The Researcher

The researcher is a registered Social Worker, licensed within Canada for almost two decades. Most of her career has been spent in health care, particularly working in the field of geriatrics. At the time of this research study, the researcher was employed as a behavioural consultant for several LTC homes within a large health region on the Canadian Prairies. The researcher was employed by the same health region (not the individual LTC homes) in which this project was conducted. In conjunction with other behavioural consultants, the researcher completed assessments of residents living in LTC homes who were displaying responsive behaviours. Prior to the start of the study, the researcher had completed, as a behavioural consultant, assessments in 27 of the 30 care homes in the health region. The overall goal of this position was to improve the quality of life for residents in the care home by teaching staff about dementia, responsive behaviours, and personalized care. The behavioral consultants made recommendations based on the information that was gathered about residents through chart reviews, meeting with staff, spending time with the residents, and talking with their family members. All of the assessments and recommendations were based on person-centered care and were resident specific. Follow up was provided after initial assessments and the behavioural consultants worked with staff to assist them in finding ways to meet the needs of the residents within the care home. The researcher did not complete any behavioural assessments in the seven homes during the current research.

When the researcher was hired within the health region in 2007 as a behavioural

consultant, she was asked to make a recommendation to Senior Leadership regarding a training program that would help staff in care homes manage responsive behaviours. The researcher conducted a literature review that identified elements that have been recommended for inclusion in a behavioural management course for staff in care homes (Danylyshen-Laycock, 2009). The curriculum of ten behavioural management programs were compared against these criteria. The Gentle Persuasive Approaches Program was recommended to Senior Leadership because it met all 13 criteria recommended in the literature. The researcher attended the GPA Coach training in September 2007 and began to teach the curriculum in three of the care homes in the health region. These three homes were not a part of the current research project. The researcher became a Master Coach in April 2010 and was responsible for implementing and evaluating the GPA program in all 30 of the care homes within the health region. In addition, she was in charge of

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training all the GPA Coaches across the province. One of the responsibilities of the Master Coach was to attend the first training session given by each of the GPA Coaches when they returned to their care homes following their two-day training program. The researcher attended the initial training session in approximately one-third of the care homes in the health region.

The researcher was aware of the fact that she had spent time in each of the care homes either as a behavioural consultant, GPA Master Coach, or GPA Coach. In the homes for the retrospective study, the researcher had completed only one behavioural assessment in each of four LTC homes in the previous four years prior to the installation of the GPA program. The researcher had never been consulted to provide a behavioural assessment in the fifth care home of the retrospective study. As the GPA Master Coach, the researcher trained the GPA Coaches for all five of these homes and attended the initial training session of the GPA Coach in one of the five homes selected. With respect to the prospective study, the researcher completed only one assessment as a behavioural consultant in each of the two care homes in the four years prior to the start of this study. Another GPA Master Coach attended the initial training of the GPA Coaches in the two prospective study homes. The role of GPA Master Coach was consistent across these two care homes.

In both of these prior roles (consultant & educator), the researcher established relationships with all of the managers/administrators/directors of care (DOC) through the

behavioural assessments and the coordination of the GPA program. There was potential for staff to see the researcher in a role of influence as the behavioural consultant or GPA Master Coach, but this potential was equivalent across all the seven care homes selected for the research project. Given that the researcher had previous relationships (to differing degrees) with the staff in the homes selected for the research, many of the participants were already comfortable with and trusted the researcher. There were no participants who declined to be a part of this study as a result of a pre-existing relationship.

Two GPA Coaches, the Clinical Nurse Leader (CNL) in the prospective study, and two nursing aides (NAs) did approach the researcher looking for help and guidance in situations in which they were working with residents with responsive behaviours. The researcher responded briefly to the staff questions but did not initiate these interactions. All conversations were documented in the field journal and the researcher monitored and evaluated the effects that occurred as a result of these interactions. The researcher felt that if she did not provide staff with

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the assistance that they were looking for, it would negatively impact the relationship that she had within the home and ultimately the data that were being collected. When the staff within the care home were requesting assistance with behavioural issues that were more complex in nature, the researcher referred them to other behavioural consultants for follow up.