report of elderly care training in...
TRANSCRIPT
Report of Elderly Care Training in Nepal
1. Background
Globally, there is unprecedented increase in ageing population. Hence, this 21st
century is said to be the century of older persons. Ageing population accounts
for 13% of world’s total population. It is also estimated that the number of
ageing population will be tripled by 2050. In Nepal, there were 1.5 million ageing
population in 2001 and 2.1 million in 2011 which constitute 6.5% and 8.1 % of
the total population, respectively. During the years 1991-2001, the annual
ageing population growth rate was 3.39 percent which is higher than that of
annual population growth rate (2.3 percent).
On the other hand, nuclear family system has replaced joint and extended
family system due to modernization and urbanization. This coupled with high
migration of youth renders elderly members unlikely to receive proper care and
love even though they are at home. In such condition, the elderly with chronic
disease and helpless needs a care taker. However, there is lack of well-trained
caretakers in Nepal to take care of elderly.
2. Problem This large number of population needs special consideration for their inclusion
in societal mainstreaming. But the situation of this population is very vulnerable
due to lack of proper care. In the context of Nepal, well-trained human resource
for the elderly care are not available.
3. Introduction of the Programme
Ageing Nepal (AN) and Hope Hermitage Nepal (HHN) in collaboration with
Ministry of Women, Children and Social Welfare (MoWCSW) and in support of
Ageing Nepal Switzerland organized a 10 day’s long elderly care training
programme from Feb. 15, 2016 to Feb 27, 2016.
The programme was focused on policies and programmes on ageing, rights of
older people, consequences of elder abuse, elderly health, Alzheimer’s and
related dementia and way to cope elderly with different personality as caregiver
in day to day life.
4. Objectives The training programme was organized to meet the following objectives.
To fulfill the gap of the caretaker shortage in Nepal and to improve long term livelihood
To increase the employment opportunity in Nepal and raise awareness of choosing caretaker as a career
To empower Nepalese women belonging unprivileged background and eager in serving elderly
5. Participants We are very happy to note that the participants of the training programme were
from different districts of Nepal.
Gender Consideration
In the context of Nepal, culturally the female are more responsible to provide
care for the child and elderly. As well as, to enhance the women empowerment
Red Circles indicate the trainee’s district that
they represent
the training programme was focused on female participants. So large number
of female (24) were involved than that of male (2) in the training.
6. Subject Coverage The following issues on elderly were covered in the training.
a) Global and national trends of ageing population and its consequences and
terminologies
b) Social Security and older persons
c) UN bodies, INGOs and donor organization in Nepal
d) Anatomy
e) Kinesthesia
f) Policy and programme of Ministry of Health, Govt. of Nepal
g) Policy and programme of Ministry of Local Development, Govt. of Nepal
h) Nutritional diet
i) Elder abuse
j) Human Rights and UN Principles on the rights of older people
k) Role of caregivers
l) Communication skill of caregivers
m) Care and need assessment and care plan
n) Nursing/ Medication management tips for caregivers
o) Living space management
p) Alzheimer’s and related Dementia
q) Potential causes of behavioral symptoms
r) Coping with changes in behavior
s) Activities of daily living and personal hygiene in care of persons with Alzheimer’s
and dementia
t) Psycho-Social counselling and skills for caregiver
u) SDG 2016 to 2030: Social cultural consequences, economic consequences,
political consequences, mainstreaming
v) Policies and programs of Ministry of Women, Children and Social Welfare, Govt.
of Nepal
w) Education and care on daily living
x) Person- centered care
y) Home Safety/ Environment
7. Resource Person Mobilization
Efforts were made to involve issue oriented well known experts from wider
sectors of Nepali society in the training. The resource persons were from
Government bodies, INGOs, NGOs and individual experts. The following table
presents the name of the experts, related organizations and the issue covered
by them.
S.N. Name Designation Organization Issue 1. Krishna M.
