A thematic literature review of innovative strategies to prepare nursing students for aged-care

Journal Pre-proof A thematic literature review of innovative strategies to prepare nursing students for aged-care

M. McAllister, C. Ryan, L. Dodd, M. Goldenberg, D.L. Brien PII:

S0260-6917(19)31410-8

DOI:

https://doi.org/10.1016/j.nedt.2020.104355

Reference:

YNEDT 104355

To appear in:

Nurse Education Today

Received date:

17 September 2019

Revised date:

30 November 2019

Accepted date:

27 January 2020

Please cite this article as: M. McAllister, C. Ryan, L. Dodd, et al., A thematic literature review of innovative strategies to prepare nursing students for aged-care, Nurse Education Today(2020), https://doi.org/10.1016/j.nedt.2020.104355

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© 2020 Published by Elsevier.

Journal Pre-proof Title: A thematic literature review of innovative strategies to prepare nursing students for aged-care Authors McAllister, M., RN, Ed D, 1. Ryan, C., 1. RN, BHltSc, MHPE, Dodd, L., 1. PhD, GradCertTEd, BCom, Goldenberg, M., 1., Brien, D.L. 2, PhD, MA, BEd, Affiliations 1. School of Nursing, Midwifery and Social Sciences, Central Queensland University

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2. School of Education and the Creative Arts, Central Queensland University.

Contact details

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Margaret McAllister, RN Ed D

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Professor of Nursing,

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CQ University Australia

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Twitter: @proffmac

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[email protected]

Conflict of Interest statement

No conflict of interest has been declared by the authors.

Funding Statement

This research received funding from Australian Collaborative Education Network and Central Queensland University Australia, Scholarship of Learning and Teaching

ABSTRACT Background: The exponential rise in people living longer but requiring residential care is adding pressure to already overstretched aged care nurses. Consequently, a person-centred care culture in residential care remains aspirational, rather than a reality. For nursing students

Journal Pre-proof in Australia and elsewhere, clinical placements in aged care facilities are under-utilised due to negative perceptions about the likelihood for learning. Creative strategies to engage students to safely challenge ageist thinking and to inspire enthusiasm for learning in this context are needed. Objectives: The purpose of this thematic review of the literature is to better understand challenges related to learning in aged care settings and identify innovative strategies to enhance nursing student learning experiences in residential aged care placements.

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Review Methods: A literature review was undertaken in 2019 using CINAHL, PUBMED,

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Elsevier, Medline, ProQuest and Google Scholar. The search was limited to papers that were

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peer reviewed, in English, and published between 2001 and the date of review (mid-2019) in

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order to situate the review in the new millennium.

Results: 47 articles and books were included in the review that introduce solutions and

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innovative strategies that could be used to improve students’ attitudes to learning in aged care

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and from older people. The literature review was categorized into three main themes, including: barriers to working with older people; the need for pedagogical change to foster

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empathy; and innovative strategies to address barriers. Conclusion: These themes are useful to consider in designing engaging learning and teaching for nursing students to be effective in working in aged care.

Journal Pre-proof INTRODUCTION Like the rest of the developed world, the proportion of Australian older adults, those aged 65 years and over (Orimo et al., 2006), has been increasing over the last century with this trend predicted to continue. In 2017, there were 3.8 million older adults (Australian Institute of Health and Welfare, 2018) in a population of 24.6 million, while, for 2030, the prediction is 6 million of 29.8 million, or over one in five of the population (AIHW, 2018). These numbers are not dissimilar to those reported internationally (World Health Organization, 2018). As the

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average age of the world population rises, residential aged care facilities, also known as long-

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term care or social care facilities in other countries (Roberts, 2017) will provide care for

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increasing numbers of older people no longer able to live independently (Grove, 2016). The

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projected growth of the use of residential aged care facilities highlights the importance of attracting trained and skilled staff and, particularly, nurses, to work in the aged care sector

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(Robinson, Andrews-Hall, & Fassett 2007).

