36 Supporting aged care staff to initiate advance care planning for people living with dementia

<h3>Background</h3> Staff working in aged care have an important role in supporting people living with dementia and their families to participate in advance care planning (ACP). However, several barriers exist, including low staff self-confidence and the complexity involved with tailoring ACP to the persons’ cognitive capacity. The Advance Project (Dementia) was funded by the Australian government to develop free, practical, evidence-based resources and training to support aged care staff to initiate ACP and assess palliative care needs of people living with different stages of dementia. <h3>Methods</h3> The resources and eLearning courses are freely accessible via the Advance Project website www.theadvanceproject.com.au Train-the-trainer sessions were held face-to-face or by videoconference. All training participants were invited to complete optional surveys to assess the effect of participation. <h3>Results</h3> 1,383 people registered for the resources, 998 participants enrolled in eLearning courses from all Australian states/territories, and 430 participants attended train-the-trainer sessions from 25 aged care organisations in four states. All clinician/manager participants agreed that eLearning provided them with useful resources to initiate ACP with people living with early or moderate dementia and with substitute decision-makers (SDMs) of people living with advanced dementia and 96% agreed they would recommend eLearning to other staff. 93–95% of clinicians/managers felt more confident initiating ACP conversations with people living with dementia and SDMs after completing eLearning. 95% agreed they were likely to use the ACP resources. 98% of careworkers found the eLearning useful. The optional post-train-the-trainer survey showed 97% agreed their workplace would use the eLearning/resources. <h3>Discussion</h3> The Advance Project has developed a high-quality suite of resources and training that is meeting a known need for better ACP for people living with dementia. Feedback about the training and resources was overwhelmingly positive. <h3>Unique Contribution</h3> The Advance Project (Dementia) training and resources address an important gap by supporting frontline staff in aged care to initiate ACP conversations and assess the palliative care needs of people living with dementia at various stages of cognitive capacity. This in turn has the potential to empower aged care services to support person-centred care at the end-of-life for this underserved yet highly prevalent population. <h3>Implication</h3> Ongoing investment in education and implementation support is needed to embed the Advance Project (Dementia) training and practical resources in aged care services, to improve confidence of the aged care workforce and help break down barriers for people living with dementia and their families to engage in important conversations about ACP.