Gautam Chairperson Ageing Nepal Global and National
Trend of Ageing Population, Care and need assessment
2. Sasmita Poudel Health Officer HelpAge International Nepal
Social Security
3. Sangita Nirola Founder member of SWATI & Former Country Director of HelpAge International Nepal
SWATI UN bodies, INGOs and donor organization in Nepal
4. Dr. Prakash Mahoto
Psychotherapist KMC Anatomy and Kinesthesia
5. Shaligram Rijal Undersecretary Ministry of Local Development
Policies and Programs of Ministry of Local Development, Govt. of Nepal
6. Prof. Dr. Pushpa Kamal Subedi
-Professor Central Department of Population Studies
Policy and programme of Ministry of Health, Govt. of Nepal
7. Dr. Tritha Rana Public Health and Nutrition Expert
Executive Board member of Nepal Public Health Foundation
Nutritional Diet
8. Sanju T. Magar Programme Officer
Ageing Nepal Elder Abuse
9. Bhumidatta Poudel
Programme Coordinator
Ageing Nepal Human Rights and SDGs
10. Deepa Deewan Treasurer The Hope Hermitage
Role of Care giver, Activities of daily living and personal hygiene in care of persons with Alzheimer’s and dementia Bathing, grooming, cleaning of people with Alzheimer’s and dementia
11. Ranjana Gurung Board member The Hope Hermitage Nepal
Role of Care Giver
12. Shanta Rai Nurse KMC Nursing Medication Management
13. Pramila Bajracharya Thapa
Chairperson Hope Hermitage Nepal
Personal Safety
Alzheimer’s and related dementia
Potential causes of behavioral symptoms
Coping with changes in behavior
Person Centered Care
Home safety for people with Alzheimer’s and dementia
14. Preety Pun Nurse - Psycho-Social counselling and skills for caregiver
15. Meera Sherchan Under-Secretary Ministry of Women, Children and Social Welfare, Govt. of Nepal
Policies and programmes of Ministry of Women, Children and Social Welfare
8. Schedule The programme was organized under the following schedule.
DAY 1
Monday, February 15 Time Content Areas Time Methodology Responsible /
Resource Person
Facilitator
10.00-10.30 Registration
Welcome tea
30 minutes Shanti Dong/ Prakash Gautam
Lea Frei/ Pramila Bajracharya Thapa
10.30-11:55
Formal opening
Chairing the guest
Training overview; expectation and objective
Short speech by the guests
Vote of thanks Chief Guest
85 minutes
Short speech
PramilaBajracharyaThapa / MC - welcome Chief Guest MoWCSW
12. 00 to 12.45 Lunch 12.45- 1.40 Introduction
Objectives and expectation from the training program
What will be covered in the training course
Scheduled and training program plan
Info about practical session 1
55 minutes Information Pramila Bajracharya Thapa/ Krishna M. Gautam
Lea Frei
1:45 – 2:40 Module 1a: Global and national trends of ageing population and its consequences and terminologies
What is ageing? Overview of ageing
National trends of ageing population and its consequences.
Changing population structure of Nepal
Global context of ageing in general
55 minutes Presentation/ Power point
Krishna M. Gautam Pramila Bajracharya Thapa
2:45 – 3:40 Module 1b: Social Security and older persons
Social security of older persons
55 minutes Presentation/ Interaction
HelpAge International
Krishna M. Gautam
Tea Break 15 minutes
4:00 – 4:55 Module 2a UN bodies, INGOs and donor
UN bodies, INGOs and donor organization in Nepal
55 minutes Sharing and interaction
Sangita Nirola Krishna M. Gautam
organization in Nepal
Day 2 (Tuesday, February 16) 4 Gatay 9.30-10.00 (Tea & Cookies) 10:00 – 11: 55 Module 3a: Anatomy
Anatomy: Educating about body structure of Ageing
2x 55 minutes
Presentation/Chart papers and power point presentation
Dr. Prakash Mahato (Physiotherapist – Ortho, KMC)
Vijaya KC
12:00 – 12: 45 Lunch 12:45 – 2:40 Module 6g: Kinesthesia
Handling patients, techniques of moving and support
2x 55 minutes Chart papers and power point presentation
Dr. Prakash Mahato (Physiotherapist – Ortho, KMC)
Vijaya KC
2:45 – 3:40 Module 2d: Policies and programs of Ministry of Health, Govt. of Nepal
Policies,
Programs of the Ministry of Health
55 minutes Presentation/Power point/ Interaction
Profess. Dr. Puspa Kamal Subedi
Krishna M. Gautam
Tea Break 15mins 4:00-4:55 Module 2e: Policies and Programs of Ministry of Local Development, Govt. of Nepal
Policies,
Programs of Ministry of Local Development
55 minutes Presentation/ Interaction
Shalikgram Krishna M. Gautam
DAY 3 (Wednesday, February 17) 5 Gatay
9:30 – 10:00 (Tea & Cookies) 10:00 – 11:55 Module 3c: Nutritional diet tips for healthy eating
Nutritional diet
Tips for healthy eating
2x 55 minutes
Presentation/ Lecture
Dr. Mrs. Tirtha Rana (Public Health and Nutrition Expert)
Krishna M. Gautam
12:00 – 12: 45 Lunch
12.45-1.40 Module 4a: Definition, types, symptoms and consequences of elder abuse
Definition,
Types,
Symptoms,
Consequences of elder abuse
55 minutes PowerPoint presentation
Sanju T. Magar Krishna M. Gautam
1:45 – 2:40 Module 4b: Human rights, UN principles on the rights of older
Human Rights of older person
55 minutes Presentation/ Interaction
Bhumidatta Poudel Krishna M. Gautam
persons, legal and organizational arrangements 2:45 – 3:40 Module 6a: Role of Caregivers
Role of Caregivers
What is a caregiver?
