ME & U-FIRST!: AN ONLINE EDUCATIONAL TOOL FOR CAREGIVERS

1. ME & U-FIRST!: AN ONLINE EDUCATIONAL TOOL FOR CAREGIVERS In-service Education & Training Maureen O’Connell & Valerie Powell Psychogeriatric Resource Consultants (PRC), Ontario

2. The presenters are both members of the core group who worked on this project as PRCs and members of the Simcoe County Dementia Network. • The Simcoe County Dementia Network applied for and received a sustainability grant ($151,840) from Ontario’s Post-Alzheimer Strategy Staff Education Committee.

3. Our purpose today To introduce: • a flexible and user-friendly internet-based education program designed specifically for Personal Support Workers. • a process evaluation of the development of this product. • an initial outcome evaluation.

4. Process Evaluation/History of Project • Identify need - PSW Feedback • Acquired funding & partnerships – Post-Alzheimer Strategy Staff Education Committee grant, CCAC • Human resources in place – staff, core group & advisory committee • Contracted web company • Ongoing feedback: Focus groups, surveys, meetings • Developed product • Tested product • Developed survey for evaluation • Launched modules • Market program • Outcome Evaluation

5. How did it start? • Developed as a result of Personal Support Worker discussion groups conducted by the Simcoe County Dementia Network (SCDN) in 2004. • 48 participants in 6 discussion groups • 29 LTC • 22 Community Agencies • 2 Psychiatric Facilities

6. Discussion Groups – Key Questions • In your program (HCA/PSW)…what information (or training) about dementia did you receive? • What were the challenges that you ran into in caring for persons with dementia? What problems did you come up against? • What, or who, helped you to manage these situations? • Is there anything that would help you now in your job (to be more effective)? • What would you would like to see put into a "package" for all staff who are becoming involved in dementia care? • Full report at www.dementianetworksc.org • Funding received in 2005 with expectation that the Me & U-First! products would be useful across the province.

7. What is Me & U-First? • A two-part project designed to build on and sustain the P.I.E.C.E.S.TM and U-First! initiatives. • Overall Goal: Using U-First! every Person with dementia will have an improved quality of life as a result of increased understanding and improved communications between Partners in Care. • The ‘Me’ reflects the personal use of U-First! by front-line workers.

8. Me & U-First! - 2 Components • 1)“Me & U-First! …... Understand me, a Person with dementia.” • Eight module E-learning series for front-line workers • Launched October, 2006 • 2)“They say I have dementia……. and some days I believe it.” My Guide for Living with Dementia • Communication and care planning tool for Persons with dementia to use with their Partners in Care. • Expected launch – January, 2008

9. Human Resources • Dementia Network Steering Committee: recruited additional key stakeholders to act as an Advisory Committee to the project. • Core Curriculum Team: 5 people including the proposal authors, project leader, Dementia Network co-chairs and PRCs • Administration: Project leader and administrative assistant • Partnerships: Simcoe County CCAC provided office space and technology support • Contracted service: web education design company

10. Key Decision Making Process: Ongoing review and revision • ongoing feedback through focus groups, surveys, and meetings • continuous review and revision to: • develop initial concepts and goals • verify available technical solutions, possibilities • decide on key elements / writing content • tested product- ‘think aloud protocol’

11. Key Elements of Me & U-First! • Web-based program to enable individualized access and pace of learning - potential to reach a larger number of front-line care providers on ongoing basis • Designed for dial-up service. • Animated characters and photos rather than video • Short narration per slide • Format and content to reinforce the use of the U-First! program and therefore the P.I.E.C.E.S.TM model • U-First! wheel to be embedded within the web site • Repetition of U-First! concepts and language • P.I.E.C.E.S. chart - filled in throughout modules • Virtual model replicates the real method used by Psychogeriatric Resource Consultants

12. U-First! & P.I.E.C.E.S.TM Understand the Person with dementia and their: • Physical well-being • Intellectual well-being • Emotional well-being • Capabilities • Environment • Social History

13. U-First! cont’d Understand the Person with dementia Flag changes Interact successfully Reflect on interactions and Report Support strengths Reinforce the Team

14. Final Product “Me & U-First! …... Understand me, a Person with dementia.”Eight module E-learning series for front-line care providers • Module 1 – Overview • Modules 2-7 – focus on each component of P.I.E.C.E.S. TM • Module 8 – Wrap-up and link to resources • Certificate upon completion

15. Features • P.I.E.C.E.S. TM charts for each of the 2 animated characters. These are filled in throughout the modules so that participants complete 2 full charts by Module 8. • Notes pages for each module capture the participants thoughts and key points as they go through the modules.