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Social isolation, loneliness and depression are common in old age, and are associated with worsening mental and physical health (Courtin & Knapp, 2017). This emphasises the need

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for well-developed psychosocial skills including empathy, but there is growing concern that health care workers are suffering from an empathy deficit, leading to uncaring health care cultures (Campling, 2015). There are many examples that exist of the serious consequences that occur when health services fail to take action on uncaring cultures. In one UK report, 290 recommendations were made to contribute to a safer, committed and compassionate caring service (Francis, 2013) with workplace psychological health also being identified as an issue in uncaring cultures (Gao et al., 2017). Not only is there neglect of, and harm to, patients, but complaints, ill-feeling, and low morale compounds, creating a vicious circle where negative culture proliferates, and stereotyped views about patients, particularly older people are unaddressed (Campling, 2015).

Journal Pre-proof The increasingly bio-medical and task-oriented approach to health care means the focus for nursing education tends to be on care directed to the physical health, safety and comfort of the client. The aim of this literature review was to identify studies and reports relevant to supporting nursing students working in aged care.

APPROACH TO THE REVIEW A thematic review was undertaken in 2019 using the databases of CINAHL, PUBMED,

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Elsevier, Medline, ProQuest and Google Scholar. Bhana (2014) explains that a thematic

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review of the literature involves sorting literature into different categories. Similar to the

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approach to qualitative data analysis, there is a search for important and meaningful themes

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about a phenomenon, to reveal patterns, regularities and inconsistencies. The patterns of

research.

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greatest relevance are interrogated to develop an argument and provide a context for future

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In this review, the search terms included “nurs* student”, combined with “attitude”, “perception” and “aged care” to identify works that discussed the learning challenges

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students face in attitudes of student nurses towards aged care placements, and “narrative”, “story” and “life story”, combined with “nurs* student” in order to locate literature relevant to storytelling within nursing training. The search was limited to peer reviewed publications written in English and published between 2001 and 2019. Exclusion criteria were: papers that focused on specialty areas other than aged or palliative care, and papers that were not relevant to nursing and nursing students. After literature were identified they were categorized as either research, literature reviews or discussion papers. Then, two members of the team discussed each paper in terms of its focus and findings. In this way, three themes were identified. RESULTS

Journal Pre-proof The result of the review was that 47 documents were included, analysed and summarised. They were then sorted into themes that were: a) barriers to working with older people; b) the need for pedagogical change to foster empathy, and c) innovative strategies to address barriers (See Table 1).

[Insert Table 1about here]

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Barriers to working with older people

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A major barrier to working effectively with older people is internalized ageism, that may not

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at first be obvious to clinicians who consider themselves to be caring, non-judgmental and

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inclusive (Jenkins & Macken, 2014). Ageism is prejudice and discrimination against people

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on the basis of their age. As Aronson (2015), Henderson et al. (2008), and Banning, Hill and Rawlings (2006) point out, there are prevailing and deeply embedded ideas within healthcare

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that privilege youth over older people and privilege the curative approach over palliative and carative methods. Such attitudes lead to students’ lack of enthusiasm for, and even

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disappointment about, working with older people, and a belief that little will be learned that will be relevant for future practice (Gillespie, 2013). In addition, these stigmatising views are not benign. Numerous reports have explained that the inattention towards the unique needs of older people leads to an absence of policy and effective care (Campling, 2015; Francis, 2013). Negative perceptions of aged care as a site for learning are reinforced when registered nursing staff are not prepared for working with nursing students and graduates, or who perceive these neophytes to be an added burden to their already demanding role (Struksnes et al., 2012). An organisational culture that is focused on clinical practice and not learners

Journal Pre-proof means that students are not supported and clinical staff remain unskilled in educational strategies. This results in missed learning opportunities (Grealish et al., 2013). Another barrier was the perception that in aged care there are many deficiencies, including equipment, adequate staffing and support that make the work context heavy, stressful and exhausting, rather than rewarding (Brynildsen, Bjork, Berntsen, & Hestetun, 2014; Gao et al., 2017). Berntsen & Bjork (2010) found that satisfaction was moderately

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higher when innovation was present, but they also discovered that major work is needed to

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further develop new approaches for learning in aged care facilities.