What are the types of care giving?
What are the responsibilities of caregivers?
55 minutes Interaction / presentation
Deepa Dewan, Ranjana Gurung
Pramila Bajracharya Thapa
Tea break 15 minutes 4:00 – 4:55 Module 6b: Communication skill of Caregiver
Communication,
Skills for caregivers
55 minutes Deepa Dewan Pramila Bajracharya Thapa
DAY 4 (Thursday, February 18) 6 Gatay
Observation in Elderly Home
10:00 - 5:00 Module 5a: Practical session 1, observation in elderly home
Observation 6 hours Hope Hermitage Deepa Dewan Krishna M. Gautam
DAY 5 (Friday, February 19) 7 Gatay
9:30 – 10:00 (Tea & Cookies)
10:00 – 11:55 Module 5b: Reflection of practical session
Reflection 2x 55 minutes
Presentation from participants
Krishna M. Gautam/ RanjanaGurung, RupaGurung
Lea Frei
12:00 – 12: 45 Lunch
12:45 – 1:40 Module 6c Care and need assessment and care plan
Assessing care need
Planning for meeting assessing care needs
55 minutes Presentation/ Interaction
Krishna M. Gautam Lea Frei
1:45 – 3:40 Module 6d: Nursing/ Medication management tips for caregivers
Ageing Nursing care
Medication management tips for caregiver
First Aid care
2x 55 minutes Presentation/ Interaction
Deepa Deewan Krishna M. Gautam
Tea break 15 minutes 4:00- 4:55 Module 6e Living space management,
Personal safety in and around house
55 minutes
Presentation/ Video/ Interaction
Pramila Bajracharya Thapa
Krishna M. Gautam
home and public space
DAY 6 (Monday, February 22) 10 Gatay
9:30 – 10:00 (Tea & Cookies)
10:00-10:55 Module 7a: Education about Alzheimer’s and related Dementia
What is Alzheimer’s and related Dementia?
2x 55 minutes
Interaction/ Video
Pramila Bajracharya Thapa
Krishna M. Gautam
12:00 – 12: 45 Lunch
12:45 – 1:40 Module 7b: Potential causes of behavioral symptoms
Causes,
Behavior,
Symptoms of Alzheimer’s and dementia
55 minutes
Presentation/ Interaction
Pramila Bajracharya Thapa
Krishna M. Gautam
1:45 – 2:40 Module 7c: Coping with changes in behavior
How to cope as a caregiver with causes of Alzheimer’s and dementia
55 minutes
Presentation/ Video/ Interaction
Pramila Bajracharya Thapa
Krishna M. Gautam
2:45 – 3:40 Module 7d: Activities of daily living and personal hygiene in care of persons with Alzheimer’s and dementia
Personal hygiene in care of persons with Alzheimer’s and dementia
55 minutes
Presentation/ Interaction
Deepa Dewan, Ranjana Gurung
Pramila Bajracharya Thapa
Tea break 15 minutes
4:00- 4:55 Module 6f: Psycho-Social counselling and skills for caregiver
Psycho-Social counseling
skills for caretaker
Stress management for caretakers
Caretakers role as psychosocial counsellor
55 minutes
Interaction
ChetnaLokshum (The Relief Trust)
Pramila Bajracharya Thapa
DAY 7 (Tuesday, February 23) 11 Gatay
9:30 – 10:00 (Tea & Cookies)
10:00-10:55 Module 2b: SDG 2016 to 2030: Social cultural consequences, economic consequences, political
What is SDG 2016 to 2030?
Social cultural consequences
Economic consequences
Political consequences
Mainstreaming
55 minutes
Presentation/ Interaction
Bhumi Dattapoudel
Krishna M. Gautam
consequences, mainstreaming 11:00 – 11:55 Module 2c: Policies and programs of Ministry of Women, Children and Social Welfare, Govt. of Nepal
Policies,
Programs of Ministry of Women, Children and Social Welfare
55 minutes
Presentation/ Interaction
MeeraSerchan
Krishna M. Gautam
12:00- 12:45 Lunch
12:45 – 1:40 Module 7e: Education and care on daily living
Bathing, grooming, cleaning of people with Alzheimer’s and dementia
55 minutes
Presentation/ Interaction
Deepa Dewan, Ranjana Gurung
Pramila Bajracharya Thapa
1:45 – 2:40 Module 7f: Person centered care
Person centered care for persons with Alzheimer’s and dementia
How to communicate?
