Kayla Demiar

CE Project Action Plan Template

Geriatric Practice Leadership Institute – Health Literate Education

MedStar, the Alzheimer’s Association, UNT Health Science Canter, and UTA Public Health

Intervention summary statement

Provide a summary description of the intervention planned.

A reader should be able to read and answer questions about the intervention:
• why,
• what,
• how,
• who and
• by when

Approximately 300 words

Communication between patients suffering with dementia and their caregivers is vital regarding positive
patient outcome. The intervention is focused on providing education to caregivers of dementia patients
in a health literate manner. By implementing trainings caregivers will develop proper communication, be
given readily available resources, and discover alternative care methods. Trainings with MedStar
Emergency Medical Technicians (EMTs) have been conducted by the Alzheimer’s Association to bring
awareness of the resources available for patients with dementia and their caregivers as well. By
introducing the information and resources to the EMTs, the EMTs will then be given the opportunity to
share what they have learned from the trainings with the caregivers of dementia patients of whom they
come in contact with. The implementation and assessment of the project will be throughout the Spring
semester of 2020. The results will then be presented to the Geriatric Practice Leadership Institute in late
April.

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Community analysis

Provide a summary description of the community this intervention plan relates to. Include a description of
community attributes
Approximately 300 words

The community involved in this intervention are the patients living with dementia and their caregivers.
Most importantly, the communication and relationship among the caregiver and patient will be analysed
and improved upon. Dementia is caused by changes in the brain that are abnormal. The changes may
include a decline in skills such as cognitive abilities that may interfere with their independent and
autonomous living and their daily activities. The symptoms may interfere and affect relationships,
feelings, or behavior (Alzheimer's Association). Dementia is a progressive disease in which it will
gradually worsen. Caregivers may be a spouse, adult children or grandchildren, nieces, nephews, friends,
or partners. There are alternative caregivers aside from loved ones that are paid, however most patients
rely on their loved ones who are unpaid for assistance. Caregiving includes a wide array of
responsibilities such as cooking, cleaning, transporting, making medical appointments and other duties
that the patient is unable to do for themselves or needs assistance in completing (Family Caregiver
Alliance). Because loved ones, EMTs, or caregivers are the first to respond to geriatric patients it is
important that information and resources provided by the Alzheimer’s Association are given either
through trainings or other forms of outreach. Although Alzheimer’s or other dementia is devastating to
the patient it is just as devastating on their caregivers. Compared to caregivers of other medical
significance that requires assistance, twice as many caregivers of patients with dementia have indicated
that the process has been considerably emotional while also having a substantial effect on their finances
and physical needs (Facts and Figures). Professional evaluation is always the most accurate diagnosis
however, Emergency Medical Technicians (EMTs) or loved ones may be able to detect dementia through
a series of visible symptoms.

Problem analysis

Provide a summary description of the problem this intervention plan relates to. Include a description of:
• Nature, severity and scale of problem?
• Distribution of problem?
Approximately 500 words
Dementia is an epidemic that affect the lives of elderly patients and their loved ones on a large scale in
the United States. According to the Alzheimer’s Association, one in three seniors dies from complications
of Alzheimer’s or other forms of Dementia while every 65 seconds someone in the United States
develops Dementia. Dementia kills more than the statistics of breast and prostate cancer combined. The
Alzheimer’s Association also reports that over 16 million Americans provide care that is unpaid for people
suffering with Alzheimer’s or other forms of Dementia. In 2019, 5.8 million Americans of several age
capacities are living with Alzheimer’s dementia. Lastly, in 2019 it was reported that Dementia and
Alzheimer’s will have cost the United States $290 billion. If there is no found solution to the rising
epidemic of Dementia, it is expected that by 2050 the costs could rise to $1.1 trillion projecting that 13.8
million will have developed the disease (Facts and Figures). The number of Americans living with the
ongoing epidemic is increasing. Although there are obstacles and challenges to improving brief cognitive
assessments there are signs of encouragement that the U.S. is detecting cognitive decline through
awareness and numerous assessments. Primary care physicians are researching different ways to
approach cognitive assessments which demonstrates a desire for improvement (Facts and Figures).

