CAN A TRAINING MODULE USING VIRTUAL REALITY HELP ADDRESS RESPONSIVE BEHAVIOURS?

Abstract

used, how it changed the care givers' knowledge of dementia services and support networks, how it affected their social connectedness to other dementia service users and providers, how its use affected care givers' burden, and how it affected service use. Feedback was also obtained to explore the app's ease of use. The networking function enabled rural dementia service providers and care givers to share information about transportation options to services, what the journey was like, and important amenities during travel and nearby the service. By involving care givers and providers in the app design and beta-testing, we add research knowledge about how to capitalise on revolutions in technology and best use technology to assist in rural dementia care. Traditional healthcare education, delivered through a series of time-limited clinical placements, often fails to deliver understanding of the experiences of older people with long term conditions. Longitudinal Integrated Clerkships and Senior Mentor Programmes allow students longer placements with continuity of contact and opportunities to learn about chronic illness and patient experience. We developed Time for Dementia (TFD) in an iterative partnership between the Alzheimer's Society, universities and the NHS. TFD was made a core part of the curriculum for all medical, nursing and paramedic students in two universities in southeast England. Students visit a person with dementia and their family in pairs for two hours every three months for two years. They follow a semi-structured interaction guide focussing on broad experience of illness and services by the person with dementia and their family , completing reflective appraisals. We conducted a mixed methods evaluation of TFD of process and its impact on student knowledge, understanding, attitudes and behaviours towards dementia using standardised quantitative instruments and qualitative interviews. The programme was delivered to all 348 eligible students using a network of 174 families. 310 (89%) of the students and 158 (91%) of the families contented to participate. Initial quantitative and qualitative analyses at 1 year suggest a positive impact on students in term of improvement in attitudes to and knowledge of dementia. This demonstrates feasibility and the preliminary data are positive. An assessment of the value of the programme will be provided by the longitudinal quantitative and qualitative data being collected. Rural residents face a higher burden of Alzheimer's disease (AD) related to healthcare access barriers. Studies of AD knowledge in rural residents are limited. The purpose of this study was to: a) Describe and compare AD knowledge in rural, under-served, older adults in two settings (West Virginia and Florida) b) Examine factors (e.g. age, sex, ethnicity, education, health literacy, caregiving experience) that may influence AD knowledge. Participants were adult community residents at low-cost retail stores and senior centers in Glades County, Florida (n = 200) and Marion County, West Virginia (n =100). The Basic Knowledge of Alzheimer's Disease scale (BKAD) was first piloted with 240 rural Fayette County, West Virginia Appalachian residents in 2013 with favorable results on reliability and validity testing using RASCH analysis. Generalized linear mixed modeling revealed that AD knowledge varied between the West Virginia and Florida sites. BKAD total scores were significantly higher (M = 15.8; SD = 2.9) in Marion County, West Virginia, compared to the Glades, County Florida sample which included 29% African American and 10% Hispanic-American participants (M = 12.75; SD = 3.37). Health literacy negatively correlated with years in a rural area (r =-.29) and years of education (r =-.47) in Florida only. Correlations between BKAD knowledge and education were significant in both the West Virginia (r = .33) and Florida sites (r = .59). Our findings suggest that determining knowledge gaps is important in designing culturally relevant educational programs to increase awareness of cognitive risk and benefits of earlier screening. Although there has been an increase in programs addressing responsive behaviours (RB) related to dementia, more is needed as caregivers still face difficulties in real-life situations. Virtual reality (VR) has been shown to give a more lifelike feel to anxiety-provoking training situations by adding psychological realism and an element of stress to interventions. This project aimed to develop and evaluate a VR module that provides a realistic environment in which caregivers, staff and students in health-care fields can gain knowledge and skills on how best to respond to RBs. Existing training materials were surveyed and two RBs were identified for inclusion in the scene: perceived verbal and physical aggression , and perceived resistance to care. The VR scenario is based on three critical moments for interventions from the user in a dining room scene involving interactions with a resident and his granddaughter (both are virtual character models with motion capture of their body and facial expressions). The module is ready to be tested on pre-professional students, staff, professors, and informal carers to determine whether it may be a useful and usable addition to existing training tools in the future. The results of this consultation will be presented as well as a discussion of the relevance for developing a training tool for all those who come in regular contact with individuals with dementia.