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Ithaca College Gerontology Institute Learning Needs Survey Report Fall 2013 Ithaca College Gerontology Institute 2013 Learning Needs Survey – Executive Summary Introduction The Ithaca College Gerontology Institute (ICGI), established in 1992 to serve as a campus and community resource, promotes and supports research, curriculum development, community education, and community service activities in gerontology. As part of our mission to serve as a community resource, the institute offers training for professionals in health and aging services through a number of internally funded and grant funded initiatives. The need for training on aging is particularly acute in rural areas, which not only face shortages of health care services and specialists, but also contain higher percentages of older adults than urban areas. While the Ithaca College Gerontology Institute (ICGI), under the umbrella of the Finger Lakes Geriatric Education Center (FLGEC), provides training on aging issues to rural health professionals in central New York, no analogous program exists for other aging services staff and professionals. Goals In keeping with its mission, the Gerontology Institute is committed to plan and deliver programs that respond to current and emerging community needs. As a result of that commitment, an online survey and stakeholder interviews were conducted in 2013 to gauge current interest in gerontology and geriatric training programs among health and social service professionals in rural western and central New York. Secondary goals included identifying stakeholders’ perceptions about specific training needs, and building relationships with potential community partners with whom we might collaborate to develop and implement future training. Summary This report provides results from responses to an online survey about the perceived gerontology/geriatric training needs and preferences of 135 health and social service workers in rural central and western New York. It also reports the results from interviews with 13 leaders from stakeholder organizations about the importance of gerontology and geriatric training for professional staff, and the ability of these organizations to support such training. Highlights from the survey and interviews include: • • • Widespread interest in further training and/or education about gerontology and geriatrics. The overwhelming majority of those surveyed (95%) expressed interest in further training in these areas. Although one type of program delivery format would not work for all the professionals surveyed, workshops were of interest to nearly all respondents. Respondents expressed a strong preference for shorter learning opportunities, such as half-day conferences, over the traditional full-day conference format. Respondents also expressed an interest in more on-site training delivered in the workplace. Stakeholders and health and social service professionals agreed on many of the topics that most need to be addressed through training opportunities. Topics mentioned most frequently fit into the following broad categories: health systems, Alzheimer’s/dementia and other mental health issues, physical aging, psychosocial aging, and aging-in-place. • There was strong organizational support for training—both financially and by allotting work time for staff to pursue development of skills and knowledge—but support is limited by staffing shortages and budgets. • Stakeholder interviews and the online survey indicated that limited budgets and time are significant barriers to participation in training and educational opportunities. High cost, distance to travel, limited time and scheduling issues were listed as the greatest barriers to gaining further knowledge and skills. • Health and social service professionals prefer to learn through face-to-face interaction with faculty experts and other students. However, respondents also expressed interest in webinars that were interactive in nature. A blended approach combining face-to-face presentations with webinars has the potential of greatly increasing access to professionals in rural areas. It may also bring down cost, further increasing access for individuals and workplaces. • The professionals we surveyed are highly experienced and the majority has received some formal gerontology/geriatric training. However, with access to outside training so limited, additional training and recent updates on aging-related issues are greatly valued and needed. Aging services practitioners state here that they need and want to learn more about the aging process and its consequent associated health and social issues. This study indicates that if we are to meet the growing needs of older adults in rural central and western New York, we must be responsive to emerging needs by employing creative strategies and collaborations to improve access to gerontology and geriatric training for health and social service professionals. Ithaca College Gerontology Institute 2013 Learning Needs Survey – Final Report Introduction The Ithaca College Gerontology Institute (ICGI), established in 1992 to serve as a campus and community resource, promotes and supports research, curriculum development, community education, and community service activities in gerontology. As part of our mission to serve as a community resource, the institute offers training for professionals in health and aging services through a number of internally funded and grant funded initiatives. This mission takes on additional significance because it is well documented that the nation’s health care workforce lacks adequate training in how to best respond to the health and social problems experienced by older adults. While critical today, the need for such training will become even more pressing as the Baby Boomers age. Not only is the need for such training driven by a demographic imperative, but it is also compounded by the fact that many experienced health care and social service workers are themselves nearing retirement age. This means much of the knowledge of aging gained through “on the job experience” will soon be lost to many organizations offering services to older adults. The need for training on aging is particularly acute in rural areas, which not only face shortages of health care services and specialists, but also contain higher percentages of older adults than urban areas. While the Ithaca College Gerontology Institute (ICGI), under the umbrella of the Finger Lakes Geriatric Education Center (FLGEC), provides training on aging issues to rural health professionals in central New York, no analogous program exists for other aging services staff and professionals. Despite this need, we have little information on the demand for gerontology/geriatric training among rural New York health and social service workers, their interest in specific aging topics, or the nature of programs and methods of instruction that would best meet their schedules and resources. Goals The Gerontology Institute plans and delivers programs that respond to current and emerging community needs. In keeping with that commitment, the primary goal of the 2013 survey was to gauge current interest in gerontology and geriatric training programs among health and social service professionals in rural western and central New York, with specific attention to the topical and delivery method preferences, in an effort to ensure that our community-based programs are sufficiently meeting the needs of our target audiences. Secondary goals included identifying stakeholders’ perceptions about specific training needs, and building relationships with potential community partners with whom we might collaborate to develop and implement future training. In 2004, the ICGI conducted a similar survey to learn about the learning needs and preferences of area health and human service practitioners. Face-to-face Interviews of Stakeholders Methodology Face-to-face interviews were conducted with 13 organizational stakeholders who were identified as leaders in health and social service organizations in the central New York region. These interviews sought to gather their perceptions about the needs and priorities for gerontology/geriatric training in their organizations and in the community at-large, as well as resources available to support such training. 