Authors have commented upon and criticised the dominance of the task-focused

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approach in health care. A major reason for this, according Garside and Nhemachena (2013),

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is the ways in which clinical competence is defined. There is a tendency for competence to

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be conceived of as only technical proficiency, and it is seen as an outcome, rather than a developing set of skills. According to Edwards et al. (2013), nursing competence does not

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differentiate technical and psychosocial skills, and this leads to psychosocial issues not being

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taught explicitly or being overlooked entirely from the curriculum. Duggan, Mitchell and Moore et al. (2013) reported nursing students commonly feel unprepared for the aged care experience because they lacked confidence in communicating with residents. Algoso, Peters, Ramjan and East (2016) identify that the focus on acute care in nursing curricula has resulted in the neglect of the foundational interpersonal skills that are central to caring, resulting in students who feel unprepared for being with, and talking to, patients. Gillespie (2013) also argues that when students do learn about aged care, they learn the ideals of practice and when they meet the reality, where care tends to be reduced to physical care, reality shock and disappointment sets in. Legg (2011) argues that, rather than be marginalized and overlooked, psychosocial care needs to be a major focus in nursing education. Psychosocial care involves addressing the

Journal Pre-proof social, psychological, emotional, spiritual, and functional aspects of a person. In order for training in such care to be effective, educators need strategies to enhance students’ psychosocial skills and to value their development. Students will then have opportunity to learn and value both skill sets, and aged care settings could provide ideal learning environments for development of psychosocial as well as technical skills.

The need for pedagogical change to foster empathy

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If barriers to caring for older people, such as ageism and a lack of competence in providing

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psychosocial care, are to be overcome, views about older people need to be based on

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connection and compassion. These are facilitated through empathy. Hovey, Dyck, Reese and

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Kim (2017) reported that attitudes towards aged care were more positive in advanced students, though they argued that the key facilitator for attitudinal change was when students

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were encouraged to have sustained involvement in the care of older people.

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Pedagogical change is needed to open students up to practical ways of engaging in person-centred care with older people. Yet, for many students, there is implicit

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encouragement to maintain a level of detachment from patients, and to attend more closely to technical tasks than interpersonal needs. A study by Tait and Hodges (2013), for example, revealed that medical practitioners lack humanistic approaches to caring for dying patients and would benefit from narrative skills to elicit the patient’s story. In a study of nursing students, Ward, Cody, Schaal and Hojat (2012) found that the more experienced one becomes as a nurse, the lower the empathy and therefore something must be occurring within the system and the work-role that erodes compassion and impedes human connection. Ward et al. (2012) argue that more empathic role models are needed so that students can internalise caring attributes through observation and imitation. Development of exemplary caring skills need to be modelled and requires deliberate training, with successful programs

Journal Pre-proof acknowledging the orientation of today’s learners towards a multi-dimensional, social approach (Francis, 2013). McCormack and McCance (2016) have led the way in developing a model for embedding person-centred care into practice, education and policy. However, whilst there are many studies on the importance of empathy in nursing, the studies of relevance to this review are focused on how empathy is considered within the context of narrative medicine (Ariso, 2018). Bazalgette (2017) suggested that arts-based activities are a means of bridging the empathy gap, and a way of building professional empathy.

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As Bruner (2010) explained, the telling and listening to stories is a human activity that

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connects people and builds understanding, which is therefore vital to developing

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interpersonal skills. In the health care context, Charon (2006) has long argued for the

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development of narrative medicine, which is the learning and valuing of storytelling skills alongside technical clinical skills. She argues that when clinicians are trained to become more

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conscious of patients’ stories, and able to tell human stories of extraordinary health-care

improves.

