Basset, T. (2016), "Guest editorial", The Journal of Mental Health Training, Education and Practice, Vol. 11 No. 2. https://doi.org/10.1108/JMHTEP-02-2016-0013
Emerald Group Publishing Limited
Article Type: Guest editorial From: The Journal of Mental Health Training, Education and Practice, Volume 11, Issue 2.
Thurstine Basset is the Director at the Basset Consultancy, Brighton, UK.
Dementia is everybody’s concern. It is a global issue. As we begin to discover more about dementia and what works well for people with the diagnosis, as well as their families and caregivers, there is still a concern that front-line staff are often insufficiently trained and prepared for their work. There is a clear gap between research, the evidence of what is helpful and day-to-day working practice.
My own experience as a family carer has, on occasions, left me in a state of bewilderment about the general lack of knowledge about dementia in services that often claim to be specialist in nature (Basset, 2013).
The six papers in this issue highlight innovative attempts to increase knowledge and enhance skills in a variety of locations in the UK.
We start with two family carers, Jones and Betts, who demonstrate how poetry can be the key to communication with people who have a diagnosis of dementia. Their own experience with a family member, illustrated with examples of deeply personal and meaningful interactions, is set in the context of the wider use of poetry in increasing wellbeing for people with dementia.
Kenny et al. present a case study of a service user involvement group for people with dementia in Kent. The “Forget-Me-Nots” are an example of service users and mental health workers, in this case psychologists, working together in a collegiate way to both learn and teach about dementia. They take a strengths-based approach and concentrate on what people with dementia can do, rather than their deficits. The paper points the way for future research and developments in this field.
In the third paper, Adefila et al. report on an experiential learning initiative in Coventry. The “myShoes” project has created a training resource, using virtual reality and game development software. The resource aims to give people a sense of what living with a diagnosis of dementia is like. Through a virtual reality experience learners across disciplines have shown increased empathy and, although the sample is small, there is also evidence of changes in practice linked to increased understanding.
Argyle and Schneider examine the use of research-based theatre in the training of front-line workers in the Nottingham area. The innovative training intervention was built around a scripted play which drew on research that had explored the stresses, coping strategies and rewards for staff caring for people with a diagnosis of dementia. Many trainees completed evaluation forms straight after the training and a small number were followed up three months later. Argyle and Schneider found evidence of increased knowledge and understanding amongst trainees but also that contextual barriers in the workplace stood in the way of their ability to change their practice.
Personally, speaking as someone who has spent many years as a trainer and a few years as a family carer with a relative in a care home, this is a very familiar finding to me. Innovative training will not change anything if it is divorced from the workplace culture and the day-to-day practice of the trainees.
In the penultimate paper, Mayrhofer and Goodman report on an audit across counties in England, Hertfordshire and Bedfordshire. They found considerable investment in dementia awareness training, but accompanied by a lack of accreditation and assessment so that a picture of a scattergun rather than a targeted approach emerged. Hence no real platform for staff to build on was established, with little sense of the need for continuous staff development. They point out that accreditation of dementia care training would be costly and that this might be a barrier to the provision of training and education that goes beyond the foundation of dementia awareness.
In the final paper, Morgan and Andrews, make a plea for a more positive approach in working with people with a diagnosis of dementia. They argue that staff need both a positive mindset and a willingness to take risks if services are going to be able to live up to the description of being person-centred. Taking on board the current policy framework, they argue for values-based and relationship-centred practice. They present interesting case studies and give some practical tips for putting positive risk-taking into practice. Again here the focus is on what people with a diagnosis of dementia can do rather than what they cannot.
The need for more of a focus on strengths was brought home to me recently when, as a carer at a consultation forum, I was present when a research project was being described to us. The research involved people with dementia being assessed at various points to determine their mental state. Once the research had been presented, a member of the consultation group who has a diagnosis of dementia said “Well don’t expect me to take part in this research as I have had enough of completing forms and tests which just show that I am gradually getting worse”.
Each of these papers shows that the gap between research and practice can be breached, even though the gap still remains wide. Overall, the papers show that innovative steps are being taken in the right direction and that progress is achievable when all those involved are able to contribute their expertise and work together.
However, and I hesitate here to make general statements based on just six papers, but the picture painted here is of innovative projects flourishing in a relatively small context, compared to the more general and widespread situation of poor investment in dementia training across the UK. We certainly need more resources for training and education, as well as a positive approach, as we deal with dementia in the twenty-first century – and let’s try to concentrate on reasons to be cheerful when we look at the future of dementia care.
Basset, T. (2013), “How can we call this specialist dementia care?”, The Journal of Dementia Care, Vol. 21 No. 3, pp. 12-14