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Stakeholder analysis

Provide a summary description of the major stakeholders related to the problem being addressed s
• What we know about the target group, description etc
• Motivation and opportunities of the target group

• Accessibility and engagement with the target group

Approximately 300 words
According to the Alzheimer’s Association, Alzheimer’s and other forms of dementia are the United
States’ sixth leading cause of death. The statistics for Alzheimer’s are one in ten people of the age of 65
and older (Facts and Figures). A major stakeholder would be geriatric patients of 65 years and older as it
is seen that they are at a 10 percent risk of developing Alzheimer’s. Individuals who are of the ages 65
and older may also be caregivers as one in three are said to be caregivers (Facts and Figures). Women
are also a stakeholder as two-thirds of affected Americans are women. Women are also approximately
making up two-thirds of the profession of caregiving; one-third of these women are daughters of
dementia patients. African Americans and Hispanics are also at a higher risk of developing Alzheimer’s or
other dementias which makes those with these ethnic backgrounds a stakeholder as well. The business
stakeholders include the health care system as Dementia is quite expensive to care for as the previous
statistics have shown as well as the estimated increase in the upcoming years. The first responders to
distress calls such as the Emergency Medical Technicians and their teams. The Alzheimer’s Association as
they continue to research to hopefully prevent future generations from developing the disease as well
as finding alternative methods to care for patients with Alzheimer’s and other dementia. The Geriatric
Practice Leadership Institute along with other organizations centered around elderly patients as patients
over the age of 65 are their target population. Local and national public health professionals are also
major stakeholders as dementia is an epidemic affecting a large population and their loved ones.

Determinant Analysis

Provide a summary description of the determinant analysis you have conducted demonstrating an
understanding of the problem
• What are the determinants of the problem
• What determinants are amenable to change
• How have determinants been prioritised or selected for change?
• What theoretical models or assumptions are being used?

Insert determinant analysis diagram and describe analysis of the causative relationship between
determinants and problem.

Approximately 400 words

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Mandates for action
Provide a summary of existing mandates for action that support investment in your intervention.

Approximately 300 words

Mandates in regard to care for dementia patients are requirements for nursing assistants. The Centers
for Medicare and Medicaid Services (CMS) requires long-term care providers to attend training in their
facilities. Training for certified nursing assistants is required and has led to less adverse events, pain, and
falls with injury and depression (Trinkoff, Storr, Lerner, Yang, & Han, 2016). As mandated by the
Affordable Care Act (ACA) and the CMS have made dementia training an annual in-service training rather
than the previous initial and single training (Hobday, Savik, Smith, & Gaugler, 2010). However, this
mandate is mainly enforced within nursing home settings and not for caregivers that visit patients living
independently. There is also a mandate regarding a dementia diagnosis as an inquiry to the community
for available public health care support programs (Weiner, et al., 2016). The current mandates emphasize
that there should be attention given to those who are caring for patients with dementia.

Existing capacity for action

Provide a summary of existing capacity and capacity gaps that support your call for extra resources and
investment to support problem solving.

Approximately 300 words

The main purpose of the project is to improve upon the care given to patients with dementia and to
improve their relationship with their caregivers by providing more training and resources to them.
However, there is a failure to correspond between dementia care needs and the capacity of the
workforce within this specialized field. A seminar hosted by the Committee on Population at the
Academies in late May of 2019 spoke to share the current issue of this imbalance of the supply of
specialists not meeting the demand of patients to care for (Scales, 2019). Direct care workers are critical
concerning the care of dementia patients and are only mandated at a federal level to train their nursing
assistants in nursing homes and are inconsistent in training standards at state-levels. The lack of
competence within the dementia workforce creates a gap between the proper care that patients should
appropriately receive.

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Project partners and governance
Provide a summary of who and how you plan to establish intervention governance structures that include
key stakeholders and assist decision making.

Use diagrams as required

Approximately 300 words

While working under Dr. Carlson, I will collaborate with her as my site supervisor along with UNT Health
Science Center, the Alzheimer’s Association, and the team at the Fort Worth Medstar to complete the
qualitative data of the project. The EMTs are the individuals currently receiving the health literate
training by the Alzheimer’s Association and through networking with both groups and stakeholders we
will be able to determine if the intervention is successful. To establish intervention governance within
the dementia workforce there is a framework included. The framework includes a societal level which
implies the policies and mandates involved in the dementia workforce. The organizational level is
associated with the workforce itself and the increasing need of more specialists within this field of care.
The community level exercises the importance of the social aspect the patient is surrounded by. The
community includes the family, friend, and other loved ones. Caregivers exist on both an organizational
level as well as the community level as caregivers interact more intimately compared to nurses or
nursing assistants in nursing home facilities. The individual involved can either refer to the caregiver and
their needs or the patient.

National Academies of Sciences, Engineering, and Medicine, 2016, Framework for care interventions

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Goal & Objectives
Insert action statements
• Goal statement
• Objectives are SMART?
• Objectives fit with analysis?
• Objectives are acceptable
• Objectives are feasible

• I will review the educational materials provided by the Alzheimer’s Association related to their
health literacy level and determine if they are suitable for a lay audience.

• I will review the information from trainings, the attendance of EMTs, and pre/post training surveys
and input this data onto an Excel Workbook to determine if the trainings are proving to be
effective.