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experience, empathy awakens, self-compassion develops, and the whole system of care

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In a different vein, White and Epston (1990) theorised how narrative can be used therapeutically with patients, such that intentional communication skills can be used to help a patient notice their strengths and capabilities and to move on from the disempowering position of being a passive patient. Corbally and Grant (2015) have applied these benefits of narrative to nursing and coined the term ‘narrative competence’ which they see as a set of skills that nurses use to listen, tell, understand, and act on, patients’ stories. Similarly, in Smith and Liehr’s (2014) story-theory, this competence involves three interrelated skills: intentional dialogue; being conscious of the self-in-relation; and creating ease. Although the development of narrative competence enhances what Corbally and Grant (2015) call ‘professional artistry’, this is a neglected area in undergraduate nursing curricula.

Journal Pre-proof McKeown, Clarke and Repper (2006) argue that, at its core, narrative competence is the antithesis of this task-orientated care and, therefore, narrative competence skills should be integrated into the foundations and overarching values of healthcare. Mangino (2014) and Smith and Liehr (2014) recommend when narrative competence is learned prior to clinical placements in safe contexts nursing students understand the need for working with patients in more intentional ways. Ariso (2018) and Savundranayagam (2014) found that well-developed narrative competence improves outcomes for clients in terms of their safety and quality of life

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and produces higher levels of reported work satisfaction and wellbeing in clinicians.

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Innovative strategies to overcome barriers

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As well as ways of improving empathy in those who care of older people, other studies have been undertaken that reveal innovative solutions to overcoming barriers. Rogan and

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Wyllie (2003) designed an intervention for nursing students that involved pre-placement

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theoretical learning, students worked with one resident, and were provided with regular support throughout their placement. They found improvements in ageist beliefs and positive

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learning experiences. Lea et al. (2017) reported similar during an action research study that improved student orientation to the aged care facility and available resources. Of course, the perception of an experience in the aged care sector can also depend on the individual student nurse’s attitudes and orientation. Berntsen and Bjork’s (2010) investigation revealed that first-year students who more highly valued aspects such as innovation, involvement, and personalisation viewed their clinical placement experiences more positively. Ryan et al. (2018) offered final year nursing students an aged care clinical placement experience to overcome ageist attitudes. A structured placement saw students rotating through a range of clinical learning issues to offer them opportunity to understand the role of aged care registered nurses. Participants reported that they mostly valued the time spent

Journal Pre-proof getting to know and communicate with residents. Willetts, Aberdeen, Hood, and Cross (2017) introduced a structured year long program following graduation that focused on aged-care and found that this focused support led to leadership and team-work skills. In a study by Williams, Ilten and Bower (2016), clinicians were recorded in their everyday practice speaking with residents. Conversations were then discussed with clinicians to raise awareness about ‘elder-speak’, a phenomenon of talking down to residents, and discussions took place on how interpersonal communications could be improved. Schwartz

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and Abbot’s (2007) approach was similar, in that they found that specific training in

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communication skills improved students’ ability to decipher indirect communication and

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higher quality care to the older adult.

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needs, allowing them to further personalise care, address concerns and, ultimately, provide

Leighton, Oddy, and Grace (2016), undertook a study that involved individuals with

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dementia and their family carers in storytelling and found that isolation and loneliness were

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reduced for patients, and empathy for their experiences was enhanced in participating staff. Kellett et al. (2010), Lawrence et al. (2012) and Bhar and Silver (2016) have also undertaken

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studies that used biographical storytelling approaches to facilitate empathy and meaning between older people and family carers. Life story has also been shown to increase diagnostic and treatment accuracy. Schwartz and Abbott (2007) found listening to a patient’s story helped the clinician understand the patient’s decision-making process and attitude towards recovery. Furthermore, engagement in storytelling is directly relevant to psychosocial skills development. According to Wills and Day (2008) storytelling promotes relationship-centred care and helps older people make meaning of their lives. In a study by Chretien et al. (2015) it was shown that students’ narrative competence increased through patient storytelling, and was sustained, increasing the likelihood that the skills would be put to use in future practice.

