Jasneet Parmar

Stakeholder Meeting: Integrated Knowledge Translation Approach to Address the Caregiver Support Gap.

RÉSUMÉ:Les aidants familiaux sont une partie intégrante et de plus en plus débordée du système de soins de santé. Il y a un écart entre ce que les données de recherche démontrent être bénéfique pour les soignants et ce qui est réellement fourni. À l’aide d’une approche basée sur l’application intégrée des connaissances (AC), une réunion des intervenants a inclus des chercheurs, des aidants familiaux, des associations de soignants, des cliniciens, des administrateurs de soins de santé et des décideurs. Les objectifs de la réunion étaient d’examiner les données issues des recherches en cours et de tenir un dialogue entre les intervenants multiples sur les lacunes, les facilitateurs et les obstacles à la fourniture d’un soutien aux aidants naturels. Cent vingt-trois individus ont participé à cette réunion. Trois populations cibles des aidants familiaux ont été identifiées pour discussion: soignants d’aînés atteints de démence, soignants en fin de vie et soignants d’aînés ayant des besoins de santé complexes. Les résultats de cette réunion sont et seront utilisés pour éclairer le développement des efforts visant à mettre en œuvre à la fois des recherches et des politiques afin de fournir un soutien aux aidants familiaux en se basant sur les preuves.ABSTRACT:Family caregivers are an integral and increasingly overburdened part of the health care system. There is a gap between what research evidence shows is beneficial to caregivers and what is actually provided. Using an integrated knowledge translation approach, a stakeholder meeting was held among researchers, family caregivers, caregiver associations, clinicians, health care administrators, and policy makers. The objectives of the meeting were to review current research evidence and conduct multi-stakeholder dialogue on the potential gaps, facilitators, and barriers to the provision of caregiver supports. A two-day meeting was attended by 123 individuals. Three target populations of family caregivers were identified for discussion: caregivers of seniors with dementia, caregivers in end-of-life care, and caregivers of frail seniors with complex health needs. The results of this meeting can and are being used to inform the development of implementation research endeavours and policies targeted at providing evidence-informed caregiver supports.

The Development and Implementation of a Decision-Making Capacity Assessment Model

Background Decision-making capacity assessment (DMCA) is an issue of increasing importance for older adults. Current challenges need to be explored, and potential processes and strategies considered in order to address issues of DMCA in a more coordinated manner. Methods An iterative process was used to address issues related to DMCA. This began with recognition of challenges associated with capacity assessments (CAs) by staff at Covenant Health (CH). Review of the literature, as well as discussions with and a survey of staff at three CH sites, resulted in determination of issues related to DMCA. Development of a DMCA Model and demonstration of its feasibility followed. Results A process was proposed with front-end screening/problem- solving, a well-defined standard assessment, and definition of team member roles. A Capacity Assessment Care Map was formulated based on the process. Documentation was developed consisting of a Capacity Assessment Process Worksheet, Capacity Interview Worksheet, and a brochure. Interactive workshops were delivered to familiarize staff with the DMCA Model. A successful demonstration project led to implementation across all sites in the Capital Health region, and eventual provincial endorsement. Conclusions Concerns identified in the survey and in the literature regarding CA were addressed through the holistic interdisciplinary approach offered by the DMCA Model.

Supporting people who care for older family members

In Canada, there are an estimated four million people caring for older family members with short- or long-term health conditions.[1][1] A recent Canadian study estimated the cost of such unpaid caregiving at

A metasynthesis study of family caregivers’ transition experiences caring for community-dwelling persons with advanced cancer at the end of life:

25 billion.[2][2] Global costs of informal care related just to dementia are estimated to

Effectiveness of a Core-Competency-based Program on Residents' Learning and Experience.

Background: Family caregivers (broadly defined as family and friends) experience multiple concurrent transitions when caring for a person with advanced cancer. Aims: To (a) explore the transition experience of family caregivers caring for persons with advanced cancer living in the community, (b) describe potential triggers for transitions, (c) identify what influences this experience, and (d) develop a conceptual framework of their transition experience. Design: Sandelowski and Barroso’s methodology for synthesizing qualitative research included (a) a comprehensive search of empirical literature, (b) quality appraisal of qualitative studies, (c) classification of studies, and (d) synthesis of the findings. Data sources: Literature was sourced from six electronic data bases. Inclusion criteria were as follows: (a) published qualitative studies (and mixed-method designs) of the caregiving experience of family caregivers of community-living persons with advanced cancer at the end of life, (b) participants (caregivers and care recipients) of 18 years of age and above, (c) studies published in English in any country, and (d) studies published between 2004 and 2014. Results: A total of 72 studies were included in the metasynthesis. Family caregivers experience a “life transition” whereby their lives are permanently altered. The participants described the process of redefining normal which consisted of coming to terms with their situation and connecting with others. Outcomes of these processes were as follows: (a) maintaining a sense of personhood, (b) reframing hope, (c) maintaining self-efficacy, (d) finding meaning, and (e) preparing for the death of their care recipient. Conclusion: The findings provide a framework to guide the development of supportive programs and future research.

Integrating Spirituality as a Key Component of Patient Care

Background The Care of the Elderly (COE) Diploma Program is a six-to-twelve-month enhanced skills program taken after two years of core residency training in Family Medicine. In 2010, we developed and implemented a core-competency–based COE Diploma program (CC), in lieu of one based on learning objectives (LO). This study assessed the effectiveness of the core-competency–based program on residents’ learning and their training experience as compared to residents trained using learning objectives. Methods The data from the 2007–2013 COE residents were used in the study, with nine and eight residents trained in the LO and CC programs, respectively. Residents’ learning was measured using preceptors’ evaluations of residents’ skills/abilities throughout the program (118 evaluations in total). Residents’ rating of training experience was measured using the Graduate’s Questionnaire which residents completed after graduation. Results For residents’ learning, overall, there was no significant difference between the two programs. However, when examined as a function of the four CanMEDS roles, there were significant increases in the CC residents’ scores for two of the CanMEDS roles: Communicator/Collaborator/Manager and Scholar compared to residents in the LO program. With respect to residents’ training experience, seven out of ten program components were rated by the CC residents higher than by the LO residents. Conclusion The implementation of a COE CC program appears to facilitate resident learning and training experience.