1 Survey Instrument These interviews were intended to gather information about stakeholder perception of training needs and priorities, and resources available to support gerontology/geriatric training at their workplaces. In addition, the interviews aimed to raise awareness that rural gerontology/geriatric training was being considered and might be available in the future. Additionally, the interviews aimed to lay the groundwork for potential collaborations and future marketing of training and education programs. The open-ended questions asked during the stakeholder interviews can be found in Appendix A. Sample The convenience sample for the stakeholder interviews was derived through several means. We selected key leaders in health and social service agencies who count older adults as a significant portion of their clientele to serve as respondents. These included organizations such as home care agencies, offices for the aging, assisted living facilities, community based senior centers, and nursing homes, as well as less obvious sites. Many of the stakeholders were members of the Gerontology Institute’s Community Advisory Board. Others were recognized as regional leaders in the areas of aging services and health care delivery. Data Collection After stakeholders were identified, we initiated contact, explained the project, and scheduled and conducted the interviews. Figure 1 shows the types of organizations at which stakeholders were interviewed. Figure 1. Stakeholder Interviews by Type of Organization Type of Organization Senior Center Nursing Home Home Health Agency Family and Children’s Services Assisted Living/Adult Home Agency Serving Developmentally Disabled County Office on Aging Continuing Care Retirement Community (CCRC) Health Planning Council Public Housing Community Foundation Senior Center Survey of Health and Social Service Professionals Methodology A web-based survey of health and social service professionals was conducted in order to learn about their gerontology/geriatric training needs and preferences. Using Qualtrics, a web-based tool, the survey questions were made available online. 2 Survey Instrument Survey questions were developed based on our programmatic interest in learning about the need for training in central and western rural New York. An earlier survey conducted by the Gerontology Institute in 2004 also significantly guided development of the 2013 survey. Survey questions can be found in Appendix B. Sample A convenience sample of respondents was derived from the Gerontology Institute database of individuals who had received our online newsletter or had participated in previous workshops, conferences, or FLGEC training events. A link to the survey was also disseminated to potential respondents via the Tompkins County Human Services Coalition listserv. Data Collection An email with the survey was sent to individuals in the sample residing in 14 rural counties in central and western NY. Most of these potential respondents worked in health care and social service agencies. Data collection efforts continued over approximately four weeks, from start date to end date. The 14 target counties included several small towns and cities, including Ithaca and Cortland, but most were predominately rural, with few services based in the county, and few organizations that provide continuing education about gerontology and geriatric issues to the local workforce. A total of 135 web-based surveys were fully completed and 224 were partially completed. Because the survey was also distributed via listservs and forwarded to many via email, the exact overall response rate cannot be accurately quantified, since it is impossible to quantify how many individuals accessed the survey listservs or had it forwarded to them by others via email. Findings Stakeholder Interviews The stakeholder interviews provided detailed and comprehensive input from leaders representing regional health and human services organizations about learning needs and preferences. In addition, the responses provided valuable feedback about the role of the institute as a community partner and provider of educational programming. In response to the question “What type of staff might benefit from additional training in aging studies, the aging process, or geriatrics?” respondents provided a variety of answers. The overwhelming majority of respondents stated that all types of staff would benefit from training in aging-related topics. Specifically, respondents suggested that training be provided to all staff, frontline staff, and front office staff. Other groups mentioned were students, health care workers, rural audiences, adult children, and staff of organizations that don’t primarily serve aging consumers, such as businesses and schools. When asked “What type of delivery methods would work best for your staff?” most respondents (80%) said that they preferred face-to-face learning experiences, but many (60%) expressed a desire to participate in webinars, especially if they provided opportunities for interaction. A majority (60%) also stated that they would enjoy a mixture of webinars and face-to-face events. 3 In regards to preferences about time frames, interview respondents expressed a preference for half-day over full-day conferences. These responses aligned with anecdotal information received from various program participants over the past few years, indicating that it has become increasingly difficult to take time away from work to attend full-day conferences and training events. Respondents also suggested that the institute partner with community organizations and provide some training in the workplace, in order to make it available to a greater number of frontline staff. When asked about frequency of training the preference was for monthly training opportunities. In response to the question “What type of training would you recommend to your staff?” the stakeholders answered that they preferred new, update information. These responses reflect the rapidly changing information available about new and emerging issues related to older adults. They also stated a preference for tailoring topics to make them relevant to the local region. When asked if they were able to support staff by paying for their training needs, most of the respondents (80%) stated that they were. In response to the question “Would staff be able to attend training opportunities during work hours?” most (80%) responded that their staff were allowed to do so. When asked about barriers to participation in learning, the most frequent responses were time availability and budget cuts. Additional barriers mentioned were transportation, weather, competing needs, and staff coverage. The most detailed information from the stakeholder interviews came when respondents were asked to suggest preferred topics that should be addressed in training. These topics were analyzed and sorted into five topical themes, listed below. 