• Susan Mockus Parks, Christopher Haines, Diane Foreman, Elizabeth McKinstry, and Terri L Maxwell.
• Department of Family Medicine, Jefferson Medical College, Philadelphia, PA 19107, USA. susan.parks@jefferson.edu
• J Am Med Dir Assoc. 2005 Jan 1;6(1):61-5.

ObjectivesTo determine if an educational program can improve knowledge and attitude among ancillary staff on end-of-life care issues in a long-term care facility.DesignA pilot study using a pre- and post-test design prior to and at the completion of an education intervention.SettingA long-term care facility in suburban Philadelphia that has 150 assisted living beds and 53 nursing home beds.ParticipantsLong-term care ancillary staff including certified nursing assistants (called "care managers" at this facility), social workers, recreational therapists, and food service workers.InterventionThe intervention was a novel educational program consisting of five in-service lectures with accompanying take home self-study modules for ancillary staff in long-term care entitled "Dignity in Dementia."MeasurementsAncillary staff attitudes and knowledge on end-of-life issues in dementia were assessed with a knowledge and attitude questionnaire pre- and post-intervention. One-year follow-up questionnaires were administered to assess long-term maintenance of knowledge and attitude changes.ResultsThirty-two ancillary staff completed the pre-intervention questionnaires. Twenty-nine ancillary staff completed the post-intervention questionnaires (90.6%). There was a significant change in the end-of-life knowledge level of the ancillary staff (P =.0270). Specifically, there was a significant change in one question dealing with dementia as a terminal disease (P = .006). There were also significant changes in the average attitude scores of the ancillary staff. (P = .0242). One-year follow-up revealed that both knowledge and attitude changes were maintained.ConclusionsThis pilot project demonstrates that a staff educational program on end-of-life care for dementia residents can improve end-of-life knowledge and attitudes among long-term care ancillary staff and that this improvement can be maintained for up to 1 year. This intervention is easily reproducible in the long-term care setting. This project is an important step in helping improve end-of-life care for dementia residents in long-term care settings by improving the knowledge and attitudes of their caregivers.

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