Moving Evidence-Informed Assessment and Management of Behavioral and Psychological Symptoms of Dementia into the Real World: Training Family and Staff Caregivers in the DICE Approach

Abstract

Objective: To investigate the impact of a one-day training program on caregivers' confidence and knowledge in managing aspects of dementia care.

Design: One-day caregiver training program featuring: 1) an interactive, multi-media format; 2) a companion manual; and 3) a "brain-storming" session at the end of the day that utilized attendees' real-world cases where the use of the DICE (Describe, Investigate, Create, and Evaluate) approach was illustrated "live."

Setting: Three different geographical sites in Michigan.

Participants: Family (n = 40) and professional (paid; n = 140) caregivers (total n = 180) for people with dementia.

Measures: Pre- and post self-ratings related to confidence in aspects of dementia care management before and directly after the training.

Results: Comparing self-ratings pre- and post-training, more than 50% of family caregivers showed improvement in confidence post-training on 11 of 12 items with significant improvement in 4 items. Among professionals, more than 50% of caregivers showed improved confidence on 3 of 12 items, with 4 items showing significant improvement. Family caregivers were significantly more likely than professionals to show improved confidence on 6 of 12 items.

Conclusions: The number of people with dementia and their family caregivers is large and growing every day with the aging of the population. Living well with dementia is the goal. Current care systems are inadequate and lead to multiple poor outcomes. Innovative solutions like the DICE Approach with delivery methods including a manual and interactive training can put the key components of good dementia care at the fingertips of the people who need it most.

Keywords: BPSD; Dementia; caregiving.