Dementia Best Practice Recommendations Focus on Person-Centered Care, Regulatory Compliance and Staff Retention

The National Alzheimer’s Association’s updated their best practice recommendations for person-centered dementia care in 2018 and for the first time included workforce (staff) as a separate and important component/area of concentration.

The workforce recommendations, released in the 2018 Dementia Care Practice Recommendations, were created to address person-centered care and mechanisms for the development of a dementia competent workforce.

These research, evidence-based recommendations concentrate on the establishment of systems and processes that offer organizational approaches to person-centered care and at the same time address many of the needs and desires of staff in long-term care.  In essence, recommendations for preparing a competent workforce are indeed a guide to staff satisfaction and retention regardless of the setting.

The recommendations, addressed in the article published in The Gerontologist, include:

Practice Recommendations for Staffing

Provide a thorough orientation and training program for new staff, as well as ongoing training.

A comprehensive orientation should be provided that includes the organization’s vision, mission and values, high performance expectations, and person-centered dementia training.  This training is essential for new staff, and should be included in ongoing education for all staff members.

Develop systems for collecting and disseminating person-centered information.

It is important that all staff know the person living with dementia as an individual.  Establish procedures for collecting person-centered information that includes choices, preferences and life history.   It is also essential that an effective process be developed to share this information with all staff.

Encourage communication, teamwork, and interdepartmental/interdisciplinary collaboration.

An organization should promote staff participation and interdepartmental/ interdisciplinary collaboration through routinely scheduled inservice programs and meetings. Training is most effective when designed to include ongoing education, communication and support.  Offering inservices and conducting meetings on all shifts is important, and will impact attendance, participation and facilitate relationships between staff.

Establish an involved, caring and supportive leadership team.

Creating a person-centered “community” is not possible without service-oriented leaders, managers and supervisors.  It is also vital that the leadership team be vision-driven, open, and flexible.  High performing leaders know that staff are the foundation of success, and when staff are valued, recognized and feel served themselves, they in turn will more likely value and serve others.

Promote and encourage resident, staff and family relationships.

Encouraging relationships among persons living with dementia, staff and families is central to person-centered care, and is fostered in part by implementing consistent staff assignment.  The involvement of all parties in planning care, activities, education and social events may cultivate successful relationships as well.

Evaluate systems and progress routinely for continuous improvement.

It is important that an organization routinely collect and evaluate information on all staff processes, including hiring, orientation, training and satisfaction.  Analysis of the data should be used to evaluate the effectiveness of all systems and identify areas for improvement.  In addition, leaders should share this information with staff, and act upon the results.

The process for implementing these recommendations are organizational in scope, with a need for sustainable programs and systems.  Once implemented in organizations we consult with we have found that these recommendations improve not only the ability to deliver person-centered dementia care (an area of increasing regulatory citations – see my last article) but have also experienced increased resident/family and staff satisfaction, as well as staff retention.

The recommendations have been posted online and were published as a supplement to the February issue of The Gerontologist.