1. Interpersonal skills Stakeholders who were interviewed suggested topics associated with communication, customer service skills, teambuilding, and change management. 2. Health systems Stakeholders identified topics related to structural issues and health systems, including health literacy for practitioners and consumers, changes in Medicare/Medicaid, and paying for long-term care. 3. Mental health Interviewees suggested topics including dementia, depression, stress management, suicide, grief, hoarding, and behavioral challenges. 4. Aging-in-place Stakeholder interviewees suggested topics included livability, housing options, community-based care, and maintaining independence. 5. Health issues Stakeholders expressed a desire for training in topics related to health issues, such as Parkinson’s disease, congestive heart failure, wound care, incontinence, chronic pain, and nutritional needs. The final question of the interviews was “What, if anything, could the Gerontology Institute provide you?” The most frequent responses to this question included workshops and speakers, partnership opportunities, monthly newsletter, and student service learning. Other responses included networking and links to educational institutions. 4 Online Survey of Health and Social Service Professionals Profession Almost 17%1 of respondents were nurses, social workers represented another 21% (see Figures 2 and 3), and nearly 24% listed administration under profession. Nutritionists made up 2% of the sample and rehabilitation therapies (defined here as physical therapy, occupational therapy, speech/language and recreation therapy) and psychotherapy and counseling combined represented 8% of the sample. Teachers and professors made up 3% of the respondents and 25% of the sample were other assorted professions. This breakdown reflects the broad representation of professions who responded to the survey. Figure 2. Survey Responses by Profession Profession (n = 135) Administration Nursing Nutrition/Dietetics Occupational Therapy Physical Therapy Psychotherapy Recreation Therapy Social Work Speech/Language Therapy Teacher/Professor Other Percent 24% 17% 2% 2% 1% 1% 2% 21% 2% 3% 25 % Figure 3. Chart of Professions Professions Administrators Other 25% Teacher 3% Social Work 21% Diete=cs 2% Admin. 24% Nursing Therapy Diete=cs Nursing 17% Social Work Teacher/Professor Therapy 8% Other 1 All descriptions, tables, charts and graphs are based on data from respondents who answered the question. 5 Training in Gerontology/Geriatrics Respondents were asked what type of formal gerontology/geriatric training, if any, they had received. As seen in Figure 4, 19% of respondents indicated that they had received no prior formal training in gerontology or geriatrics. 78% stated that they had received training through some form of continuing education, such as conferences or workshops. More than 52% had taken a course in gerontology or geriatrics. 4% had completed a geriatrics rotation, while 19% had a gerontology/geriatric certificate, and 9% combined had a bachelors or minor in gerontology. In contrast, nearly 28% went out of their way to explain that they had learned about gerontology/geriatrics in other ways, including on-the-job experiences. Figure 4. Training in Gerontology/Geriatrics Training in Gerontology 90 80 70 60 50 40 30 20 10 0 78% 52% 19% 28% 19% 4% 6 2% 7% Experience in Profession Aside from formal training, respondents bring an enormous amount of knowledge gained through onthe-job experience (Figure 5) to geriatric services in central and western New York. 41% of respondents reported more than 25 years of experience in their profession. Another17% claimed between 16 and 25 years of experience in their profession and 28% indicated that they had between six and 15 years of experience. Only 14% of respondents had five years of professional experience or less. Clearly, these responses indicate that health and social service workers contribute a wealth of hands-on knowledge and skills to any formal training in the subject, and these can be tapped to enhance the learning experience. At the same time, many of these workers may be nearing retirement, underscoring the importance of addressing this training in less experienced workers. Figure 5. Experience in Profession Years of Experience in Profession 0-‐5 Years 14% 25+ Years 25+ Years 41% 6-‐15 Years 28% 16-‐25 Years 17% 16-‐25 Years 6-‐15 Years 0-‐5 Years 7 Preferred Learning Format The survey asked respondents to rank their interest in the following four types of gerontology/geriatric training or education: workshops/conferences offered with and without continuing education credits (CEUs), webinars, and face-to-face training. The majority of respondents indicated that they were interested in all the options (see Figure 6). Overall, respondents indicated slightly more interest in workshops and conferences than in webinars. Of the four options, workshops/conferences without continuing education credits (CEUs) received the greatest interest, with over 92% of respondents expressing some level of interest and more than half stating they were very interested. Focusing on only those who were very interested, workshops/conferences for no credit again ranked highest. Figure 6. Preferred Learning Format: Interest in Program Types Interest in Program Types 80 70 60 50 40 30 20 10 0 Wkshp/Conf No Credit Very Interested Wkshp/Conf CEUs Webinars Somewhat Interested 8 F2F Networking Not Interested Importance of CEUs When asked whether or not it was important that they receive professional CEUs for their training (Figure 7), respondents were evenly divided, with approximately half saying they were very or somewhat important and half saying they weren’t important. Professional CEUs were very important to 15% of respondents, somewhat important to 32%, and not important for 54% of respondents. Figure 7. Importance of Receiving CEUs Importance of Receiving CEUs Very 15% Somewhat 32% Not Important Somewhat Important Not 54% Very Important Workplace Support for Training When asked if they were able to attend training with pay during their work hours (Figure 8), 65% said they were, while another 25% said they might be able to. In contrast, only 11% stated that they could not. Figure 8. Ability to Attend Training with Pay A=end Training with Pay During Work Hours No 11% Yes Maybe 25% Yes 65% Maybe No 9 Willingness to Attend Training Outside of Work Hours When asked if they were willing to attend training outside their work hours (Figure 9), 34% said they were, while another 25% said they might be willing to. 41% stated that they were not willing to participate in training outside work hours. Figure 9. Willingness to Attend Training Outside of Work Hours A=end Training Outside of Work Yes 34% Maybe25% Yes No Maybe No 41% Fee Structure When respondents were asked if they