Journal Pre-proof Bhana (2014) sees storytelling, role-playing and journaling as examples of teaching strategies that facilitate critical thinking and develop interpersonal skills. These skills form the basis of developing therapeutic nurse-patient relationships and may assist student nurses, particularly of younger generations, to overcome barriers to interpersonal interactions in clinical practice. Similarly, Schroeder (2016) and Heliker and Nguyen (2010) have reported that teaching story skills assisted students to view older adults with less bias around age, race and culture. A study by Chretien et al. (2015) found that medical students developed narrative

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competence after listening to older person’s stories and reported being able to use the

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experience to shape their practice.

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According to Mager (2019) it is important that story-work be done carefully and

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sensitively so that exposure to traumatic stories do not themselves add to clinicians’ or patients’ trauma. All of these findings on innovations and recommendations, opens up an

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opportunity to introduce storytelling education into nursing students’ preparation for clinical

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learning, particularly in aged care settings. Storytelling facilitates a sense of community and bond formation, develops interpersonal and communication skills, and gives students purpose

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in an aged care clinical placement.

DISCUSSION

The literature reveals that in nursing and nursing education – as in society more broadly – there is a need to explicitly address ageism, and how it may exist unconsciously amongst individuals and groups. The studies reviewed indicate that students’ (as well as many health workers’) ageist attitudes towards, and other negative perceptions of, older people and caring for older persons are widely known. Many nursing students are unenthusiastic towards undertaking placements in aged care and may not appreciate the potential careers in the aged care sector. This needs to be addressed within the nursing curriculum. Efforts to work in

Journal Pre-proof partnership with the aged-care sector in providing clinical learning needs to be expanded. The education sector is responding to these perceptions in a number of ways; preparing students and aged care staff for clinical placements using interventions with both pedagogical and experiential aspects, partnering with organisations to better design aged care placements and introducing students to older persons using innovations from the creative arts, yet the endurance of negativity points to a clear opportunity to develop these innovations further. The literature reviewed also suggests that finding ways to become more conscious of

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biases as ageism through an exploration of the self in relation to others may be a useful

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strategy to combat such stereotyped and prejudicial views – whether casual or systematic –

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and build a more inclusive society. Assisting students to develop communication skills and

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narrative competence before undertaking a placement in aged care may be a way to enhance the positivity of their experience. Cultivating nursing students’ positive aspirations, goal

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setting and reflection on practice as preparation for a positive placement experience is

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essential. It is also important for students to be given the opportunity to rehearse learned

placement.

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communication strategies, such as intentional story-telling skills, in safe contexts prior to

Combining aspects of the creative arts, particularly in engaging in story-telling and sharing, has been shown to give students confidence when communicating with older people; increasing efficacy and providing a sense of purpose during the clinical placement. This approach can build students’ enthusiasm for aged care, as well as their capabilities in empathic engagement, communication, cultural competence, and collaborative goal setting. Without such interventions, graduates are likely to remain unwilling to specialise in aged care and be poorly equipped to do so. By empowering students to make a positive contribution to the aged care service, enhanced narrative competence can break down stigma, build clinical confidence, and increase the appeal of residential aged care facilities for nursing students,

Journal Pre-proof thus expanding the use of these sites as a vital learning experience. Student empowerment and re-alignment of attitudes must, moreover, result from a systemic, multi-faceted approach which begins at a foundational level and continues over the span of nurses’ careers. CONCLUSION Residential aged care is rich in opportunities for teaching and developing the essential humanistic qualities that support person-centred care. Narrative competence and storytelling

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are contemporary examples. Such innovations in care are needed in order to ensure that aged care residents are supported to live meaningful lives, alongside the follow-on effect for nurses

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so that their work-role extends beyond tasks, to become more person-focused and interesting.

