz-training-program-certification

essentiALZ® Dementia Care Training Program & Exam This comprehensive training program covers five topic areas including the basics of Alzheimer's and dementia, person-centered care, ...

4. withpower.com withpower.com/trial/phase-dementia-4-2024-5184b

Training Programs for Dementia Care What data supports the effectiveness of the treatment essentiALZ, essentiALZ Plus, Project ECHO, and Project Extension for Community Healthcare Outcomes for ...

5. sciencedirect.com sciencedirect.com/science/article/pii/S1041610224016983

An evaluation of the CARES® Dementia Basics Program ... From pre-test to post-test, modest improvements were detected in sense of competence in performing dementia care (ps < 0.01) and dementia-based knowledge, F(2, ...

6. ahcancal.org ahcancal.org/News-and-Communications/Blog/Pages/Dementia-Care-Training-and-Certification-Research-Study.aspx

Dementia Care Training and Certification Research Study It will determine whether these trainings help staff feel better trained and result in better outcomes for both residents and staff. Learn more ...

7. trialx.com trialx.com/clinical-trials/listings/290401/evaluating-a-national-person-centered-training-program-to-strengthen-the-dementia-care-workforce/

Evaluating a National Person-Centered Training Program ... This project will compare two training models of an evidence-based online dementia care training program for direct care staff in assisted ...