Increasingly, adults are taking on the care of older adults in their homes, providing a significant contribution to the health care system in Ontario. However, recent research by The Change Foundation found 75% of caregivers had not received any training specific to the health care needs of the person they were caring for while 63% were unsure of how to navigate the health care system. Conversations about this lack of information and skills at the McMaster University Institute for Research in Aging (MIRA) and with Hamilton’s Thrive Group, a private company committed to building a community of quality and responsive services in the health care system, led to discussion with the McMaster Centre for Continuing Education (CCE) about how this might be addressed.
Recognizing that caregivers are often restricted to their homes, offering access to information and skills via a blended learning model was seen as the best approach. The knowledge and resources of MIRA, including its Optimal Aging Portal, the Thrive Group’s experience and desire to better serve its clientele, and the online learning expertise of CCE serve as the foundations of the concept.
In April 2018, the Centre for Continuing Education, together with MIRA and Thrive Group, was awarded funding by the Ministry of Seniors Affairs to support the ongoing improvement of education for caregivers of older adults. This description presents the planning and development steps of the initiative. After the initial offering of the blended learning course for adult caregivers of older adults in fall 2018 and its assessment, this Pocket of Innovation will be updated to reflect the final design and delivery of the course, as well as the results of the evaluation.
The goal of the project is to develop a blended learning model to:
- Increase caregivers’ knowledge and skills to provide quality care for older adults;
- Increase caregiver capacity to stay well;
- Increase caregiver ability to navigate the online and in-person health and community services systems; and
- Enhance caregivers’ online technology skills.
The first project activity, taking place in July and August 2018, is to develop the curriculum, with a focus on evidence-based content organized into four modules. At the time of writing. the focus of each module is as follows:
Introduction: roles and responsibilities, ethical and legal issues as well as helping the caregiver-learners to prepare for the content of the course and online learning experience.
Health and Medical Foundations: human body, hygiene, nutrition, hydration, falls and injuries and palliative and end-of-life care.
Navigating the System: gaining access to specialists and services, having courageous conversations with health care providers and making the choice to go to emergency or call the doctor.
Self-Care: stress management, managing the changing of roles in becoming a caregiver and maintaining perspective regarding limits of caregiver role.
Once the curriculum is defined, the subject matter expert will work with an instructional designer and a learning systems technologist to design and build the course. The modules will be completed in September 2018 for an October launch.
The modules are online, so caregiver-learners can work through them on their own time, within the course time limits. Case studies, testimonials, documents, and presentations by researchers and professionals are to be engaging, user-friendly and easy to follow. Video is to be used rather than slides and voice-over. The delivery of content is supplemented by discussions which may be held face-to-face or online. These sessions are designed to encourage connections and sharing among the caregivers. The interactive sessions are to be held once or twice over the 6-8 weeks of the course.
The goal is to deliver the program to 40 participants in the Hamilton area and another 40 in Sudbury and Timmins, where McMaster is working with local partners.
Outcomes and Benefits
Evaluation of the effectiveness of the course content and design is planned, involving caregivers, facilitators, students, and team members who supported the implementation and delivery of the program. Planned elements of the evaluation include:
- Pre- and post-experience questionnaires for caregivers to measure self-reported knowledge, ability and skills in caregiving, confidence, well-being, perceptions of health of older adults in their care, understanding of and access to health and social service system, knowledge of online technology, and general satisfaction with the course.
- Focus group with 8 - 10 caregivers to determine appropriateness of the curriculum and their perceptions of their knowledge and efficacy in using new knowledge to care for older adults, navigate and access the health and social services system and perceptions of their own mental health and well-being.
- Research with discussion leaders, support staff and project leaders, exploring suitability of curriculum, development and delivery models, and scalability of project.
Challenges and Enhancements
Many caregivers may require technological support which is available through the project grant in this initial stage. If the project continues or is scaled up, covering these costs might be a challenge.
Caregivers may also encounter problems with content, requiring personal contact and support.
During the fall 2018 offering, funding for respite care is provided so that caregivers can leave the home for group sessions. Future courses are not likely to have this funding, potentially limiting the possibility of face-to-face contact.
The course is being designed with minimal reliance on regional content so that it will be possible to scale-up or make it more widely available across the province and country. The scalability of the project is an important component of the planning and evaluation processes.