Dementia and the care of people with the condition has been an area of growing interest and concern within gerontology for many years. In more recent years UK health and social care policy related to dementia has highlighted the need for specialist dementia care training to be provided to all those who care for people with the condition (NICE/SCIE 2006; Alzheimer's Society 2007). It is also likely that the UK National Dementia Strategy will highlight the need for better staff education and training across heath and social care when it is published later this year.

The University of Bradford was the first higher education institution to develop academic awards and qualifications specifically related to dementia, with the development of its distance learning undergraduate courses in Dementia Studies in the early 1990s. We now have a full portfolio of undergraduate and postgraduate courses in these areas, which run alongside our buoyant short course provision and consultancy, service evaluation and research work around dementia care. A number of other UK Universities have also developed specialist postgraduate courses in Dementia Studies in more recent years and a Higher Education for Dementia Network (HEDN) has been established for academics working in this area (Hope, Pulsford, Thompson, Capstick, & Heyward, 2007). There is, however, very little published evidence about how and whether education in dementia care has a positive impact on students or their practice. In particular the criticisms regarding the theory-practice gap (Corlett 2000) levelled at education of health care professionals working in any field is an area of concern. Is dementia education implementable into dementia care practice?

Within the Division of Dementia Studies we undertook a small scale, informal evaluation of the experiences and thoughts of a few undergraduate and postgraduate students undertaking study with us. Dementia Studies students were contacted on two occasions to seek out their experiences of studying. Semi-structured telephone interviews were conducted with students who had successfully completed the module Dementia Care: Guiding Principles. In addition all current Dementia Studies students were contacted via e-mail and asked to provide examples of positive outcomes and also difficulties they had experienced in applying what they had learnt into practice. In all, the experiences of 17 students studying on Undergraduate and Postgraduate programmes in Dementia Studies were gathered.

Overall students were very positive about their studies and the impact it was having on them as dementia practitioners and practice within their workplace. Some had at times faced difficulties in implementing what they had learnt in practice. Literature on the theory-practice gap suggests two possible reasons for this, the first is that idealist theory taught in the classroom is impossible to implement in practice (Corlett 2000). The second is that the cultures of care in practice are not amenable to implementation of theory (Institute of Medicine 2003). The latter of these two reasons appeared to be applicable to the students whose experiences we accessed. One commented:

In my previous role working in a care home I had difficulty implementing what I had learnt because of the culture at that time

And another stated:

There is sometimes difficulty in changing practices when you work in a large organisation. Feeding what I have learnt up to a regional or national level is hard if not impossible at times.

All of the students described some positive benefits that undertaking dementia education had provided. These largely related to two key areas, the first was increased knowledge that they were in turn able to pass onto colleagues. Students gave examples of how this had been directly beneficial to changing care practice and making a difference to the people with dementia they cared. The second area was in giving them increased confidence to challenge existing practices.

Some quotes from students included:

I believe my studies have helped me and my colleagues to seek possible meaning behind the actions of people with dementia rather than write off behaviours as part of the condition

As a care home inspector I now feel much more confident about challenging the practice of nursing and qualified staff

It’s a confidence thing … I’m very conscious that I’ve got things to say now

These findings indicate the cultures of care within many dementia care settings can make implementation of theory difficult. However, the increased knowledge and confidence that dementia education provides to students is a driver for change and improvement. This suggests that if more people are given the opportunity for specialist dementia education, cultures of care will change making implementation of theory less problematic.

So what does it tell us about dementia education and its future in the UK? Well, the prominence of dementia on the national agenda and the publication of the National Dementia Strategy later this year mean the care of people with dementia is going to remain a significant focus within health and social care in coming years. It is clear from the small-scale evaluation we conducted of Dementia Studies students from the University of Bradford, that dementia education can have a positive effect on students, their practice and on the care within the settings in which they work. Funding for education continues to remain an issue across the sector and whether the National Dementia Strategy serves to direct more funds towards dementia education in the future remains to be seen. What is clear is that where organisations or individuals are committed to improving the quality of dementia care, and can find funds to provide specialist education in dementia studies, this is likely to have benefits for practice.

So in a time when the quality of care for people with dementia is an area of significant concern within the UK, can we afford not to invest in dementia education for dementia care workers? As education providers we know where we want to go with dementia education in the future in order to continue our work in improving the lives of people with dementia and those who care for them. The question is how much are the government and health and social care providers willing to invest in terms of going there with us? That, I guess, depends on how much they really value people with dementia.

References

Alzheimer's Society (2007). Home from home. London, Alzheimer's Society.

Corlett, J. (2000). The perceptions of nurse teachers, student nurses and preceptors of the theory-practice gap in nurse education. Nurse Education Today20: 499-505.

Hope, K., Pulsford, D., Thompson, R., Capstick, A., & Heyward, T. (2007). Hearing the voice of people with dementia in professional education. Nurse Education Today27(8): 821-824.

Institute of Medicine (2003). Executive Summary: Health Professions Education: A Bridge to Quality, National Academy of Sciences. Available from http://newton.nap.edu/execsumm_pdf/10681.pdf. Accessed on 23.11.07

NICE/SCIE (2006). Clinical guidelines 42: Dementia. Supporting people with dementia and their carers in health and social care. London, National Institute for Health and Clinical Excellence.

The Bradford Dementia Group provide a full range of short courses, accredited study, study days, consultancy, service evaluation and research services related to dementia care. For further information please contact 01274 233996 or dementia@bradford.ac.uk or see our web-site www.brad.ac.uk/acad/health/dementia