Why dementia training is necessary for senior care business owners
It may seem obvious that senior care business owners should have dementia training. Unfortunately, there are countless senior care businesses that don’t invest time or money in their workforce to adequately train them in dementia care.
Dementia care requires care providers to be comprehensively knowledgeable about many illnesses that produce dementia symptoms. A caregiver may report that their parent or loved one “has dementia”. However, Alzheimer’s is vastly different that Vascular Dementia and Lewy Body. Behaviors differ, the progression of the illness differs, the use of medications differ, the cost of care differs. Untrained caregivers are a recipe for disaster.
Often, caregivers are in denial of the changes their loved one is experiencing. The person may not have a formal diagnosis when they enter the care experience whether it be home care, legal planning, senior housing, palliative and/or hospice care. Your company may be the first encounter the client or family member has to address the dementia issues at hand. It’s critical that your entire staff be comprehensively trained. Your sales and marketing team, your administrator answering the main number, your aides, your nurses and of course you as the business owner.
Key facts about dementia
Currently more than 55 million people have dementia worldwide, over 60% of whom live in low-and middle-income countries. Every year, there are nearly 10 million new cases.
Dementia results from a variety of diseases and injuries that affect the brain. Alzheimer disease is the most common form of dementia and may contribute to 60–70% of cases.
Dementia is currently the seventh leading cause of death and one of the major causes of disability and dependency among older people globally.
In 2019, dementia cost economies globally 1.3 trillion US dollars, approximately 50% of these costs are attributable to care provided by informal carers (e.g. family members and close friends), who provide on average 5 hours of care and supervision per day.
Women are disproportionately affected by dementia, both directly and indirectly. Women experience higher disability-adjusted life years and mortality due to dementia, but also provide 70% of care hours for people living with dementia.
Alzheimer’s and Related Dementias Resources for Professionals
Get tools and training for your practice: Access free clinical practice tools, training materials and more resources for physicians, nurses, social workers, and other professionals.
- Cognitive assessment tests
- Tools and guidelines for diagnosis and management
- Professional training and curricula
- Patient care
- Clinical trials and studies
- Patient and caregiver education
Cognitive assessment tests
Brief assessment tools are designed to detect early cognitive changes. If tests indicate possible impairment, further evaluations are warranted.
The following are examples of brief cognitive assessment tests, listed in alphabetical order, that are available to the public.
AD8 Dementia Screening Interview
This brief test was originally designed as an informant screening tool but has also been validated as a direct questionnaire for the patient. The test consists of eight yes-or-no questions about changes in the person’s thinking, memory, and behavior. This screening tool is available in English and Spanish and takes about three minutes to complete. No formal training is needed to administer the test. Use of the AD8 requires a license.
NIH Toolbox®
The NIH Toolbox® includes more than 80 stand-alone measures, as well as batteries to assess cognitive, emotional, sensory, and motor functions. Administered on an iPad, each battery takes about 30 minutes. All tests have been translated into Spanish and various tests are available in other languages.
Mini-Cog
The Mini-Cog is a three-minute instrument for the patient that consists of two components: a three-item recall test for memory and a clock drawing test. This is a free tool and is available in many languages. Training for use of this tool takes about ten minutes.
Short Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE)(PDF, 1.9M)
The IQCODE is a questionnaire that is completed by a relative or friend who has known the patient for 10 or more years to gather information on changes in cognition and function in 16 areas. This free screening tool has been translated into multiple languages.
Quick Dementia Rating System (QDRS)
The QDRS was originally designed as an informant tool and later validated for use with patients as well. The QDRS consists of 10 categories, each with five options that characterize changes in the patient’s cognitive and functional abilities. This tool is free and does not require any training to administer it.
Tablet-Based Cognitive Assessment Tool (TabCAT)
Developed by researchers at the University of California, San Francisco, this 10-minute assessment evaluates memory, executive/speed, visuospatial, and language skills. An optional three-minute informant survey is also available to provide information about functional impairment and behavioral changes. This assessment has been translated into multiple languages. Users must complete an account request form and adhere to a user agreement to access the tool. There may also be licensing fees depending on use.
