A dementia first aid course dealing with frustrating and challenging behaviour was set up to support people who care for members of their family with dementia
Many people with dementia are cared for by family members, who may receive little advice or support. This article describes a course developed to help carers deal with frustrating and challenging behaviour.
Citation: Pogson R (2015) A dementia first aid course for family carers. Nursing Times; 111: 41, 24.
Author: Richard Pogson is a memory nurse at Hertfordshire Partnership University Foundation Trust.
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It is estimated that two-thirds of the 850,000 people with dementia in the UK are looked after in the community by more than 670,000 carers and this number is set to rise (Alzheimer’s Society, 2014). Dementia treatment is patient-focused but we identified that carers also need support. This was the starting point of our dementia first aid course, which offers support and advice to family carers.
The dementia first aid course
Dementia first aid is a problem-solving, stress-reducing and crisis prevention training programme for family carers of people with dementia. It teaches carers how to identify, understand and effectively cope with common behavioural and psychological symptoms of dementia. The course runs parallel to Hertfordshire’s post-diagnostic support service, which offers support and practical advice to those recently diagnosed with dementia.
The inspiration for the service came from a Mental Health First Aid course in Australia, which focused on raising public awareness of mental health in the community.
Our original course comprised three separate four-hour sessions delivered over three weeks. We found that carers could not commit to this so reduced the course to one afternoon with four sessions; carers found this more useful.
How does it work?
The course is delivered by a team of clinicians including psychiatrists, psychologists and nurses. It covers four areas, which are designed to benefit both the carer and the person with dementia for whom they are caring.
The first session includes an overview of dementia, its likely course and the specific features of the disease, such as:
- Understanding language function breakdown;
- Recognition/misidentification of symptoms;
- Coordination difficulties.
People with dementia often become confused and disorientated so carers are taught various coping strategies to address difficult behaviour. For example, an individual may repeatedly ask for a deceased parent - carers are taught to direct the conversation towards memories of their parents rather than misleading individuals or ignoring the question.
This gives carers down time and helps them change how they think and feel about experiences or situations. They focus on how they feel in the present rather than the past or future, which tends to absorb our time. Regular practice of this technique can reduce and alter the perception of stress and help develop emotional perception and insight, concentration and focus.
Coping with challenging behaviour
We developed FACE - an acronym that can be used when developing action plans to cope with common behaviours that challenge and frustrate carers (Box 1). Carers are introduced to it and we explain how it can help them cope with difficult situations.
Box 1. Tackling challenging behaviours
The FACE acronym was developed to help family carers develop action plans to address challenging behaviours
- Face the situation with compassion
- Assess the risk
- Counsel the person
- Engage in pleasurable activities (person centred/achievable)
The next step
We have held five dementia first aid courses to date. We will roll this out to a wider audience, encourage health professionals to attend, and are in the process of setting up a programme to introduce it across Hertfordshire. Recognising the fragility of many carers and the huge emotional demands of caring for someone with dementia, we believe an investment in carers is an investment in the health service.
Alzheimer’s Society (2014) Dementia 2014. Opportunity for Change.