would be willing to pay an annual fee for continuing education (Figure 10), the majority responded No (47%). Some responded Maybe (42%), while a very small percentage (11%) responded that they would be willing to pay an annual fee. Figure 10. Willingness to Pay Annual Fee Willingness to Pay Annual Fee Yes 11% Yes Maybe 42% No No 47% 10 Maybe Frequency of Educational Opportunities Respondents were asked to identify the maximum number of gerontology educational opportunities they would attend per month (Figure 11). A large majority (87%) of respondents answered one to two times per month, while a few (11%) answered three to five times per month, and even fewer (2%) responded more than 10 times per month. Figure 11. Frequency of Educational Opportunities Frequency of EducaIonal OpportuniIes 3-‐5 Times 11% > 10 Times 2% 1-‐2 Times 1-‐2 Times 87% 3-‐5 Times > 10 =mes Resources and Barriers The survey asked about the top three factors that prevent people from pursuing further training. More than half of respondents cited high cost (62%), scheduling issues (62%), and limited time (53%) respectively, as the top three barriers to receiving further training. Distance (38%), lack of interest in topic (39%), work responsibilities (23%), and family responsibilities (12%) were also listed as barriers. Figure 12 shows all seven barriers and percentages. Figure 12. Top Barriers to Training Top Barriers to Training 70% 60% 50% 40% 30% 20% 10% 0% 11 Aging Services Listserv The Gerontology Institute seeks to provide access to current information on aging-related issues, as well as continuing education. The survey provided an opportunity to find out more about the ways health and aging services practitioners prefer to receive information. When asked if they would be interested in participating in a listserv specifically for aging services (Figure 13), the majority (71%) responded yes, 20% responded maybe, and 9% responded no. Figure 13. Aging Service Listserv Aging Services Listserv Maybe 20% No 9% Yes Yes 71% No Maybe Interest in Receiving Further Education The survey asked respondents to indicate their level of interest, if any, in further education or training in the field of gerontology and geriatrics (Figure 14). The overwhelming majority of respondents expressed some interest in further education or training in the field: 37% were somewhat interested and 58% were very interested. This validates a compelling need and readiness for the outreach educational programs that the ICGI provides to health and human services practitioners in the region. Figure 14. Further Education Not Interested 5% Further EducaIon Very Interested Somewhat Interested 37% Very Interested 58% 12 Somewhat Interested Not Interested Suggested Training Topics-General Our open-ended question eliciting respondents’ top three suggestions for training topics yielded a rich array of information. More than 300 responses from the survey respondents were subsequently coded into four topic categories (see Appendix C for a complete listing of topics). Because an open-ended question was used, the large number of congruencies among the responses takes on additional significance. The categories that emerged as training topics “most needed or wanted” are listed below in order: 1. Community services and health systems The concerns expressed in this area included healthcare reform, changes in Medicare/Medicaid, supportive services and guardianship, workforce, care transitions, person-centered care, insurance, financial issues, disasters and aging, and systems change. 2. Alzheimer’s disease/dementia Respondents were interested in assessment and differentiation between the various dementias, the behavioral changes and how to manage them, a better understanding of treatments and therapies, and how to provide support and activities for people with these conditions as well as to their caregivers. 3. Psychosocial aging Respondents requested training about psychosocial needs, mental/emotional health and illness, including such issues as grief, loneliness and denial. Depression was a major concern, as well as access to treatment for mental health problems. There was also significant interest in how to assess mental status and capacity. 4. Health and aging Respondents expressed a need to know more about chronic disease (diabetes, arthritis, heart disease, and osteoporosis) management and treatment, medication, falls prevention, incontinence, nutrition, and wellness. Suggested Training Topics-Alzheimer’s/Dementia Another open-ended question eliciting respondents’ top three suggestions for training topics related to Alzheimer’s Disease and other forms of dementia also provided useful information. The survey respondents provided over 300 responses that were coded into five topic categories (see Appendix D for a complete listing of topics). The categories that emerged as training topics about Alzheimer’s/Dementia “most needed or wanted” are listed below: 1. Behavioral interventions Responses indicated an interest in topics such as managing combative behavior, interventions (validation, behavior modification and reality techniques) training, de-escalating agitated patients, calming mood swings, angry and agitated behavior, etc. 2. Alzheimer’s/dementia (physical aspects) Respondents expressed an interest in topics such as neurological changes, stages, physical changes, medications, diagnosis, physical pain, and recent research updates. 3. Alzheimer’s/dementia (psychosocial aspects) 13 Suggested topics included coping strategies, social isolation, losing/maintaining independence, mental health, spirituality/grief, maintaining quality of life, safety, etc. 4. Caregiving Respondents expressed an interest in learning more about communication, stress-management, self-care, family dynamics, etc. 5. Service providers/network/health system Suggested topics included adult protective services, access to mental health services, dementia respite programs, health care coverage, long-term care planning, systems change, care transitions, etc. Summary This study reports on the perceived gerontology/geriatric training needs and preferences of 135 health and social service workers in rural central and western New York. It also explores ideas held by 13 leaders from stakeholder organizations about the importance of gerontology and geriatric training for professional staff, and reports on the ability of these organizations to support such training. The study results demonstrate a great deal of interest in further training and/or education about gerontology and geriatrics. The overwhelming majority of those surveyed (95%) expressed interest in further training in these areas. Although one type of program delivery format would not work for all the professionals surveyed, workshops were of interest to nearly all respondents. In response to limited time available, workers expressed a strong preference for shorter learning opportunities, such as half-day conferences, over the traditional full-day conference format. Respondents also expressed an interest in more on-site training delivered in the workplace. Stakeholders agreed that a gerontology or geriatric background was an asset and noted enthusiasm for the availability of continuing education for staff who serve older adults. Stakeholders and health and social service professionals agreed on many of the topics that most need to be