Occupational adaptation as a social process for dementia care teams.

BACKGROUND: Few studies have examined a group's collective experience of occupation using occupational therapy theoretical models. Dementia caregiving requires a diverse team of caregivers who learn and work together to resolve shared challenges. An Occupational Adaptation (OA) theory-based training program for dementia care teams was developed to better understand the team's adaptive process inherent in cooperative caregiving. AIM/OBJECTIVES: Describe how the team learned together and how the training impacted their teamwork. MATERIALS/METHODS: Fourteen employees at one continuing care retirement community underwent OA-based training. During the program, the team analysed and resolved challenging dementia care cases. Participant observations, participant journals, open-ended surveys, and follow-up semi-structured interviews were analysed. RESULTS: The thematic framework included five steps: unite around a shared challenge, tap the collective adaptive repertoire, collaborate on case-specific plans, implement with teamwork, and return for ongoing problem solving and integration. The program enhanced appreciation for teammates' knowledge, skills, and experiences, learning from each other, and integration of team-centered OA process. CONCLUSION/SIGNIFICANCE: The OA-based program appears to have facilitated adaptation that was complex, social, and generalisable. OA theory is enriched with a social view of occupational adaptation opening new opportunities for therapists and researchers to understand and facilitate adaptation among teams.

Adapting the Connect-Home transitional care intervention for the unique needs of people with dementia and their caregivers: A feasibility study.

AIMS: After leaving skilled nursing facilities (SNF), 20% of people with dementia (PWD) are re-hospitalized within 30 days. We assessed fidelity, acceptability, preliminary outcomes, and mechanisms of the Connect-Home ADRD transitional care intervention. DESIGN: A feasibility study of Connect-Home ADRD. METHODS: The Connect-Home intervention was adapted for dementia-specific needs. PWD and caregiver dyads in 2 SNFs received transitional care. Data sources included interviews with PWD and caregivers and a review of health records. RESULTS: 19 of 34 eligible dyads (56%) were enrolled. The intervention was feasible (components delivered for >84% of dyads) and acceptable (dyads rated it very helpful and not difficult to use). Connect-Home ADRD adaptations included in-home support to manage symptoms of dementia and unplanned events, such as transition to hospice. IMPACT: Connect-Home ADRD is feasible, acceptable, and merits future research as an intervention to reduce rapid return to acute care following SNF stays.

Outcomes of Team-Centered, Occupational Adaptation-Based Versus Traditional Dementia Workforce Training.

Background. Dementia workforce training aligned with Occupational Adaptation (OA) theory may facilitate teams resolving challenges in the care environment more than traditional skills-based (SB) training, although comparisons are needed. Purpose. This pilot study compared effectiveness of an OA and SB program on relative mastery and team development for dementia care teams at a continuing care retirement community. Method. In a quasi-experimental study, employees underwent nine sessions in an OA or SB program. Relative Mastery Measurement Scale and Team Development Measure results were collected pre-, mid-, post-intervention. A 3 × 2 ANOVA determined differences in group score changes across time. Findings. Data from 28 employees (14/group) showed group-by-time interaction reached statistical significance for both relative mastery (F = 3.17, df = 2, p = .05) and team development (F = 8.38, df = 2, p = .001). Implications. OA-based training may improve dementia care teams' collaborative mastery over real-world challenges. While preliminary findings inform program developers, further research must explore clinical effectiveness.

Comparing Occupational Adaptation-Based and Traditional Training Programs for Dementia Care Teams: An Embedded Mixed-Methods Study.

BACKGROUND AND OBJECTIVES: With a growing demand for a dementia-capable workforce, attention shifts from disseminating knowledge of care strategies to facilitating teams translating knowledge into practice. Occupational Adaptation (OA) is a theoretical framework used to facilitate people resolving real-world challenges through active problem-solving, using relative mastery as its measure. This pilot study evaluated if and how OA-based training improves dementia care teams' relative mastery and team development more than a skills-based (SB) program. RESEARCH DESIGN AND METHODS: We report results of an embedded mixed-methods study with 28 employees of a continuing care retirement community (2 groups randomly assigned to 9-week programs). Data collection entailed 2 surveys conducted pre-, mid-, and postintervention; observations; journals; and follow-up interviews. We extended beyond quantitative and qualitative analyses with cross-cutting analyses exploring exemplar and exceptional cases. RESULTS: The OA group reported significantly greater improvements in relative mastery and team development (p < .05). Qualitative data supported the statistical findings and illuminated processes that led OA to outperform SB. OA participants, those who analyzed real cases and alternated collaborative planning with cooperative action, were more likely to indicate pre-post differences in relative mastery and team development. DISCUSSION AND IMPLICATIONS: We identified features of the OA program that diverse participants deemed effective; features that suggest how OA could underpin clinically relevant learning for workers. Further research is required to develop evidence of clinical effectiveness; however, our findings have relevance for agencies wishing to promote knowledge translation and collaborative problem-solving in dementia workforce training.