Care worker training

Care workers are an important part of the social world of the person living with dementia. Most care worker training interventions focus explicitly on providing care workers with sufficient knowledge and skills to improve the delivery of care (for example providing education, training, support, or supervision). [1] Research indicates that when aged care workers have adequate knowledge regarding dementia and stronger skills in responding to responsive behaviours (also known as expressions of unmet need), care is more likely to lead to better outcomes for people living with dementia. [2]

This evidence theme on care worker training is a summary of one of the key topics identified by a scoping review of dementia research. If you need more information on this topic, try using the PubMed search below.

We found eight systematic reviews that assessed the impact of care worker training. Multiple studies report the benefits of training. These include improvements in:  

• Interactions between care workers and residents [3]
• Functional ability of the person with dementia [2]
• Medication management [4]
• Care worker competencies [5]
• Care workers’ perceptions about their work capability [5]
• Care workers' attitudes to dementia. [6]

There is also evidence that care worker interventions may reduce pain and/or physical discomfort for people living with dementia in the short term. [3]

The evidence of the effectiveness of care worker training interventions is inconclusive for:

• Responsive behaviours [3, 7]
• Falls [3, 4]
• Antipsychotic medication use [3, 4]
• Restraint use. [2, 5]

This is because some studies report benefits of care worker training, while others report no benefits.

There was no clear evidence that care worker training programs have a direct influence on:

• Quality of life for the person living with dementia [2, 3]
• Mood of the person living with dementia [2, 3]  
• Level of agitation of the person living with dementia [2]
• The number of admissions to hospital [3]
• The quality of care provided by care workers [3]
• Care worker burnout. [5]

More research is needed to determine the benefits of care worker training. However, care worker training interventions were more likely to be effective when:

• They were multi-faceted (e.g., included hands-on support, or clinical auditing in addition to the training). [2]
• They combined education and supervision. [3]
• Programs focused on mood specifically targeted depression. [3]
• They focused on building an understanding of the behaviours of people living with dementia. [6]

The reviews highlighted concerns about the methods used in some of the studies. This reduces the degree of certainty we might have about the benefits of care worker training. For example:

• Studies were not always clear about the type, frequency, intensity, and duration of the intervention. [6, 7]
• There were often only a small number of people in the studies. [5, 7, 8]
• There was considerable variation between the training programs. [6]
• Researchers did not assess the effect of the training on the quality of care by directly watching what care workers do. [3]
• Studies did not account for other factors that may influence care workers’ attitudes, such as job satisfaction, self-esteem, burnout, empathy, social support or the overall care philosophy of the care facility. [6]

• Speak to colleagues or managers about training you believe would be useful.
• Complete some online training (some free resources listed below).

• Provide regular and appropriate staff training.
• Encourage and support care workers to approach managers about current workplace challenges.
• Be familiar with and incentivise care workers to complete online training courses (some free resources listed below).
• Seek feedback from care workers on what training they would find useful.

1. Blake D, Berry K, Brown LJE. A systematic review of the impact of person-centred care interventions on the behaviour of staff working in dementia care. J Adv Nurs. 2020;76(2):426-44.
2. Bauer M, Fetherstonhaugh D, Haesler E, Beattie E, Hill KD, Poulos CJ. The impact of nurse and care staff education on the functional ability and quality of life of people living with dementia in aged care: A systematic review. Nurse Educ Today. 2018;67:27-45.
3. Bird M, Anderson K, MacPherson S, Blair A. Do interventions with staff in long-term residential facilities improve quality of care or quality for life people with dementia? A systematic review of the evidence. Int Psychogeriatr. 2016;28(12):1937-63.
4. Gulka HJ, Patel V, Arora T, McArthur C, Iaboni A. Efficacy and generalizability of falls prevention interventions in nursing homes: A systematic review and meta-analysis. J Am Med Dir Assoc. 2020;21(8):1024-35.e4.
5. Cabrera E, Sutcliffe C, Verbeek H, Saks K, Soto-Martin M, Meyer G, et al. Non-pharmacological interventions as a best practice strategy in people with dementia living in nursing homes. A systematic review. Eur Geriatr Med. 2015;6(2):134-50.
6. McKenna M, Brown LJ, Muller C, Vikram A, Berry K. The impact of psychosocial training on staff attitudes towards people living with dementia: A systematic review. Int J Older People Nurs. 2023:e12528.
7. Spector A, Orrell M, Goyder J. A systematic review of staff training interventions to reduce the behavioural and psychological symptoms of dementia. Ageing Res Rev. 2013;12(1):354-64.
8. Zhao Y, Liu L, Chan HY. Dementia care education interventions on healthcare providers' outcomes in the nursing home setting: A systematic review. Res Nurs Health. 2021;44(6):891-905.