addressed. Topics mentioned most frequently fit into the following broad categories: health systems, Alzheimer’s/dementia and other mental health issues, physical aging, psychosocial aging, and aging-in-place. Organizations serving older adults would welcome additional training options. They support training both financially and by allotting work time for staff to pursue development of skills and knowledge, but their support is limited by staffing shortages and budgets. Some workplaces completely covered training fees, tuition for education and travel expenses. Others that have experienced severe budget cutbacks in recent years could pay very little. As indicated in both the stakeholder interviews and the online survey of health and aging services practitioners, limited budgets and time are significant barriers to participation in training and education opportunities. High cost, distance to travel, limited time and scheduling issues were listed as the greatest barriers to gaining further knowledge and skills. Health and social service professionals prefer to learn through face-to-face interaction with faculty and other students. However, respondents also expressed interest in webinars that were interactive in nature. A blended approach combining face-to-face presentations with webinars has the potential of greatly increasing access to professionals in rural areas. It may also bring down cost, further increasing access for individuals and workplaces. 14 The professionals we surveyed are highly experienced and the majority has received some formal gerontology/geriatric training. However, with access to outside training so limited, additional training and recent updates on aging-related issues are greatly valued and needed. Aging services practitioners state here that they need and want to learn more about the aging process and its consequent associated health and social issues. This study indicates that if we are to meet the growing needs of older adults in rural central and western New York, we must be responsive to emerging needs by employing creative strategies and collaborations to improve access to gerontology and geriatric training for health and social service professionals. 15 Appendix A Stakeholder Interview Questions 1. What type of staff might benefit from additional training in aging studies, the aging process, or geriatrics? 2. What type of delivery methods would work best for your staff? 3. What would you look for in a training series you would recommend to your staff? 4. Are you able to support staff by paying for their training needs? 5. Would staff be able to attend training opportunities during work hours? 6. What are some of the important topics that should be addressed in training? 7. How often would you like training opportunities to be available? 8. What are the barriers for you and your staff to attend training opportunities? 9. Due to our unique position as part of Ithaca College, what, if anything, could the Gerontology Institute provide you? 10. Other Items: Page 1 Appendix B 2013 Learning Needs Survey Questions 1. What is your primary place of work? (Check only one.) Acute Care/Hospital (1) Adult Day Care (2) Ambulatory Care (3) Assisted/Assistive Living (4) Educational Institution (5) Other ________________________________ (16) (please specify) Health Department (6) Home Care (7) Hospice (8) Mental Health Agency/Dept. (9) Nursing Home (10) Office for the Aging (11) Private Practice (12) Senior Center (13) Senior Housing (14) Social Services Dept. (15) 2. What is your home zip code? ______________ 3. What is the zip code at your workplace? ____________ (If you don’t know your work zip code, in which town or village is it located? ________________________) 4. What profession do you practice at your primary workplace? (Check only one.) Administration (1) Audiology (2) Dentistry (3) Medicine_________________ (4) Pathology________________ (16) (specialty) Nursing __________________ (5) (degree or certification) Nutrition/Dietetics (6) Occupational Therapy (7) Optometry (8) Pastoral Counseling (9) Pharmacology (10) Physical Therapy (11) Psychotherapy (12) Recreation Therapy (13) Rehabilitation Medicine (14) Social Work (15) Speech/Language Teacher/Professor (17) Other ______________ (18) (please specify) 5. How many years of experience do you have in this profession? _____ 6. Please indicate the formal training you have received related to gerontology or geriatrics. (Check all that apply.) None (a) Gerontology/geriatrics course(s) (b) Certificate Program in Geriatrics/Gerontology (c) Geriatrics Rotation (d) Conferences, Workshops, or other Continuing Education (e) Minor in Gerontology (f) Bachelor’s Degree in Gerontology (g) Other _______________________________________ (h) 7. Name three topics related to serving older adults on which you and/or your staff most want or need training: Page 1 8. Name three topics related to dementia on which you and/or your staff most want or need training: 9. Please rate your interest in each of the following types of programs we might offer: Very Interested (3) Somewhat Interested (2) Not Interested (1) a. Workshops/conferences offering no credits b. Workshops/conferences for continuing education credit c. Webinars d. Face to Face Networking Opportunities e. Other __________________________________________________________________________ 10. How important is it to you to receive professional CEUs for the training sessions you attend? Very Important (3) Somewhat Important (2) Not Important (1) 11. Are you able to attend training with pay during your working hours? Yes (1) No (0) Maybe (2) Don’t Know (8) 12. Are you able to attend training with pay outside your working hours? Yes (1) No (0) Maybe (2) Don’t Know (8) 13. Does your workplace pay the fees for some or all of your training? Yes (1) If yes, up to what amount? _______________________ No (0) Maybe (2) Don’t Know (8) 14. Are you willing and able to pay for training opportunities not supported by your workplace? Yes (1) No (0) Maybe (2) If yes, how much would you be willing to pay for a 3 hour session? _________ Page 2 15. What are the top three factors that might prevent you from receiving further training? None (a) Limited time (b) Scheduling issues (c) Cost is too high (d) Too far away (e) Not interested in topic (f) Family responsibilities (g) Can’t get away from work (h) Other ____________________________________________________________________ (i) 16. On a scale of 1 to 5, with 1 being the least preferred time and 5 being the most preferred time, please rate the following training opportunities timeframes. Half-day sessions on weekdays: 1 2 3 4 5 (a) Full-day sessions on weekdays: 1 2 3 4 5 (b) 1-2 hours on weekdays: 1 2 3 4 5 (c) 2-4 hours on weekdays: 1 2 3 4 5 (d) Other (specify) ____________________________________________________ (e) 17. Please indicate the best days for training opportunities that would work for you. (Check all that apply.) Mondays (a) Tuesdays (b) Wednesdays (c) Thursdays (d) Fridays (e) Weekends (f) 18. What is the maximum number of Gerontology educational opportunities would you attend in a month (conferences, workshops, webinars, etc.)? 