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Older adults with dementia, when hospitalised, frequently experience responsive behaviours. Staff struggle to manage responsive behaviours without specific education. We aimed to enhance staff knowledge and confidence with care for older adults with dementia and responsive behaviours on medicine units at a Canadian hospital. An online dementia education program was disseminated to staff as part of a broader quality improvement project. Gentle Persuasive Approaches (GPA) encourages staff to reframe responsive behaviours as self-protective expressions of unmet needs and learn to assess their meaning. Participants completed online quantitative and qualitative measures of self-efficacy, competence and knowledge in dementia care at three times: immediate pre-, immediate post- and six to eight weeks post-GPA eLearning. Immediately post-GPA, participants showed significant increases relative to baseline in dementia care self-efficacy, competence and knowledge. Self-efficacy scores increased further eight weeks post-GPA. Before GPA, few participants described dementia-specific strategies for de-escalating a patient’s agitation. Eight weeks post-GPA, participants described application of tailored, person-centred, non-pharmacological interventions and successful application of GPA strategies. GPA eLearning strengthened staff preparedness to interact with older adults experiencing responsive behaviours, thus enhancing their care.

Education is needed for enhanced capacity of acute hospitals to provide dementia care. A nonrandomized controlled, repeated-measures design was used to evaluate a dementia education program delivered to an intervention group (IG, n = 468), compared to a wait-listed group (n = 277), representing separate sites of a multisite hospital. Participants completed self-efficacy for dementia and satisfaction measures and provided written descriptions of dementia care collected at baseline, postintervention (IG only), and at 8-week follow-up. Oral narratives were gathered from IG participants 8 weeks postintervention. The IG demonstrated significant improvement in self-efficacy scores from baseline to immediately postintervention ( P < .001), sustained at 8 weeks. There were no changes from baseline to 8 weeks postintervention evident in the wait-listed group ( P = .21). Intervention group participants described positive impacts including implementation of person-centered care approaches. Implementation of dementia care education programs throughout hospital settings is promising for the enhancement of dementia care.

Statement of the Problem: Nurses face a high level of risk of violence compared with other workers, with higher frequency towards those who are younger and less experienced. Risk of violence is similar for health care aides, and nursing students, with health care aides experiencing the highest rate of injury because much of their work and clinical practice is in long-term care settings where many residents are at risk for challenging behaviours due to cognitive changes. The purpose of this project was to evaluate the effects Gentle Persuasive Approaches© (GPA) training had on health care assistant students’ knowledge and ability to care for patients who have the potential for responsive behaviours. GPA is a training program recognized in Canada as best practice in the management of responsive behaviours of patients, providing learners with the skills to interact and intervene to diffuse escalating care situations. Methodology: A mixed-methods approach with a quasi-experimental, repeated measures design was used. Health care assistant (HCA) students received GPA training by certified faculty coaches prior to their clinical practice. Repeated measure questionnaires were administered pre-GPA, post-GPA, and post-clinical practice. Focus groups allowed students to reflect on how GPA prepared them for managing responsive behaviours post-clinical practice. Findings: The results demonstrate the effectiveness of offering evidence-based dementia training program while students are still in their educational program to better prepare them to provide person-centred care and keep themselves and their patients safe.

Imagining future events and remembering past events rely on a common core network, but several regions within this net- work—including the hippocampus—show increased activity for imagin- ing future events compared to remembering past events. It remains unclear whether this hippocampal activity reflects processes related to the demands of constructing details retrieved across disparate episodic memories into coherent imaginary events, encoding these events into memory, novelty detection, or some combination of these processes. We manipulated the degree of constructive processing by comparing activity associated with the initial construction of an imagined scenario with the re-construction of an imagined scenario (imagine vs. re-imag- ine). After accounting for effects of novelty and subsequent memory, we found that a region in the hippocampus was preferentially activated for newly constructed imagined events compared with re-imagined events. Our results suggest that the hippocampus may support several distinct but related processes that are critical for imagining future events, and they also indicate that a particular region within posterior hippocampus may uniquely contribute to the construction of imagined future events. V C 2013 Wiley Periodicals, Inc.

Although our ability to remember future simulations conveys an adaptive advantage, enabling us to better prepare for upcoming events, the factors influencing the memorability of future simulations are not clear. In this study, participants generated future simulations that combined specific people, places and objects from memory, and for each trial, made a series of phenomenological ratings about the event components and the simulation as a whole. Memory for simulations was later assessed using a cued-recall test. We used multi-level modelling to determine whether the phenomenological qualities of event components (familiarity, emotionality and significance) and simulations (detail, plausibility) were predictive of whether the simulation was successfully encoded and later accessible. Our results demonstrate that person familiarity, detail, and plausibility were significant predictors of whether a given future simulation was encoded into memory and later accessible. These findings suggest that scaffolding future simulations with pre-existing episodic memories is the path to a memorable future.