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In addition, ageist beliefs may be replaced by an appreciation that older people have stories to

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White, M. & Epston, D., 1990. Narrative Means to Therapeutic Ends, New York, WW Norton Willetts, G., Aberdeen, S., Hood, K., & Cross, W., 2017. The dynamic role of the graduate nurse in aged care: An Australian experience of delivering an aged care graduate nurse program. Collegian, 24(4), 397-402. Williams, K. N., Ilten, T. B., & Bower, H., 2016. Meeting communication needs: topics of talk in the nursing home. Journal of Psychosocial Nursing and Mental Health Services 43(7), 38-45. Wills, T., & Day, M. R., 2008. Valuing the person’s story: use of life story books in a continuing care setting. Clinical Interventions in Aging 3(3), 547. World Health Organization, 2018. Ageing and health. Accessed September 2, https://www.who.int

Journal Pre-proof Table 1: Review Findings THEME

Author, Year

Literature

Results and Findings

type 1.

Barriers to working with older people 2. Algoso et al., 2016

2

An examination of the Australian Curriculum revealed an over-focus on acute care learning, which results in students’ lack of skills in working with older people, and limited challenges and replacement of ageist beliefs A physician argues that clinicians have ageist attitudes which lead to exclusion, isolation, and avoidance of older patients, as well as the absence of policies, plans and research that could lead to better care for the older person Students indicated disappointment at not being allocated to acute hospital settings for clinical placement Lack of innovative learning to engage students in aged care nursing is a barrier Students perceived deficiencies in aged care routines and equipment for learning A critical analysis of the world-wide phenomenon of inquiries of neglect in health care cultures is because of the absence of kindness. Sustaining positive caring cultures requires exercising intelligent kindness Nursing students feel unprepared and lack confidence in communication with older people Teaching technical skills is deliberate in courses, but psychosocial skills are often ad hoc This royal commission into health care neglect in the UK found staff lacked compassion resulting in unsafe care practices

4.

Aronson, 2015

3

5.

6.

Banning et al., 2006

1

7.

8.

Berntsen & Bjork, 2010

3

9.

10. Brynildsen et al., 2014

1

11.

12. Campling, 2015

3

13.

14. Duggan et al.,2013

1

15.

16. Edwards, 2013

2

17.

18. Francis, 2013

3

19. 21.

20. Gao et al., 2017 22. Garside & Nhemachena, 2013

1 3

23.

24. Gillespie, 2013

25.

26. Grealish et al., 2013

27.

28. Henderson et al., 2008

1

Aged care work is stressful and requires target coping strategies Nursing competence is a concept that can only be reached when the nurse is expert, and thus is not a clear or useful term to use in developing a student’s range of skills. It does not differentiate technical and psychosocial competence. Students perceive aged care as less relevant for their professional aspirations The organizational culture in aged care was a barrier to students’ learning Students perceived aged care as depressing and unchallenging

29.

30. Jenkins and Macken 2014 32. Legg, 2011

3

Reflective writing overcomes ageist assumptions in students

3

Psychosocial care is overlooked in nursing education

1

Lack of support for staff working with students in aged care settings leads to poor student learning and role modelling

33.

1

na

Struksnes et al., 2012

ro

-p

re

lP 3

Jo ur

31.

of

3.

Pedagogical change to foster empathy 34.

Ariso, 2015

3

Author argues that clinicians should use Gallagher’s interaction theory to enrich and understand patient narratives

35.

36. Bazalgette, 2017

2

Arts is one means of bridging the professional empathy gap

37.

38. Bruner, 2010

3

39.

