Employee attitudes towards aggression in persons with dementia: Readiness for wider adoption of person-centered frameworks

What is known on the subject: Person-centered care, as compared to standard approaches, is a widely accepted, evidence-based approach for managing aggressive behaviour in persons with dementia. The attitudes, beliefs and values of long-term care and mental health nursing employees are important prerequisites to implementing person-centered practices. Research shows that nursing employees typically support person-centered approaches; however, less is known about the attitudes of non-nursing employee groups. What this paper adds to existing knowledge: Nurse managers and administrators tended to agree with person-centered approaches for managing aggression in dementia, suggesting some prerequisites are in place to support wider adoption of person-centered frameworks. Employees with more resident contact tended to support person-centered approaches the least, suggesting discipline-specific trainings may not be adequate for preparing frontline staff to use person-centered techniques. Attitudes towards aggressive behaviour may be especially varied and contradictory within certain employee groups, providing implications for facility-wide initiatives. Implications for practice: Person-centered values and practices should be monitored and reinforced across the organization. Person-centered trainings should be interdisciplinary in nature and focused on care areas, such as mealtime or bathing. Long-term care facilities should consider allowing nurse management and registered nurses to share the burden of direct resident care with frontline employees on a more regular basis. Abstract: Introduction Implementing person-centered care requires shared attitudes, beliefs and values among all care employees. Existing research has failed to examine the attitudes of non-nursing employees. Aim This study examined attitudes towards aggression among nursing and non-nursing employees to address gaps in existing research and assess readiness for wider adoption of person-centered frameworks. Method The Management of Aggression in People with Dementia Attitude Questionnaire was used to survey attitudes of employees in Michigan-based nursing homes. Results Overall, employees preferred person-centered over standard approaches. Job title was a significant predictor of paradigm support. Frontline employees were found to support person-centered attitudes the least. Wide-ranging responses were noted within employee groups. Discussion Job title may influence the degree to which an employee supports and utilizes person-centered approaches. Employees with the most contact with persons with dementia may be the least likely to implement person-centered approaches. In contrast to prior studies, years of experience was not a significant predictor of attitude towards aggressive behaviour. Wide-ranging responses indicate that employee attitudes are varied and complex. Implications Person-centered approaches should be trained within care areas rather than individual employee groups. Programs should be interdisciplinary and seek to establish a shared understanding of person-centered beliefs and values.