Camille Tranter and Dr. Barbara Heise PhD, APRN, BC, CNE, College of Nursing

Introduction

According to the Alzheimer’s Association (2012), one in eight older adults has Alzheimer’s disease (AD) and by 2050, someone will develop AD every 33 seconds doubling the current number of people suffering from AD. The purpose of this pilot study was to explore the impact of an end-of-life educational module on nursing home staff perceptions of end-stage dementia care. End-of-life education may improve the quality of care for nursing home residents with advanced dementia.

Methodology

Nursing home staff, including RNs and CNAs, were asked to complete a demographic survey, the UCLA Geriatric Knowledge Survey, and the UCLA Geriatrics Attitude Scale. These surveys examined staff’s attitudes toward and knowledge of older adults. The participants then received an educational module aimed at improving the staff’s knowledge of the proper care of older adults with end-stage dementia. After this module, staff attitudes and knowledge were reassessed using the UCLA Geriatric Knowledge Survey and the UCLA Geriatrics Attitude Scale. Permission to use the UCLA Geriatric Knowledge and Geriatric Attitude Scale was obtained from the UCLA Academic Resource Center. This study received permission from the BYU Institutional Review Board as well as Garden Terrace Nursing Home.

Results

Five staff members participated in this study and their responses were analyzed using a paired ttest and the Wilcoxon Signed Ranks test. The responses of each participant before the educational module were compared to the responses after the educational module. The UCLA Geriatric Knowledge Survey responses and the UCLA Geriatrics Attitude Scale responses were examined separately.

The impact of the educational module was not significant when analyzing the UCLA Geriatrics Attitude Scale results (p =.076). Similarly, the impact of the educational module was not significant when analyzing the UCLA Geriatric Knowledge Survey results (p = .063).

Discussion

While the results of this study were not significant, further research needs to be done to assess the impact of an educational module on end-of-life care. It is possible that an educational module would improve attitudes toward the geriatric population and that an educational module would improve knowledge about end-of-life care for those with dementia if the study included more participants. This research is considered a pilot study, and due to the small number of participants it is difficult to tell whether the educational module had any impact.

Conclusion

Most patients with Alzheimer’s disease live out their lives in nursing homes (Houttekier, Cohen, Bilsen, Addington-Hall, et al., 2010). Formal caregivers in nursing homes must keep pace with information and training necessary to provide appropriate end-of-life care for patients with advanced dementia. Thus, it is essential that nursing home staff have positive attitudes toward the elderly and are aware of the current literature on this subject to provide the best end-of-life care possible. An end-of-life educational module may improve attitudes and knowledge of these caregivers.

References

• Alzheimer’s Asssociation. (2012). 2012 Alzheimer’s Disease Facts and Figures. Alzheimer’s & Dementia, 8(2).
• Houttekier, D., Cohen, J., bilsen, J., Addington-Hall, J., Onwuteaka-Philipsen, B., & Deliens, L. (2010). Place of death of older persons with dementia. A study in five European countries. Journal of the American Geriatrics Society, 58(4), 751-756