1-2 times (a) 3-5 times (b) 6-9 times (c) More than 10 times (d) 0 times (e) 19. How far would you be willing to travel to attend training sessions in aging related topics? Less than a half hour (a) Half hour (b) 1 hour (c) Up to 2 hours (d) Greater than 2 hours (e) 20. Does your organization allow you to go out of your county for training opportunities? Yes (1) No (2) Maybe (2) Page 3 21. How interested are you in obtaining (further) education or training in gerontology and geriatrics?? Very Interested (1) Somewhat Interested (2) Not Interested (3) 22. Would you be interested in a listserv specifically for aging services professionals? Yes (1) No (2) Maybe (2) 23. We would appreciate any additional comments you might have related to education and training in gerontology and geriatrics: Thank you for taking time from your busy schedule to complete this survey!! Page 4 Appendix C Suggested Topics-General Aging Question: Name three topics related to serving older adults on which you and/or your staff most want or need training. (Note: Responses appear as submitted, with minor edits.) disasters and aging, dementia care, caregiving Effective strategies and techniques for caring for individuals with dementia. Coping techniques for care givers. Technical sessions focusing training in specific areas (individual skill sets, i.e. how to deal with difficult people) aging in place and future planning for individuals with IDD, retirement and alternative programming for retiring individuals from OPWDD certified day programs, self-care for direct support professionals How Health Care Reform impacts older adults - there is a lot of fear regarding this topic Original Medicare compared to Medicare Advantage Local options for supportive services elder abuse, dementia/Alzheimer’s How to engage older adults in learning about assistive devices that might help them Actually, I work in the employment field and we rarely serve anyone older than 55 - 60, so I probably don't have much to contribute to this survey after all. Mental Health/Depression Life Stage Transitions - Can we/How do we facilitate decision-making process? Other-thandementia Chronic Health Issues - i.e. Arthritis, Parkinson's, Diabetes Things we all need to know about the physical aging process that we never learned earlier in life. Serving/reaching/engaging baby boomers in relevant ways Pharmacology for older adults Financial Planning 1. Safe medication administration 2. Assessments Non-surgical intervention for osteoarthritis What comes next after the gray hair, joint pain , reduced energy and stamina Diabetes Type 2 and how it affects every system Behaviors and the culture of normalcy (So many people have been working in the field for so long and behaviors that they once considered "normal" in the aging process, are not, and staff are very challenged to see these behaviors as not "normal" and something to be addressed. 1. Frail elderly in disasters 2. The pathophysiology of aging 3. Falls prevention Medicare Affordable Care Act, Health Insurance Exchanges NYS Medicaid Re-design Team DEMENTIA MENTAL ILLNESS IN THE ELDERLY NON MEDICINAL INTERVENTIONS FOR AGGRESSIVE/COMBATIVE PTS Hoarding- Mental Health Issues Working with families- long distance caregiving Aging in Place- Preparing the Community in face of budget cuts working with individuals at end of life; stress reduction for staff; behavior modification techniques, especially for residents with dementia Understanding the needs of rural older population depression dementia caregiver respite How to navigate the world of Medicare and insurance related needs. How to get prescription support for those in the donut hole with Medicare. Resources for housing for the elderly when SNF is not an option and there isn't enough money to hire privately. family caregiving of difficult clients; care transitions; stress management Dementia Behavior issues Family Outreach dementia, deinstitutionalization, intergenerational living 50+ job hunt assistance how social security is affected if you work after you retire Activities in which they can enjoy : Music Therapy ;Art Therapy; Exercise ;Pet Therapy; Death and dying, Psycho-social needs of the elderly elder populations with developmental disabilities, services for elderly, day habilitation programing for elderly disabled individuals Communicable diseases/Immunizations of older adult population,HIV in elderly Nutrition, living accommodations, Visual changes; developmental disabilities & aging; navigating Medicare and other resources for medical funding. urinary incontinence, balance, treating cardiac & breathing disorders- CAD, AFib, COPD, NYS DOH Regulations Elder Respite Care practices Overall care practical ways to help older adults plan for their changing needs as they age, how to find financial assistance to help older adults age in place especially how to pay for modifications to their homes, how to educate, and advocate for change in how society views the inevitable aging process and break down the stereotypes about older adults Taking time to answer questions, patience, different assessment skills needed due to advanced age--what's normal BC the pt is an elder? Caregiving insurance counseling housing Areas of the brain and skills least likely to be affected adversely by aging processes dealing with behaviors of dementia residents, dealing with demented family members, and on opposite side dealing with residents who are alert and oriented x's 3 who are in SNF due to fraility or end of life care. Medicare Affordable care act Medicaid frail elders substance abuse mental health issues....depression mental health interventions with depression and dementia 1. Education metrics and competency-based testing 2. Strategic planning skills 3. Change management Emotional/Mental Health challenges for elders, behavioral intervetions & management, dementia care Transportation Caregiving needs Physical disabilities How to determine when a senior can't live on their own. managed long term care, case management, geriatric mental health Seniors with Disabilities, Medicare/Medicaid Dementia- higher level training, not basics Managed care Advocacy Financial abuse, depression and fund raising Managing LTC home care options as relates to health care reform: options, payors, skilled, chronic, respite Chronic disease self-management support groups Connecting older adults and/or their caregivers to needed support services in a rural county Depression, nutrition, physical activity Falls Prevention Teaching young people how to talk to old people Brain Fitness and Nutrition alternatives to use of antipsychotic medication for agitation secondary to dementia Behavioral vs. pharmacological approaches to problem behaviors; Oxy derivative drugs/addiction; dealing with difficult families Mental Health and Gerontology Family Dynamics Dementia Assessing pain in geriatrics, Managing behaviors, relationships Transportation Depression dementia Fall and harm prevention. Managing expectations formed in another era/generation. Managing dementia/Alzheimers in the acute care environment. legal rights - medical serving the poorest seniors services for veteran seniors how to empower someone to take control of their life, not do for them. long term care options and financing osteoporosis complementary and alternative professional communication with people with dementia, complexities of pharmacology and older adults, culture change and aging (beyond the sales pitch) Crisis services for caregivers Patient Centered Care: Developing action plans (or care plans) that are meaningful Technologies to help with