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4. Delivery: providing learning and development in dementia care

Providing learning and development in dementia care can be challenging because people living with dementia:

  • have diverse needs
  • have support needs that often change over time
  • often need support from different health and social and community services at the same time.

People living with dementia often have other well-being, social or health needs. So it’s important that local leaders work together.

Delivering learning and development in person-centred care can be tricky. It’s less about knowledge and more about values and experience — we sometimes think staff understand person-centred care better than they do.

Delivering person centred care within busy work environments is also challenging.

Important

Above all, working in a flexible way to appreciate the experiences of people with dementia and their families.

All partners will have the right attitude, knowledge and understanding to promote a person-centred care approach.

What good looks like

The local learning and development approach is co-produced with people with dementia, families, and staff.

It's co-ordinated with partners through regional learning and development plans and partnership structures

Learning and development plans are realistic and achievable. They:

  • are based on listening to what staff and local people want
  • offer a diverse range of learning and development opportunities and multiple access channels for staff and others to participate.

Learning and development is about the values, attitudes, communication and behaviour of teams. This needs an experiential approach to learning and development, as well as openness and honesty about our own biases.

There’s a focus on person-centred care. It’s the one thing we can do that will have the biggest impact on the well-being of people with dementia because it has the power to change the experience and culture of care. But it needs a ‘whole system’ approach where:

  • influencers shape the vision and promote partnerships across the ‘whole system’ of care and support
  • influencers are trained, supported and supportive to others
  • influencers have the tools and resources they need to support learners
  • local care and support providers know that people with dementia and their families use many services, often at the same time, so they work together
  • enough learning and development activities take place in the right places and with the right people to reach a tipping point that changes the culture and experiences of people with dementia and their families
  • staff are allowed the time and space they need to develop positive attitudes towards dementia, and to learn, grow and reflect
  • evidence-based models are used to involve people with dementia and their families
  • every person living with dementia is seen as unique, with their own identity, history and cultural social norms, rather than through the prism of dementia
  • family and carers’ experiences are included in a holistic way.

Nursing student placements in care homes are valuable. Placements are an effective way for students to understand what it’s like to live with dementia and care for people with dementia in a person-centred way.

Person-centred care learning and development content should be based on understanding the person’s unique dementia pathway. It should focus on:

  • understanding the early signs of dementia
  • providing ‘active listening’ support in a sensitive and thoughtful manner
  • promoting dignity, respect and independence
  • asking about and understanding people’s individual experiences, including their concerns and anxieties
  • providing advice and support to access preventative, community and specialist services
  • having enough time to listen and care.

The main features of effective learning and development programmes

Research shows the impact of training and education on staff skills and confidence when supporting people with dementia (Surr et al, 2017).

An English study commissioned on behalf of Health Education England in 2018 looked at What Works? in dementia education and training. It:

  • is the most comprehensive evaluation of dementia learning and development in the UK so far
  • resulted in a number of academic works, including Surr & Gates, 2017; Surr et al, 2017; Surr et al 2020a; Sass et al, 2019; Smith et al 2019; Surr et al 2019; Surr 2020b
  • looked at the characteristics of the most effective dementia and training session.

This is what it found:

Content:

  • is tailored to be relevant and realistic to the role, experience and practice of the learners
  • includes specific tools, methods and approaches to underpin the provision of care
  • presents the experience of living with dementia through video, simulation or the direct involvement of people with dementia in the training.

Length:

  • is ideally more than half a day for each subject area. Longer and more in-depth programmes (one to two days) are more likely to produce positive results
  • if a programme is made up of a number of sessions, each session should be at least two hours long.

Delivery:

  • uses small or large group face-to-face learning (either alone or alongside another learning approach) and avoids didactic teaching methods.
  • includes interactive learning activities and opportunities for learner discussion and interaction, using case examples or video-based scenarios, or drawing on examples from the learners’ own practice
  • uses a variety of learning approaches, so as to not rely too much on any one approach, such as booklets or e-learning
  • is by a knowledgeable, skilled and experienced facilitator who is also an experienced clinician or practitioner and can deliver the training flexibly.

Context

You should make sure:

  • there’s a supportive organisational context and learning culture, accompanied by strong, dedicated dementia training and practice leadership
  • you use a dedicated training space
  • you have a physical environment that supports good dementia care.

Useful resources

  • One in a Million Dementia Training. Available in Welsh and English, this resource is based on the Good Work framework’s competencies and includes a video guide, training slides, handouts and evaluation templates.

  • Magic moments in dementia care services: A storytelling approach to learning and development. This resource shows you how to capture the small things that make a big difference in care, and how to use this as a learning activity.

  • Cardiff and Vale regional team’s dementia training slide pack. The team offers learning and development at informed, skilled and influencer levels.

    The informed level training is offered online and this is at a slightly higher level than the Dementia Friends training. The team also offers a three-day face-to-face course at skilled level and trains influences to be the eyes and ears on the ground.

    It routinely uses videos, pictures and stories in training.

  • Cardiff and Vale of Glamorgan region’s training request templates.

    This is a learning and development plan that’s supported by partners and has funded a learning and development team that works with partners. The team’s put a learning and development framework in place that’s based on the three groups of people identified in the Good Work Framework: informed, skilled and influencer.

  • Cardiff and Vale of Glamorgan: Training Tools document.

  • Swansea University’s Developing Evidence and Enriched Practice (DEEP) course. This development opportunity for influencers is aimed at boosting the role of influencers.

    It’s a 30-hour programme over 10 weeks, and provides practical ways to gather knowledge and to help interested people get together to think and plan how to improve dementia learning and development.

    It will help you develop an approach that involves people, is meaningful and effective.

  • Joseph Rowntree Trust’s Better Life Programme 2013 learning resource. This programme provides helpful case studies that could be used as content for local dementia learning and development programmes.

  • Relive (by Karin Diamond): Dementia experience day. A day of experiences from the perspective of a person living with dementia. It’s particularly useful for influencers.


Next section: Evaluating impact

Go to the next section: 5. Evaluating impact.

First published: 15 June 2022
Last updated: 9 November 2022
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