When selecting a tool to use, it’s important to be aware of the patient’s culture. One tool may not be appropriate for all patient populations.
Like all brief tests, a positive result of any of these tests should be followed up with a more comprehensive evaluation or referral to a specialist. For more information, visit:
- Assessing Cognitive Impairment in Older Patients from NIA
- Cognitive Assessment and Care Plan Services from the Centers for Medicare & Medicaid Services
- Cognitive Assessment Considerations: Understanding the Evidence from NIA
Tools and guidelines for diagnosis and management
ACT on Alzheimer’s Provider Practice Tools
Find decision support tools for assessment, diagnosis, and disease management, developed by a Minnesota group of health, government, and nonprofit organizations.
Alzheimer’s Disease Diagnostic Guidelines
Get detailed information about the NIA/Alzheimer’s Association Diagnostic Guidelines for Alzheimer’s Disease.
Assessment of Cognitive Complaints Toolkit for Alzheimer’s Disease
Developed by the California Alzheimer’s Disease Centers, a statewide network of 10 dementia care Centers of Excellence, this toolkit provides primary care providers with the tools necessary to recognize normal cognition, diagnose Alzheimer’s disease, and identify other cognitive problems requiring specialty referral.
Caring for Older Patients With Cognitive Impairment
Use this quick guide to develop care strategies, discuss clinical trials, and make medical and family support plans for older adults with cognitive impairment.
CMS Cognitive Assessment & Care Plan Services
This webpage by the Centers for Medicare & Medicaid Services (CMS) provides information on cognitive assessment and care plan services (code 99483), including what it covers and how to bill for it. CMS also created a related educational video for health care providers.
Cognitive Care Kit
This toolkit from the American Academy of Family Physicians provides information on cognitive evaluation and diagnosis and disclosure, as well as patient care resources.
Cognitive Impairment Care Planning Toolkit
This toolkit from the Alzheimer’s Association provides recommendations and tools for using the 99483 Medicare code for cognitive assessment and care planning for patients with cognitive impairment.
Diagnosing Lewy Body Dementia
Review symptoms and guidelines for distinguishing Lewy body dementia from other dementias.
Diagnosing Frontotemporal Disorders
Get information about diagnosing frontotemporal dementia and related disorders.
DIAMOND-Lewy Assessment and Management Toolkits
Funded by the U.K.’s National Institute for Health Research, these toolkits are designed to improve the diagnosis and management of Lewy body dementia.
Guide to Billing Codes for Dementia Services (MS Word, 1.6M)
This guide from the National Alzheimer’s and Dementia Resource Center provides billing codes and guidance to bill third-party payers, such as fee-for-service Medicare and private insurance, for dementia care services.
KAER Toolkit: 4-Step Process to Detecting Cognitive Impairment and Earlier Diagnosis of Dementia
This toolkit is focused on the KAER model developed by the Gerontological Society of America Workgroup on Cognitive Impairment Detection and Earlier Diagnosis and offers tools and resources to implement the four steps in the KAER model.
Medical Care of Adults With Down Syndrome: A Clinical Guideline
Find recommendations on assessment and diagnosis of dementia in adults with Down syndrome.
Next Steps After a Diagnosis of Alzheimer’s Disease
Use this handout to refer patients diagnosed with Alzheimer’s disease to information and resources about health care, safety, and more. Available in English and Spanish.
Practice Guideline Update: Mild Cognitive Impairment
These guidelines from the American Academy of Neurology provide recommendations for clinicians concerning the assessment, diagnosis, and treatment of mild cognitive impairment.
Recommendations for Operationalizing the Detection of Cognitive Impairment During the Medicare Annual Wellness Visit in a Primary Care Setting
These recommendations from an Alzheimer’s Association-convened group of experts provide primary care physicians with guidance on cognitive assessment during the Medicare annual wellness visit and when referral or further testing is needed.