disabilities. Specifically training for older people who are not technology-savvy. Understanding health care billing/Medicare Finding, or knowing about, local resources for older adults/networking memory loss and grief connecting older adults to new social opportunities mental illness and older adults How to have older adults accept help for their limitations staff receives annual training in CPR/AED but we should have more about behavioral issues, physical and mental health, and disabilities, delirium Family dynamics, mental health issues in older adults, nutrition for older adults How to help clients begin/have the difficult conversations with their aging loved one, Latest news on how the federal/state governments are supporting the aging populations and their caregivers, End of Life issues adults with disabilities Adults who hoard and the risks to their health grandparent relationships chronic pain dementia Caring for people with MULTIPLE chronic conditions and how to balance. Connecting physicians with community resources. Advance health care planning - having conversations about this Mental Health issues, Family Dynamics, How to serve the growing needs/demands of this population with less money and lack of programs/services. Assessing Executive Functioning Elder Crime Victims finding funding working with families cultural changes Guardianship logistics, supplemental needs trusts and assessing capacity How to accept changing independence (i.e.: how to move from their own apartment into a group/nursing home). How to help them take meds independently. How to help them accept the effects aging has on them physically, mentally and emotionally. Dementia related education, preventing falls in elders, changes in Medicaid and Medicare coverage and eligibility including prescription and special help programs for medications psychosocial adjustment to aging and disability special concerns of LGBT elders Mental Health & Aging, Changes in Health & Long Term Care System, Addiction in the Elderly coping with the depression that comes from all the losses updates on any diseases : arthritis, CHF, macular degeneration unweighted ambulation; stroke recovery; balance Addiction intervention and treatment methods. Education with alcohol and drugs used safely. care transitions, systems change, creating a comprehensive care plan mental health issues nutrition and exercise - strategies for encouraging older adults to make positive changes how to help older adults cope/deal with family dynamics especially as their lives change (driving, housing, health issues) Medicare Benefits - how they work, what they cover Neurology of aging and memory PCA is the fastest growing career related to the elderly (in both NY and OHIO) and they make 20K or under with no benefits. I notice your survey doesn't even mention this field. This work is not only needed, but when talking about care for the elderly, the worker needs to be fairly compensated or compromises are made. I have heard of it and seen it while in the field. If we want to address elder care, we better address and change delivery of services so the worker can reflect pride, respect and dignity for their client as they are receiving it from their employer! Working with cognitive impairment mental health issues in the aging population Helping serve them when they WANT and do stay in their homes even though they aren't managing well. down barriers so they will be more willing to TRY services or activities for older adults Helping break Transferring/re-positioning client Communicating with client and/or family about issues like end of life/spirituality getting people medical care, transportation, meeting needs for people who are lonely 1. Working with People with Development Disabilities. 2. Working with minorities 3. Starting own business to help the elderly Dementia, Mental illness, medication needs I teach belly dancing every week at Longview, and sometimes Longview residents audit my Writing classes at IC. Practical day to day assistance for elderly reflecting the many change they experience Mental health issues Medications of elderly Appendix D Suggested Topics-Dementia Question: Name three topics related to dementia on which you and/or your staff most want or need training. (Note: Responses appear as submitted, with minor edits.) new research about Alzheimer’s, chronic pain and dementia, caregiving for dementia patients I don't subscribe to the notion of (sub)topics related to dementia, rather when training care givers, dementia training should include all "topics". Note, a car without wheels is of no use.... as a car, as a means of transportation. differential diagnosis particularly in individuals assumed to have dementia d/t primary diagnosis of down syndrome; meaningful recreational opportunities for individuals with dementia; dual diagnoses of dementia and IDD Facilitating quality mental health diagnosis and treatment for those newly afflicted with a mental health symptoms, concurrent with an early to mid-stage dementia diagnosis How to best work with primary care providers who are reluctant to make a diagnosis and don't refer patients to specialists in dementia care Role of Adult Protective Services in serving those with dementia Local options for supportive services. Learn more about dementia and how to assist individuals especially in the early stages. How to navigate the hospital and mental health system. Caregiver Support - Dealing with Denial Losing Independence/Driving/Wandering Alternatives to use of anti-psychotics in snfs 1. Ways to de-escalate an agitated patient 2. Enjoyable and appropriate activities 3. Medications Reality orientation or let's get along interventions for being with someone who repeats the same question every 1.5 minutes Social isolation of caregivers Identifying Pain in residents with dementia, 1. When to engage Adult Protective Services 2. How to assess the home situation and care giver needs when they are caring for a person with dementia 2. Assessment of mental status when alterations already exist DISCUSSION OF ALL UNBRELLA DIAGNOSIS EFFECTS OF DEMENTIA ON FAMILY/CAREGIVERS AND RESOURCES AVAILABLE NEUROLOGY ETIOLOGY Issues related to dealing with behaviors Working with Families behavior modification techniques to use with residents with dementia; communication techniques for residents with dementia natural progression behavioral interventions medications Dementia related care providers and programs for respite to those caregivers that can give more time than an hour or two a week. Tricks of the trade.......easy at home solutions that are proven to help the caregiver at home with personal care and the patient's quality of life. An example of this would be the use of baby monitors for safety or using children's sippy cups when the patient is no longer to handle a regular cup. This tips and ideas are priceless for a family that is new to the caregiving and the families that have already "been there and done that" often have great insight. The newest research related to dementia regarding treatments both through medication and also through alternative therapy. screening; dementia vs. delirium; creating a care plan around diagnosis mood swings anger behavior communication, stages, caregiving How to help families cope with dementia nursing home staff cope with dementia How to help residents cope with dementia How to help best ways to