40. Charon, 2006

3

41.

42. Corbally & Grant, 2015

3

43.

44. Francis, 2013

3

45.

46. Hovey et al., 2017

2

47.

3

49.

48. McCormack & McCance, 2011 50. Mangino, 2014

This philosopher argued that narrative is a human activity that connects people and creates understanding Narrative medicine fosters empathy, strengthening practitioner and patient relationships After reflecting on the narrative turn in research, these authors argue the need for “narrative competence” in students because it will enhance person-centredness This royal commission into health care neglect in the UK made many recommendations to change practices including focus on compassion, and safety Attitudes towards aged care are improved when students are taught about issues of ageing Person-centred practice underpins nursing and healthcare

51.

52. McKeown et al., 2006

2

3

Narrative Competence benefits for Student Nurses include sense of community This review of the literature examined the benefits of narrative interventions and argued that narrative should be an overarching value

Journal Pre-proof 53.

1

This discourse analysis of communication identified need for including more person-centred communication skills in curricula

56.

54. Savundranayagam, 2013 55. 57. Smith & Liehr, 2014

3

58.

59. Tait & Hodges, 2013

1

60.

61. Ward et al., 2012

1

62.

63. White & Epston, 1990

3

Developed a theory that focuses nursing care around intentional dialogue, creating ease and being conscious of the self in relation to the other This study revealed that medical practitioners lack humanistic approaches to caring for dying patients and would benefit from narrative skills to elicit the patient’s story This longitudinal study found that the more contact students have with patients, the more empathy declines, suggesting compassion fatigue and that empathic role models are needed This seminal approach to therapy says that people can learn to “re-story” their lives, and engage in more optimistic self-talk and goals

Innovative strategies to address barriers

67. Bhana, 2014

2

68.

69. Bhar & Silver, 2016

1

70.

71. Chretien et al., 2015

1

72. 74.

73. Heliker & Nguyen, 2010 75. Kellet et al., 2010

1 1

76.

77. Lawrence et al., 2012

2

Lea et al., 2017

1

80.

Leighton et al., 2016

3

81.

Mager, 2019

82.

Rogan & Wyllie, 2003

83.

Ryan et al., 2018

84.

Schroeder, 2016

85.

1

86.

Schwartz and Abbott, 2007 Willets et al., 2017

87.

Williams et al., 2016

1

88.

Wills & Day, 2008

1

78.

lP

79.

of

66.

Perception of first-year nursing students to aged-care learning moderately positive Generation Y nursing students will develop interpersonal skills relevant for caring for older people if they are encouraged to engage in storywork Listening to patient stories had positive impact on student engagement and resident satisfaction Students’ narrative competence increases following patient storytelling activities Story-sharing breaks down bias based on age, race and culture Biography work with family and staff caring for older people improves confidence and attitudes Psychosocial interventions including biographical storytelling, improved staff attitudes towards residents This action research study improved student orientation as a way of improving students’ confidence and care in aged care Storytelling stimulates sensory experiences for people with dementia and builds empathy in staff Storytelling groups increases happiness and wellbeing in older adults

ro

3

-p

65. Berntsen & Bjork, 2010

re

64.

1

Jo ur

na

1

1 3

1

An intervention that involved theoretical learning, working with one resident, and regular support led to improvement in ageist beliefs and positive learning experiences. A structured clinical placement where final year students learn different disorders of old age reduces ageist attitudes Student were taught story-theory and then interviewed an older person and this improved attitudes, empathy and the appreciation of trust Students taught story telling skills helps them improve holistic care by improving cultural understanding and decision-making skills A graduate year in aged care improves leadership skills needed to change practice This study involved recording clinicians speaking to residents, and then an education experience where discussion took place around elder-speak and ways to change. This study used Life story books to help older people make meaning of their lives

Notes: Literature Type: 1 = Research, 2 = Review, 3 = Discussion/Polemic