Intervention research
Summarise the intelligence from previous interventions (intervention research) that demonstrates you
have considered the learnings from previous effort. How has this informed your strategy mix?

Limit to 250 words

The complexity of dementia care related interventions emanates from several sources. There is a diverse
population concerning Alzheimer’s and other dementia as there is early onset as well as the main
population of patients of 65 years and older. The caregiver population is also vastly different as there
may be adult children, grandchildren, spouses, or other relatives who occupy the role. The designs of
interventions may be multileveled and target several levels regarding the caregiver or the dementia
patient. The conceptual National Institute of Health stage model is a framework of intervention research
development used throughout dementia implementation research (Agency for Healthcare Research and
Quality, 2019).

Strategy mix
Summarise the rationale and describe the strategy mix
• Describe strategy mix
• Do strategies fit with objectives (what is the logic model)
• Why do we think they have merit and are likely to work?
• Are strategies supported by intervention research evidence?

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Evaluation Plan

Describe the evaluation plan, specifically describing methods, how evaluation relates to goals and objectives
and the types of evaluation:
• Process
• Impact
• Outcome
• Capacity
• Economic evaluation.

What are the evaluation research questions?

What theoretical frameworks are used?

How are we accounting for confounding effects on evaluation results?

(intervention vs control comparisons etc)

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Evaluation stage Method Description of data collection / Data type Answers Question No? Output/
analysis method Disemmination
Formative

Process

Impact

Outcome

Capacity

Economic

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Activity planning
Work package descriptions

Activity/Task Method Who When

To be determined. Kayla Demiar By April 2020
Review educational
materials used by the
Alzheimer’s Association for
the health literacy level

Microsoft Excel Online Kayla Demiar By April 2020

Conduct qualitative data
analysis tasks, as assigned by
Dr. Carlson

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Budget

Project costs

Item Costs1

1. Investment by permanent staff (FTE estimates only)

2. Project budget:
a) Temporary project staff - (insert level, FTE and time period)
b) Associated non labour and corporate overheads
c) Other (itemise)
Project budget-total

Resource contribution from stakeholders

Estimated margin of error

Cost implications post-project

Justification

1 If project is multi-year, add additional columns and provide costs for each financial year.

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Project Schedule- timelines
Strategy/Activity Accountable Months (adjust timeframe as necessary)
Officer/s Duration Jan Feb Mar April May June July Aug Sept Oct Nov Dec
Project strategy implementation / finalisation activities
Material Review Dr. Carlson
Qualitative Data Dr. Carlson

Project management activities

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Risk management

What do you foresee might go wrong, and how will you plan to manage?

Risk Risk Management Activities

Preventive Contingent

Communication management

What plan do you have to keep stakeholders informed and to ensure project effects/impacts are shared
and utilised?

What How With/To Whom When/how often

Excel Workbook Online sharing Dr. Carlson/GPLI team Weekly

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References/ intelligence sources

Alzheimer's Association. (n.d.). What Is Dementia? Retrieved from https://www.alz.org/alzheimers-

dementia/what-is-dementia

Agency for Healthcare Research and Quality. (2019, July 25). Care Interventions for People With

Dementia (PWD) and Their Caregivers. Retrieved from

https://effectivehealthcare.ahrq.gov/products/care-interventions-pwd/protocol

Facts and Figures. (n.d.). Retrieved from https://www.alz.org/alzheimers-dementia/facts-figures

Family Caregiver Alliance. (n.d.). Caregiving. Retrieved from https://www.caregiver.org/caregiving

Hobday, J. V., Savik, K., Smith, S., & Gaugler, J. E. (2010). Feasibility of Internet training for care staff of

residents with dementia: The CARES program. Journal of Gerontological Nursing, 36, 13–21.

doi:10.3928/00989134-20100302-01

National Academies of Sciences, Engineering, and Medicine , Schulz, R., & Eden, J. (2016). Families

caring for an aging America. Retrieved from

https://www.johnahartford.org/images/uploads/reports/Family_Caregiving_Report_National_Ac

ademy_of_Medicine_IOM.pdf

Scales, K. (2019, June 18). It's Time to Build Dementia Care Competency in Direct Care. Retrieved from

https://phinational.org/its-time-to-build-dementia-care-competency-in-direct-care/

Trinkoff, A., Storr, C., Lerner, N., Yang, B., & Han, K. (2016). CNA training requirements and resident care

outcomes in nursing homes. The Gerontologist, 57, 501–508. doi:10.1093/geront/gnw049

Weiner, J. M., Gould, E., Shuman, S. B., Kaur, R., Ignaczak, M., & Maslow, K. (2016, September).

Examining models of dementia care: final report. Retrieved from

https://aspe.hhs.gov/system/files/pdf/257216/ExamDCMod.pdf

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