Professional training and curricula
Training Curriculum: Alzheimer’s Disease and Related Dementias
Sixteen core modules and 11 supplemental modules developed by the Health Resources and Services Administration HRSA Bureau of Health Workforce to train the primary care workforce about dementia care, help providers address caregiver needs, and help caregivers cope with the challenges of caregiving.
ACT on Alzheimer’s Dementia Curriculum
This curriculum for clinicians and professionals in many disciplines covers assessment, diagnosis, treatment, caregiver support, and science.
Alzheimer’s Training for Health Care Providers
This nine-module continuing education credit course from the University of Kentucky trains health care providers, especially those in medically underserved areas, in dementia diagnosis and treatment, management, and related topics.
Alzheimer’s Disease and Related Dementias Mini-Course
This mini-course includes four video presentations and companion slides from the University of Washington Alzheimer’s Disease Research Center. Topics covered include healthy and unhealthy brain aging, clinical essentials of Alzheimer’s disease and related dementias, vascular brain injury, and a research framework for Alzheimer’s disease and related dementias.
Training for professionals is also available through voluntary and professional organizations.
Patient care
Talking With Your Older Patients
Learn tips for improving your communication with older patients, working with families and caregivers, and providing care to a diverse population.
Best Practice Caregiving Tool
This searchable database of vetted dementia care programs is designed to help health care and community-based organizations make informed decisions.
Eldercare Locator
This nationwide service from the Administration on Aging, U.S. Administration for Community Living, connects older Americans and their caregivers with trustworthy local support resources, including in-home help and transportation.
Clinical trials and studies
Alzheimers.gov Clinical Trials Finder
Search for clinical trials and studies on Alzheimer’s and related dementias, cognitive impairment, brain health, and caregiving.
Dementia Research and Clinical Trials
Get information and resources for helping people find and understand clinical trials.
Alzheimer’s and Dementia Outreach, Recruitment, and Engagement (ADORE) Resources
ADORE is a searchable collection of materials designed to support recruitment and retention into clinical trials and studies for Alzheimer’s and related dementias. It includes examples of Clinician Partnerships with Alzheimer’s Disease Research Centers and other materials.
Talking With Your Patients About Alzheimer’s and Related Dementias Clinical Trials
Find guidance, in English and Spanish, for discussing Alzheimer’s and related dementias clinical research studies with your patients. Also, access resources to help them learn more about participation.
Patient and caregiver education
NIA Alzheimer’s and related Dementias Education and Referral Center (ADEAR)
The National Institute on Aging’s ADEAR Center offers information and free print publications about Alzheimer’s and related dementias for families, caregivers, and health professionals. ADEAR Center staff answer telephone, email, and written requests and make referrals to local and national resources.
Video: How Alzheimer’s Changes the Brain
This four-minute video shows how Alzheimer’s affects the human brain and looks at promising ideas to treat and prevent the disease.
Alzheimers.gov
Find information and resources from federal government agencies for people with dementia, caregivers, families, and professionals. The site is also available in Spanish.
Video: What Is Dementia?
Learn about dementia, a term used to describe conditions that cause the loss of the ability to think, remember, and reason. This video covers some of the common types of dementia, associated symptoms, and what you should do if you experience memory symptoms.
For more information
NIA Alzheimer’s and related Dementias Education and Referral (ADEAR) Center
800-438-4380
adear@nia.nih.gov
www.nia.nih.gov/alzheimers
The NIA ADEAR Center offers information and free print publications about Alzheimer’s and related dementias for families, caregivers, and health professionals. ADEAR Center staff answer telephone, email, and written requests and make referrals to local and national resources.
Alzheimers.gov
www.alzheimers.gov
Explore the Alzheimers.gov website for information and resources on Alzheimer’s and related dementias from across the federal government.
In Conclusion:
Employers must have adequate training in order to be effective for their clients/patients. As medical advancements and supportive services emerge, employers need to educate themselves and those they serve. Mandatory training for formal care providers can also be a significant competitive edge. If you or or business is looking for training ideas and resources, call me for a free 15 minute consultation @ 440-212-4987.