Summary CARING FOR THE PEOPLE WITH DEMENTIA CASE STUDY GRADED DISTINCTION

Dementia is described as a significant decline in cognitive function that interferes with living independently and performing everyday life activities adequately. In dementia, there are neuropsychiatric symptoms as well as behavioral and psychological symptoms of dementia (BPSD) that are present in many dementia residents depending upon the stage (LaMukherjee, Biswas, Roy, Biswas, Gangopadhyay, & Das 2017). Dementia residents that are behavioral are typically challenging to care for in the home. Therefore, they are placed in long-term care facilities such as nursing homes. Caregivers of the behavioral dementia residents need education that is explicitly geared to understanding techniques to care for the resident appropriately. Because Dementia is progressive in nature, behavioral problems that require expertise and knowledge is essential to reduce behavioral symptoms in the dementia resident as well as decrease stress, burnout and burden of the caregivers to increase efficacy. Keywords: Dementia, Behavioral, Caregivers, BPSD, Efficacy Introduction There is not enough information regarding the dementia resident and the impact that these residents have on caregivers. Because of the dementia resident’s behavior, delivering quality care can be challenging. The dementia resident has behavioral issues that are complex and require unique skills from the caregiver in order to deliver optimal care. Behavior dementia residents are unlike elderly aging adults in that the behavior can be violent, or difficult, causing TIMELINE/PLAN 3 stress to both the resident and the caregiver. Therefore, with education and increased knowledge, implementation of the unique skills needed to care for the dementia behavioral resident could prove essential. Since the staff is not adequately trained to care for behavioral and psychological symptoms of dementia (BPSD) residents, many times frustrations cause the caregiver to either lash out at the resident, call in sick, and in some cases resign. Through the years, there have been several incidents of mistreatment of dementia residents that are behavioral (Alzheimer’s Association, 2018). It is quite challenging to provide care to residents with behavioral and psychological symptoms of dementia (BPSD). However, there is no excuse for abuse of the resident under any circumstances. Because of the inappropriate delivery of care, frustrations from both the resident and the caregiver can lead to unfortunate situations regarding care. Local Problem The most common problems with BPSD residents are those of agitation, aggression and at times hallucinations (Alzheimer’s Association, 2018). Understanding how to adequately care for residents with BPSD, using knowledge and skills through education, will significantly curtail the negative reaction from the resident as well as staff. Because dementia is devastating on caregivers as well as the resident with no immediate cure, new approaches to managing challenging behaviors through a variety of techniques are needed (Gitlin, Mann, Vogel, & Arthur, 2013). Therefore, the problem that needs addressing is that in long-term care settings, there is a need for an evidence-based structured training program regarding behavioral issues in dementia residents to improve staff self-efficacy, decrease call-ins, resignations, turnover and resident abuse related to the management of behavioral dementia residents. With proper education, negative staff responses can be alleviated. TIMELINE/PLAN 4 Intended Improvement/Purpose/Expected Outcome The purpose or intended improvement of this DNP project is to educate caregivers in order to care for residents with BPSD effectively. It is essential for the caregiver to understand the reasons behind the aggressive behavior in order to properly combat the situation. Once again, education is the key to an effective resolution of the unfortunate situation. Learning to recognize triggers can increase staff efficacy as well as have a positive outcome for the resident. Because behavioral and psychological symptoms of dementia are so prevalent, there is no doubt that a well-organized, presented educational program, to the caregiver population, will help not only the resident but all staff involved. This DNP project will help caregivers learn competencies and skills to enable them to implement their skill to reduce the problems associated with caring for the BPSD resident. When these skills are learned, this could decrease the change of harm or risk to the resident as well as to the staff. There is a need for further research to gather data to implement the appropriate educational program that uses specific techniques to enhance learning for the caregiver. The intent and goal are to arm the caregivers with sufficient amounts of information that would allow them to use the learned strategies that will decrease the difficulty in caring for the dementia residents all while meeting the needs for all parties involved. Expected outcome. The expected outcome of this DNP project is that caregivers of BPSD residents will learn from the educational materials and activities that have been created to ensure the quality of care for the resident. The project will also be designed to educate the caregiver to ensure that their needs are also met to decrease burnout, call-ins, and resignations. It is the desire that all staff that cares for residents with BPSD will willingly participate in the project. However, it has already been established by the facility that all educational programs are TIMELINE/PLAN 5 mandatory in order to continue employment with the facility. Caregivers of the BPSD residents through proper education have the ability to enhance the quality of life for these types of residents. Also, proper education can enhance the quality of the working relationship between staff and residents. Study Question/PICOT Question The clinical question that this DNP project will answer: In Long-Term Care fa