Promoting an understanding of dementia for staff who deal with the public over the counter challenge

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Promoting an understanding of dementia for staff
who deal with the public over the counter -
challenges and achievements

• Chris Shanley
• Sharon Quirke
• Lynn Shaw
• Anne Sammut
• Centre for Education Research on Ageing
• Alzheimers Australia NSW

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Outline of session

• Overview of project
• Needs analysis
• Engaging organisations to work with
• Information and training resources developed for
  each organisation
• Hurdles and how to overcome them
• Concluding remarks

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The project

• Funded by NSW Department of Ageing, Disability
  and Home Care
• A project within their 5-year dementia plan
  called Future Directions for Dementia Care and
  Support in NSW 2001-2006
• Collaboration between CERA and Alzheimers
  Australia NSW

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Rationale behind project

• People living with dementia potentially interact
  with a range of staff who provide services to the
  public
• e.g. Post Office, banks, public transport,
  shops, Government Departments

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• People with dementia can get into problems
  connected to symptoms of dementia
• e.g. memory loss, not being able to express
  themselves, becoming confused, becoming lost
• Such problems can be minimised if public contact
  staff have a basic understanding of dementia and
  can respond to the person with care, dignity and
  respect

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Methodology underlying the project

• Approach a range of large organisations
• Work with those willing to participate to develop
  training programs for their public contact staff
• Set out to go beyond training - to analyse
  customer service environment and review policies
  and procedures
• Programs to be particular to the needs and
  learning infrastructure of each organisation
  rather than being a single, generic resource

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Needs analysis

• Literature search
• Web search
• Focus groups with carers and with people living
  with dementia

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Consultations with carers and people living with
dementia

• Two focus groups with carers
• One focus group with people with mild dementia
• 20 people in focus groups plus individual
  interviews with three carers

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Main problem areas

• Managing financial affairs and banking
• Using public transport
• Functioning in a general retail setting e.g.
  paying for things, becoming confused
• Dealing with public officials at all levels

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General issues

• Lack of policies about dealing with dementia -
  staff do not follow-up
• Decline in customer service generally
• Physical design of large shopping centres
• Difficulty recognising someone has dementia
• Special issues for people with dementia in the
  younger age bracket
• Dilemma about whether to self-disclose about
  having dementia
• Dilemma between protecting someone and preserving
  their privacy and autonomy

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Conclusions of needs analysis

• Very little done in this area of work
• Definite potential benefits for people with
  dementia and carers
• Attitudinal needs patience, empathy, courtesy
• Knowledge needs a basic understanding of
  dementia, being able to detect indicators or
  warning signs that a person may be having trouble
  because of dementia
• Skill needs basic communication skills for
  immediate situation and a clear understanding of
  follow-up

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Initial approach to organisations

• Negotiated between funding body and CERA
• Tried to get a mixture of organisation types
  bank / retail / Local govt / State govt
• Tried to get some that had expressed some
  interest and others new to the issue
• Involved a letter from DADHC to senior person in
  the organisation

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Organisations approached

• Woolworths
• Roads and Traffic Authority
• State Transit Authority (buses)
• NSW Police
• Gosford Council
• NSW Businesslink (for Dept of Housing)
• St George Bank
• LATER Coles Myer / Pharmaceutical Society of
  Australia

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Final organisations in project

• Pharmaceutical Society of Australia (representing
  community pharmacists)
• NSW Police
• Gosford Council

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Pharmaceutical Society of Australia

• Pharmacy Self Care Program
• Just under 2,000 pharmacies nationally
• Fact Card for general public titled Alzheimers
  disease and other causes of dementia
• 16-page magazine with sections on the topic for
  pharmacist and pharmacy assistants
• CPE questions for both groups

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NSW Police

• Attempted to extend agenda beyond training
• Strong emphasis on wandering
• Multi-prong reinforcement of material
• Package for workplace education officers
• Self-directed multimedia learning program
• Article in Policing Issues and Practice Journal
• Section within FAQ program on Police Intranet
• SMIT program

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Gosford Council

• Education program with customer service focus for
  all public contact staff
• Interactive education program from either CD or
  Councils intranet
• Looking to adapt program to be suitable for all
  Councils

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Hurdles in using this approach

• Low/no interest if not initiated within own
  business planning
• Low/no interest if we could not find an internal
  supporter/advocate with some influence
• Many organisations undergoing major restructuring
  so unreceptive to new, marginal initiatives
• Private sector find it difficult to see relevance
  to their business interests
• No legislative, regulatory or social pressure on
  organisations, as with physical disability
• Low interest if topic not included in nationally
  accredited training packages for industry

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Overcoming difficulties

• Locate advocate within organisation
• Make benefits to organisation clear
• Go beyond imparting information
• Cost effective programs
• Develop partnerships collaborations
• Develop resources that are relevant, attractive
  easy to use

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Conclusions

• Public contact staff have an important role in
  the lives of people living with dementia
• Outcomes for all can be improved with basic
  training about dementia for public contact staff
• Guidelines and resources have been trialed and
  are available to support this kind of work