16. Me & U-First! Demonstration • Sample from Module 3 – Intellectual • Consistent format • Common initial slides • Learning objectives • U-First! concepts • Application of U-First! as summary • Narration and written info • Example with Mimi and Joe • P.I.E.C.E.S.TM chart • Access to U-First! wheel

17. Final Stage of the Process • Launched modules in Simcoe County – October, 2006 • Web launch in December, 2006 • Marketing Me & U-First!– initial blitz, promoted locally and provincially through newsletters, e-mails, demonstrations and presentations at workshops, conferences, and videoconference • Summative/Outcome Evaluation

18. Process Evaluation: A Few Identified Challenges • Inconsistent communication with project leader • Technical support for off-site project leader • Complexity of e-learning • Meeting deadlines (of contracted agency) • Time commitment of core group • Maintaining momentum • Utilization of volunteers • Unrealistic time line. 6 month project extended over one year.

19. Summative Evaluation: • measurable objectives- developed by evaluation committee • questionnaire to measure objectives- developed & tested by York U. Nursing students • questionnaire – pre & post test data processed for Outcome Evaluation

20. Measurable Objectives • To improve the quality of the interaction between the formal care provider and the Person living with AD & RD through • ↑increased confidence • ↑improved attitude • ↑increased understanding of the Person with dementia • ↑awareness of U-First

21. Questionnaire • 19 questions – • most were 5 point Likert-type scale • 3 demographic • 3 qualitative • Before modules launched -tested for validity and reliability by York students – This pilot test found that PSWs were open to computer learning, however access to computers and internet service was difficult • When project launched – collected 31 pre questionnaires and recently collected 37 post questionnaires • Copy at www.dementianetworksc.org

22. Outcomes • Looking at questions that addressed • confidence • attitude • understanding of the Person with dementia • awareness of U-First • Findings: overall, there was no significant change in confidence and attitude and understanding, with high mean scores both pre and post. • Use of U-First! went from low to high in LTC sector • Of interest is that when the variables were separated into years worked as PSW, the longer they had worked, in the 10-20 yr and 20+ groups- levels of confidence, satisfaction, attitude, & knowing the Person all declined from Very high to High.

23. Qualitative Responses • Pre • “Better understanding of dementia, behaviours, and how to deal with them” • “Allow more time with resident 1 on 1” • “Having more time to spend with residents. Not having to rush to do care, etc.” • Post • “Having more information on their background , when they came to live at our facility, where they are born, work, etc.” • “Communication with other team members. Also learning from others’ experiences”

24. Product Report from OCSA Report June 14/07 Number of Participants Enrolled– 869 • 52% work in LTC Homes, 40% in community agencies • 75% of participants are taking the course from office, 25% from their home • Between 85% and 93% rated modules 2 to 8 either extremely useful or very useful • Module 1 received those ratings by only 67%

25. Me & U-First! • Potential uses • Orientation tool • New employees • Employees who are new to a dementia specific unit • Continuing education tool • Part of annual in servicing • Drop in ‘lunch and learn’ • Employer support

26. Me & U-First! How to Access • www.u-first.ca • Web-site is maintained by the Ontario Community Support Association (OCSA) • OCSA also has the mandate to deliver U-First! in Ontario. • Modules are free but must register first time • Certificate will be supplied on completion of modules • CD of modules is available for a cost of $25.

27. Me & U-First! Second component • Program has two distinct components, both designed to build on and sustain the P.I.E.C.E.S.TM and U-First! initiatives • 1)“Me & U-First! …... Understand me, a Person with dementia.” • Eight module E-learning series for front-line care providers • 2)“They say I have dementia……. and some days I believe it.” • My Guide for Living with Dementia

28. Comments and Questions! Thank you! Maureen O’Connell oconnellm@cgmh.on.ca 705-721-6764 Valerie Powell powellv@cgmh.on.ca 705-721-6754