Authors (including presenting author) :
Hon YL(1), Leung CO(1), Tang HY(1), Chu SSK (1), Fung WY(1), Leung CN (1), Chan WS(1), Fung KM(1), Lee CK (1), Sham SW (1), Wong QYP(1)
Affiliation :
(1) Psychogeriatric Team, Kwai Chung Hospital, Hong Kong
Introduction :
" Better Team; Better Service". Health care professionals from different disciplinary backgrounds to combine unique skills and knowledge to deliver high-quality and timely care, focused on the needs of service users and their carers. Accordingly, in view of ageing in place, it is well known that dementia becomes more prevalent with increasing age. However, there is currently no treatment available to cure dementia. The consequent increased disability burden and costs of long-term health and social care will be substantial. In Hong Kong, employing foreign domestic helpers (FDHs) for care of elderly is common. However, FDHs are not specially trained for care of elderly with dementia. Therefore, "All-round training workshop and educational materials" were developed by multidisciplinary team members of Psychogeriatric Team, KCH for FDHs to strengthen their caregiving ability and subsequently to reduce their stress in caring of elderly with dementia.
Objectives :
(1) To strengthen the caregiving ability of FDHs.
(2) To evaluate the effectiveness of domestic helper workshop on caring for elderly with dementia.
Methodology :
Four all-round full-day workshops with live demonstrations and multidisciplinary approach were conducted in August 2015 till now, including topics on pathology of dementia by psychogeriatric doctor; stress management by clinical psychologist; care management on BPSD by psychogeriatric nurses, safe transferring and lifting by physiotherapist; and structured day activities and home safety by occupational therapist. The content of the workshop was based on a focus group of 21 FDHs interviewed in May 2015 with five most distressing BPSD (Delusion, Aggression, Depression, Irritability and Sleep Disorders) identified by using Neuropsychiatric Inventory (NPI) assessment. The workshops were delivered in English and Chinese, with live translation by an Indonesian interpreter. The effectiveness of the workshops was measured using modified version of NPI for BPSD symptom score, and a 6-point likert scale for carer strain on individual symptoms before and 1 month after the workshops. Based on the experience outcome, a trilingual guidebook "Caring for elderly with dementia: Guide to foreign domestic workers" was produced by the project team in English, Indonesian and Chinese. The project was funded by the Health Care and Promotion Fund. A trilingual video was filmed for easier understanding of the content of the guidebook and for community promulgation by the funding of Kwai Tsing District Office, Home Affairs Department.
Result & Outcome :
113 FDHs attended the workshop. Paired sample T-test was conducted to evaluate the impact of the workshops. The post-workshop symptoms score (mean = 7.66, SD = 8.27) was shown to be significantly lower than the pre-workshop symptoms score (mean 17.25, SD = 15.06), p< .001. The post-workshop carer strain score (mean = 1.97, SD = 2.85) were also shown to be significantly lower than the pre-workshop carer strain score (mean = 8.59, SD = 6.47), p< .001. The decrease in behavioural symptoms and carer strain score in all five symptom domains were found to be statistically significant. The workshops are now regularly provided for FDHs. A trilingual guidebook was published in June 2016 (30,000 copies). 10,000 copies were given to carers (including other hospitals and community partners). A book launch was held in November 2016 to promote the content of the guidebook to 36 community support service units (DECC, NEC) in Kwai Tsing , Tsuen Wan and Sham Shui Po districts. The guidebook was also made available online for public reference.
