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Background: The NHMRC‐funded Promoting Independence Through quality Care at Home (PITCH) project aimed to improve outcomes for people living with dementia and their paid and family carers via an evidence‐based dementia specialist training program for home care workers (HCWs). PITCH training was co‐designed with HCWs, family carers and people with dementia, consisting of 2×3.5 hour sessions, delivered face to face (F2F) or on‐line. Methods: Stepped‐wedge cluster RCT including 18 home care services in rural and urban VIC, NSW, and SA cluster‐randomised into one of two arms. Data collection from 18 July 2019 to 12 May 2022. Analyses included linear mixed models with intention to treat. Results: N = 213 HCWs completed baseline measures, N = 144 completed 6‐month follow‐ups, and N = 120 completed 12‐month follow‐ups. 172 HCWs completed the training program. N = 148 (86%) completed all training sessions; N = 81 F2F and 67 online. Primary outcome measure: HCWs' Sense of Competency in Dementia Care Staff (SCIDS) was higher after training (p = 0.04). This was driven by F2F training: SCIDS for HCWs completing F2F training was higher vs no training (p = 0.003) and online training (p = 0.015). There was no difference between online training and no training (control condition). Secondary outcome measures: Overall, HCW scores on the Dementia Attitudes Scale (DAS) showed no difference between training and no training. However, F2F training was associated with higher DAS compared to no training (p = 0.05) and online training (p = 0.05). Training improved scores on the Dementia Knowledge Assessment Scale (DKAS, p = 0.03). This was also driven by F2F training (F2F vs no training p = 0.024; F2F vs online p = 0.026). There was no difference between online training and no training for DAS and DKAS. Training had no effect on Strain in Dementia Care Scale (SDCS) scores. Discussion/Conclusion: Receiving F2F PITCH training improved dementia attitudes, dementia knowledge, and sense of competence in delivering dementia care for HCWs versus no training and online training. The HCW workforce has unique challenges to accessing and completing training and education to deliver evidence‐based dementia care. Minimising these challenges is critical to the delivery of quality home care. PITCH training now has evidence for its efficacy but only when delivered face‐to‐face. [ABSTRACT FROM AUTHOR]

Background: In Australia approximately 30% of older people are from culturally and linguistically diverse (CALD) backgrounds. Hospitals are difficult places for people with dementia and even more difficult for those from CALD backgrounds. 75‐90% of patients with dementia experience behavioural and psychological symptoms of dementia (BPSD) during a hospital stay, with agitation and aggression most common1,2. The factors associated with being acutely unwell, combined with unfamiliar environments, heightened by difficulties in communication, can exacerbate BPSD resulting in increased morbidity/mortality and distress. Our aim was to identify the current state regarding BPSD management, compare this with best practice, and inform policy development particularly in relation to those most vulnerable such as people from CALD backgrounds. Method: Retrospective and prospective observational mixed‐methods design in Victorian hospitals. Six studies were conducted: 1) literature review regarding management of patients with dementia; 2) state‐wide population‐level analysis regarding patients with dementia; 3) inpatient‐ward point prevalence of BPSD; 4) hospital‐wide audit regarding the severity/impact of dementia; 5) gap analysis regarding models‐of‐care for patients with dementia; 6) interviews exploring the experiences of staff and family members of patients with dementia. Result: The synthesised results will be presented. We will outline how these will contribute to a best practice model‐of‐care for people with dementia in hospital. The challenges in establishing and obtaining relevant data related to dementia, delirium and BPSD in hospitals impacting on evidence‐informed policy will also be highlighted. Conclusion: Policy development for hospital management of people with dementia, particularly minority groups, is a challenge. This is due to the diversity of the population, the diversity in which the condition presents, the speed/severity of disease progression and the multi‐component interventions required. It is further complicated by the complexity of hospital systems and difficulties associated with obtaining meaningful and accurate qualitative and quantitative data. Comprehensive and collaborative approaches are urgently needed. References: 1. Sampson EL, et al. Behavioural and psychiatric symptoms in people with dementia admitted to the acute hospital. British J Psych. 2014;205(3):189‐96. 2. White N, et al. The management of behavioural and psychological symptoms of dementia in the acute general medical hospital. Int J Geri Psych. 2017;32(3):297‐305. [ABSTRACT FROM AUTHOR]

Background: People living with dementia increasingly prefer to live in their own home as their care needs progress. Home care workers (HCWs) are essential for supporting independent living, and need training and support on how to deliver evidence‐based and best‐practice dementia care. The home care workforce is diverse, and in Australia, the number of workers who identify as culturally and linguistically diverse (CALD) in 2020 represented 21% of the total direct‐care workforce. The Promoting Independence Through quality Care at Home (PITCH) project aims to improve outcomes for people living with dementia and their paid and family carers by co‐designing and testing an evidence‐based specialist training program for dementia care. A pragmatic stepped‐wedge cluster RCT is being conducted to evaluate the program. To date, 227 HCWs from seven home care providers across Australia have completed baseline measures. Method: HCWs completed the Strain in Dementia Care Scale (SDCS), Sense of Competence In Dementia Care – Staff (SCIDS), Dementia Attitudes Scale (DAS) and Dementia Knowledge Assessment Scale (DKAS). Associations between these measures was assessed using Pearson correlations. HCWs were grouped into CALD/non‐CALD groups based on self‐reported cultural background. ANOVAs examined group differences by CALD status. Result: For the whole sample, SCIDS was correlated with DAS (r = 0.599, p<0.005) and DKAS (r = 0.257, p<0.005). DAS and DKAS were moderately correlated (r = 0.334, p<0.005). Nearly 30% of HCWs in our sample identified as CALD. The CALD group showed lower DAS, DKAS and SCIDS compared to the non‐CALD group (p's<0.001). No differences were observed on SDCS (p = 0.58). Conclusion: HCWs who were more knowledgeable about dementia had more positive attitudes toward dementia and a higher sense of competence in dementia care. HCWs who did not identify as CALD showed greater dementia knowledge, more positive dementia attitudes, and higher sense of competence in dementia care. Findings suggest that better dementia literacy supports more positive attitudes to dementia and sense of competence, and highlights that more targeted and specialized support may be beneficial for staff from CALD backgrounds (who comprise a high proportion of the Australian aged care workforce). Findings have implications for clinicians, researchers, policy‐makers, educators, and providers of dementia services. [ABSTRACT FROM AUTHOR]