How to diverting their mind.
55 minutes
PowerPoint presentation
Pramila Bajracharya Thapa
Krishna M.Gautam
2:45 – 3:40 Module 7g: Home Safety/ Environment
Home safety for people with Alzheimer’s and dementia
55 minutes
Presentation/ Video/ Interaction
Pramila Bajracharya Thapa
Krishna M. Gautam
Tea Break 15 Minutes 4:00 – 4:55 Module 8a Preparation for practical
Information for the practical 2
55 minutes
Information
Ranjana Gurung, Rupa Gurung
Krishna M. Gautam
DAY 8 (Wednesday, February 8) 12 Gatay
Caregiver in Elderly Home
10:00 - 5:00 Practical session 2, caregiver in elderly home, day 1
Orientation for practical 2
6 hours
Hope Hermitage
Ranjana Gurung, Rupa Gurung
Krishna M. Gautam
DAY 9 (Thursday, February 25) 13 Gatay
Caregiver in Elderly Home
10:00 - 5:00 Practical session 2, caregiver in
6 hours
Hope Hermitage
Ranjana Gurung, Rupa Gurung
Krishna M. Gautam
elderly home, day 1
DAY10 (Friday, Febrary 26) 14 Gatay
9:30 – 10:00 (Tea & Cookies)
10.00-11:55 Module 8d Report/presentation/questions
Report
Presentation
Questions of the practical 2
2x 55 minutes
Participants Presentation
Ranjana Gurung, Rupa Gurung
Krishna M. Gautam
Lunch 1:00- 1:45 1:45 – 2:10 Module 8d Report/presentation/questions
Report
Presentation
questions of the practical 2
85 minutes
Participants Presentation
Ranjana Gurung, Rupa Gurung
Krishna M. Gautam
Tea Break 15 Minutes 2:30 – 4:00
Final exam
90 minutes
Questionnaire
Lea Frei/ Krishna M. Gautam
Krishna M. Gautam / Pramila Bajracharya Thapa
4:00 – 4:30 Course Evaluation
30 minutes
Lea Frei/ Krishna M. Gautam
Pramila Bajrcharya Thapa
4.30 – 5:00 Closing Ceremony
30 minutes
Chair by Meera Sherchan from Ministry / All team members Ageing Nepal / HH
Shanti Dong Prakash Gautam
9. Evaluation
There was a detailed evaluation of every lesson, the practical’s and the whole
course. Here the most significant results are pointed out.
In a rating from 1 to 10 the students gave an average of 9.6 points for the question
‘how useful they think the taught subject will be for their work as a caregiver’.
Almost the same result showed us the evaluation filled in by the teachers. They
rated 9.4 points.
By the evaluation of the ’general degree of difficulties’, the number given by the
student is 4.7 and the teachers rated an average of 5. The rating in the students’
and the teachers’ evaluation was far spread between 1 and 10. To mention is that
the level of education of participants reached from very low to high. Some of them
can’t read or write and others are highly educated.
For the ‘mediation of the subject matter’, the student rated an average number of
9.4.
10. Lessons Learned
This is the very first training for Caregivers on Ageing in Nepal. It has been
proved as a milestone in the field of elderly care in Nepal. The organizing team
got an opportunity to learn the following lessons.
Time frame of training: The organizing team triggered that the time frame was
not convenient for the trainees as some of them were working already as
caregivers in different old age homes. So, the team realized that the trainees
faced problem in time management.
Compulsion of power point in Nepali language: As most of the trainees were
from grass root level of the society, they faced difficulty in understanding the
training materials which were presented in English language. The training would
be more effective if all slides were in Nepali language.
Degree of difficulties: The rating was spread. Parallel to the knowledge level of
the students. The training would be more effective if the students would have
the same level of experience and education.
11. Glimpses of the training
Ms. Meera Sherchan, Chief of Senior Citizen’s Unit, Ministry of Women, Children and Social Welfare,
Government of Nepal delivering speech in the first day of the training
Chief Guest and guests of the training at opening ceremony
Ms. Pramila Bajracharya Thapa, Chairperson of Hope Hermitage Nepal and Mr. Krishna M. Gautam taking
Sessions
Trainees at The Hope Hermitage Nepal for the practical session
Group Work and Presentation