communicate, helping individuals maintain physical health, maintaining social integration visual perceptual changes that impacted by Alzheimer’s dementia; caregiver issues; mild cognitive impairment vs. dementia dementia update-current research, treatment, communications... engaging in ADL's/treatment All dementia issues how to keep individuals with dementia safe while preserving quality of life, Patience, how to handle a forgetful pt, compassion and not getting upset BC the pt can't remember things. medications respite options safety How to help clients accept dementia and need to ask for appropriate help. Evaluation of individuals' strengths as well as liabilities. How to provide learning opportunities at the proper pace for older clients. Dealing with behaviors, dignity of dementia residents, and dementia resident's families. spirituality caregiver burnout up to date information on etiologies mental and behavioral health interventions 1. Working with family members in relation to their loved one's changing condition 2. Hands-on practice with calming agitated residents 3. Redirecting residents behavioral interventions, disease process, communication Types of dementia How to help families deal with the reality of dementia How to deal with behaviors affecting the client with dementia How to tell when a senior with dementia can't live on their own. dementia capability, evidence based interventions, creative arts Affordable care models for dementia, best practice Cutting edge discoveries in dementia wondering, mood swings, insurance coverage/LTC placement Managing difficult behaviors Long term planning How to work effectively as a family unit when caring for someone with dementia Understanding signs of dementia, teaching people with dementia how to redirect agitated and wandering residents how to intervene when resident wants to go home how to react when a person thinks (inaccurately) that their spouse is still alive Assisting caregivers Dementia as a terminal disease Nutrition and hydration behaviors, behaviors, behaviors Driving and dementia Visual perceptual deficits living options Managing dementia/Alzheimers in the acute care environment. Choices made in admitting demented patients into the acute care environment; choices made to keep demented patients out of acute care environments. Opening a memory-care facility in your community. legal rights what works-loving the loss of mind caring for the caretaker-griefwork helping caregivers cope with caring for someone with dementia. determining causes of dementia. determining the decision making capacity of someone with dementia. professional communication with people with dementia (limited context and time), recognizing improper medication of people with dementia and what to do about it, what is "undue influence" and how to prove it Accessing mental health services for those with dementia Dual diagnosis Alzheimer's and Developmental Disability handling difficult behaviors Understanding/communications, safety issues grief forming new relationships social opportunities How to deal with individuals who are in the beginning stages of dementia memory loss, speech/hearing loss, depression dealing with aggressive behavior Dementia Specific day program is a service provided by the Alzheimer's Association, Central New York Chapter. We are able to provide our own training on dementia to our staff. How do you support caregivers/families of those with dementia how to help someone in beginning stages how to get someone to quit a job, move, stop driving, etc. how to educate others - spouse, family members, friends, neighbors Advance health care planning Understanding the likely trajectories of decline and red flags Legal aspects trying to help a client who has dementia/Alz. and no family or informal supports - and is making unsure choices, Coping with the dx. - for the person and the family, Grief - based on this terminal dx. types dementia and capacity (competence) assessing for communication skills quick guide to assess what stage someone might be in along with how to work most effectively with people in that stage. How it relates to mental illness. How to receive care for it if they are in mental illness treatment. How to communicate staff's concerns with psychiatrists/therapists/PCPs. providing care and approach to care with various stage of illness, crush myth or misinformation often promoted within long term care facilities, more ideas to preserve dignity and integrity of client teaching caregivers about dementia diagnosis and practical applications for family caregivers Drug Interaction in the Elderly, Delirium, Support for Care Givers medication management encouraging independence different forms of dementia behaviors; fear of falling; sensory ideas incorporating a dementia screen into home based assessments, working with challenging behaviors related to dementia or other chronic diseases at congregate dining sites, systems change assisting families when they are dealing w/ their family member w/ "sun downers" Helping people w/ ideas to deal with wandering tendencies caregivers/family members - how to support caregivers earlier (and reach them before they are at the breaking point) how to help families provide positive experiences for their loved ones with dementia (simple ways to make them more comfortable, happy, or enjoy the moment) how to encourage good health to prevent/delay onset of dementia Neurology of dementia This is obsolete in that I work independently in a home. The service agencies need to provide this training, and do with worksheets, not very thorough. I have been in the health field profession as a therapist and home care aid as well as having a BA in Psychology, I understand the empathy, understanding Redirection, dealing with difficult behaviors, positive approaches to use during personal care Ways to help those with dementia stay safe in their own homes Systems for reminding people about whatever they need to know (appointments, when to pay bills, etc.)-- when they forget to look at calendar ? Medications- latest and greatest-- especially meds to manage behavior From an MD point of view: what is helpful to know during an appointment Validation Technique training Effects of medications (skin, muscle tone, behavior (sun downing), etc.) Building positive relationships with other staff caring for people with dementia remembering/going to appointments, medication management for people who do not qualify for home nursing service, making sure people have food and eat that live alone 1. What to do with people with dementia. 2. how to help families. 3. programs for people with dementia Medications Support services Caregiver Stress Developing Meaningful Connections Transitioning to Nursing Home Care how to deal with dementia recreation and leisure activities for clients with dementia aggression and dementia differentiating b/w the forms skill sets or coping skills to lengthen caregivers longevity of ability to provide quality care experiential therapies to alleviate stress/agitation Fall prevention Combative behavior Engaging residents in meaningful activity discerning mood disorder from dementia Program planning for individuals with dementia Maximizing quality of life; discovering best approaches to individual care; safe interventions. dealing with dementia how defined treatments managing behaviors, nutrition,, elder abuse prevention