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John V. Hobday
Media Department and
As a way of measuring actual behavior change after direct-care workers finished the CARES® Dementia Basics & Advanced Care™ Online Training Program, HealthCare Interactive founder and CEO John Hobday, and University of Minnesota researchers Joseph Gaugler, PhD, and Kay Savik, MS, set out to develop a simple way to measure whether or not employees were delivering person-centered care to people with dementia. The result is a validated measurement tool called the CARES® Observational Tool (COT™). After several refinements, multiple tests, and reviews by 9 interdisciplinary, scientific experts, the COT is considered to be an excellent and easy-to-use method to establish whether caregivers are providing person-centered care to people with dementia.
Based on the care concepts taught in CARES, (www.hcinteractive.com/cares), the COT measures the following aspects of person-centered care: connecting with the person; assessing behavior; responding appropriately; evaluating what works; and sharing with others. Supervisors and other observers use what is called a “dichotomous scoring system” for each of 16 items in the COT, scoring 1 point if the action is observed, and scoring 0 points if it is not. The scores are then totaled (16 indicating that all 16 staff behaviors were observed, and 0 indicating that none of the staff behaviors were observed).
Once the COT is scored, administrators have an invaluable opportunity to spot critical gaps in person-centered care, which can then be addressed with staff training and individual performance appraisals. The COT is of tremendous importance in settings where person-centered care is at risk. These settings would include residential facilities who serve people with moderate-to-severe cognitive impairment, and in locations where business practices favor maximum efficiency over person-centered care. Another equally important use of the COT is as a training tool—assessing staff understanding and performance of person-centered care concepts. The COT can also be used as an informal peer-to-peer observation tool that can help transform person-centered care principles into practice.
In all, the COT is a simple yet highly effective method of measuring how well person-centered care is being implemented in residential settings for people with dementia.
Details about the COT can be found in volume 34 of Geriatric Nursing or at www.hcinteractive.com/COT.