The Ontario CLRI at Baycrest develops and evaluates innovative educational approaches designed to enhance not only knowledge and skills, but also values and attitudes in learners. With the assistance of interprofessional summer interns, an initial dementia simulation was created and trialed. A final version is presented here in the form of a toolkit. The scripts and resources in this toolkit have evolved over time using a quality improvement approach and are meant to foster participant awareness and insight into living life with frailty and dementia.
This toolkit contains:
- Information facilitators need to know regarding dementia and dementia
- Simulation techniques and sample scenarios based on common experiences of the
elderly in the healthcare system
- Additional modifications for the scenarios
- Ideas on how to structure the simulation session for an interprofessional audience,
including the debrief
As a result, this toolkit will allow users to:
- Identify and utilize dementia simulation techniques and scenarios
- Use these simulations to engage participants in reflection and develop a deeper
understanding of dementia and frailty
Move to Trash
Dementia Simulation Toolkit 2.0
Teamwork, Leadership, Solution-Focus
This experiential learning activity is a low-fidelity simulation suitable for entry-level and advanced educators and simulationists. The purpose is to foster reflection and insight about teamwork, leadership and solution-focused problem-solving. The simulation typically lasts 3-5 minutes and at least 15 minutes should be allotted for pre-briefing and debriefing for up to 4 teams.
- For each group of 4-6 staff, one 24-piece puzzle is required. A clock is needed to time the activity.
- Remove and keep the puzzle box lids nearby so that the final picture isn’t known for each puzzle, remove one center piece (marked on the back to identify the puzzle it belongs to) and hide it nearby (e.g., on your person).
- For more than 1 group, ideally use multiples of the same puzzle, removing the same puzzle piece from each one.
- Provide context, rationale and expected length of time for the activity, including the debriefing.
- Separate staff into groups of 4-6. Designate 1 person per group as the “observer”.
- Each group gets a puzzle (without lid) to complete.
- Brief the groups: “This game allows a group to work together. Are you clear on who is in your group? There are no rules. The only objective is to complete the puzzle. You have 3 minutes to put the puzzle together starting now.”
- Groups finishing the puzzle will often ask about the missing puzzle piece. Respond along the lines of, “If the puzzle was a resident and you were missing information needed for the resident’s care, what would you do?” This usually incites searching activities.
- If someone asks for the lid, picture or missing piece, give it to them. The key is for someone to ask appropriately; not just demand it or assume that you will give the missing piece. Creative individuals will sometimes look through the facilitator’s belongings without asking and we’ve never dissuaded it, as it shows risk-taking and resourcefulness.
- Some groups will need more than 3 minutes to complete the puzzle. Time can be extended by increments of 3-5 minutes to add pressure to the task. Some groups may not finish the puzzle during the allotted time. Use your judgment about when to wrap up the puzzle-making.
- Be sure to leave adequate time for debriefing – it’s key to translating learning to practice!
- Ask the observer/s to comment on teamwork and interaction styles – e.g., was there a clear leader? If yes, were they elected or did they just take command?
- Ask the group members to comment on their role on the team. How did they contribute to getting the job done?
- Did group members use different strategies to put the puzzle together (e.g., edges, corners, colours, shapes or even looking at other groups)? How did that influence the group’s ability to problem-solve?
- Discuss if group members asked about and searched for missing information or not (picture, missing piece).
- Did the activity reflect their usual problem solving style at work (or in general)? What was different? What was similar?
- What solutions did they come up with to solve the twist to the activity? (i.e., the missing piece)
- How does this activity translate into day-to-day work? What can we take away from this activity?
- Have group members been in a situation when they were the missing puzzle piece (that prevented achievement of a goal)?
During debriefing, the facilitator encourages staff reflection while highlighting and positively reinforcing emerging themes:
- Team work: common goals, effective communication (listening, wording questions and requests appropriately), collaboration, mutual respect, speaking up about information the team may need
- Leadership: leading, following, being inclusive
- Solution-focus: creativity, risk-taking, determination to achieve a goal
During this webinar, the Ontario Association of Residents’ Councils (OARC) shares their exciting new education program called Through Our Eyes: Bringing the Residents’ Bill of Rights Alive. What makes Through Our Eyes different? It’s high in resident engagement and yields an education session unlike any other. Even residents living with cognitive changes are invited to successfully participate in the development and delivery of the education.
The success is uncharted as we move from theoretical learning to poignant, life affirming learning through connection and relationship. Join OARC in this exciting new chapter of educating on the Residents’ Bill of Rights – learning that is truly resident centred and makes a difference in the lived experience of residents!
The Through Our Eyes webinar was part of a 3-part Culture Change Webinar Series created to share new learnings and best practices with those who are working to change the culture of aging. The series was hosted by the Schlegel-UW Research Institute for Aging in partnership with the Ontario CLRI.
This webinar was originally presented on February 22, 2017.
About the presenter
Dee Lender, Executive Director, Ontario Association of Residents’ Councils (OARC)
Dee Lender is the Executive Director of the Ontario Association of Residents’ Councils – the largest long-term care Residents’ Council Association in Canada, supporting Residents’ Councils from a variety of long-term care homes across Ontario.
Dee’s passion for person-centred care began 25 years ago as a university student in Gerontology. Throughout her career as Activity Director, Coordinator of Family and Resident Services, Educator, Counselor and Consultant, Dee understands the challenges and importance of our changing culture and changing demographics. Dee has fostered authentic relationships, pursues open contribution from all those in the long-term care community, care partners and residents alike, and is keenly interested in educating future generations of care partners.
Most recently Dee has become certified in P.I.E.C.E.S and continues to explore new ways to work with residents so that all voices are heard and effective Residents’ Councils flourish.
Designed to enhance nursing, personal support worker and allied health gerontological specialty knowledge in the early identification and care of older adults living with frailty at risk of acute deterioration.
A Game to Foster Team Collaboration in the Care of Persons with Dementia
The Baycrest CLRI team along with 2015 summer interns created and trialed a card game called Trigger Match that stimulates team discussion and enhances specific team skills regarding the care of persons with responsive behaviours.
The resources in this toolkit were developed using a quality improvement approach and are meant to foster player and facilitator awareness and insight into working together to find care solutions for long-term care residents with responsive behaviours related to dementia.
Complete Toolkit: Trigger Match Toolkit
Appendix A: Behaviour Cards
Print a ready-to-cut Behaviour Card Deck.
Appendix B: Trigger Cards & Chance Cards
Ready-to-print Trigger and Chance Card Deck.
Appendix C: Behaviours & Trigger Card Blank Templates
Ready-to-print: List of all the behaviours and triggers in an excel sheet, and blank template for the Behaviour and Trigger Cards.
Appendix D: Trigger Match Pocket Card/Cheat Sheet
Ready-to-print Cheat Sheet is meant to be printed double-sided with 6 slides of page 1 and 6 slides on page 2 on a 8.5 ” x 11” sheet. This produces 6 cheat sheets per page.
Appendix E: Sample Presentation/Handout to Introduce the Game
Ready-to-print sample presentation/handout to introduce the game.
The Centre for Education at Baycrest has created an online resource to lessen the complexity, confusion and challenge of locating reliable information about dementia for caregivers and those with concerns about dementia and memory loss.
Dementia Resources from Around the World is now accessible online at http://www.baycrest.org/dementiaresources.
This webpage has a selection of the best available senior-friendly web resources on dementia. It is for individuals experiencing symptoms of the disorder and their caregivers.
The selected websites provide information on dementia including risk factors, sign and symptoms, diagnosis, treatment options, strategies to cope with daily life challenges, and available support groups. The information is available in multiple formats (i.e., video, PDF, pamphlets, games) to make it accessible to everyone. The websites included on the site were evaluated to ensure they provide reliable and valid information on dementia.
Melissa Donskov, Mary-Lou Vander Horst, Raquel Meyer
The three inaugural Ontario Centres for Learning, Research and Innovation (CLRI) in Long-Term Care (LTC) — Baycrest, Schlelgel, and Bruyère — presented a panel discussion on April 15, 2015 at the OANHSS Annual Conference.
The presenters were: Melissa Donskov (Director of Operations, Bruyère CLRI), Raquel Meyer (Manager, Baycrest CLRI), and Mary-Lou Vander Horst (Director, Schlegel CLRI).
The presentation, “Teaching Long-Term Care Homes: Current and Future Opportunities”, opened with an overview of the history and international experience of teaching long-term care homes. This was followed by a discussion on the Ontario experience, as well as the goals and structure of the Ontario CLRI Program.
The presenters shared the innovative approaches and projects undertaken by each CLRI, and discussed some of the key elements such as partnerships, internal/external influences, as well as integrating education, research, and quality improvement initiatives into the operational framework of a LTC home. The three speakers also participated in a discussion about the future vision and opportunities for teaching LTC homes; and their potential to foster cultures of learning, inquiry, and innovation across the sector.
Teaching LTC Homes: Current and Future Opportunities
Click on the link above for a copy of the presentation slides.
Education Toolkit: How to Screen Older Adults for Depression using the Patient Health Questionnaire (PHQ)
This toolkit is designed as a health professions educational resource for educators seeking to teach healthcare staff and students on using the Patient Health Questionnaire (PHQ) to screen older adults for depression in long-term care. The content of this education places specific emphasis on how to recognize signs and symptoms of depression, how depression is different from dementia, when and how to screen for depression using the PHQ-2, strategies to promote safety and wellness in persons with depression. Experiential learning techniques include the use of video simulations (found in Education Toolkit Part 2-3) for participants to practice and receive feedback using the screening forms. Slides, handouts and evaluation materials are also included for adaptation and use by the educator.
Education Toolkit: How to Screen Older Adults for Delirium using the Confusion Assessment Method (CAM)
This toolkit is designed as a health professions education resource for educators seeking to teach healthcare staff and students on using the CAM to screen older adults for delirium in long-term care. The content of this education places specific emphasis on how to recognize signs and symptoms of delirium, when and how to screen for delirium using the CAM, and strategies to promote safety and wellness in people with delirium. Experiential learning techniques include the use of video simulations (found in Education Toolkit Part 2-3) for participants to practice and receive feedback using the screening forms. Slides, handouts, and evaluation materials are also included for adaptation and use by the educator.
Toolkit: Interprofessional Education & Care (IPE/C)
Information and resources to help team members and students learn and work interprofessionally.