Introduction
In recent years, there has been an increasing international emphasis on the use of interdisciplinary teams within health care. For example, there are journals dedicated to interdisciplinary care; the Journal of Interprofessional Care encourages “collaboration within and between education, practice and research in health and social care.” Similarly, Learning in Health and Social Care focuses, in part, on collaborative learning in a variety of health care environments. Special issues of Gerontology and Geriatrics Education about interdisciplinary care were published in 2003 and 2006, and a comparable issue of Educational Gerontology in 2002. Likewise, the current issue of International Psychogeriatrics focuses on multidisciplinary mental health care for older adults.
The terms “multidisciplinary” and “interdisciplinary” are often used interchangeably in relation to health care teams as both teams engage professionals from multiple disciplines. However, a distinction between multidisciplinary and interdisciplinary care can be made. A multidisciplinary team involves members who have independent roles and only feel responsible for the clinical work of their discipline; no common treatment plan is developed (Zeiss and Steffen, Reference Zeiss, Steffen and Edelstein2001). On the other hand, interdisciplinary team care includes a greater degree of interdependent collaboration among team members (American Psychological Association, 2007; Zeiss and Steffen, Reference Zeiss, Steffen and Edelstein2001). The interdisciplinary team develops shared goals for patient outcomes and outlines how the disciplines will work together to create the desired outcomes (Zeiss and Steffen, Reference Zeiss, Steffen and Edelstein2001). Sharing and integrating information from multiple perspectives of the team is the core of interdisciplinary, integrated care (American Psychological Association, 2007). Finally, interdisciplinary teams maintain shared leadership and power in decision-making across the team's disciplines (American Psychological Association, 2007).
Interdisciplinary care is sometimes used in the provision of health care to populations with complicated needs (Pfeiffer, Reference Pfeiffer, Siegler, Hyer, Fulmer and Mezey1998; Zeiss and Steffen, Reference Zeiss, Steffen and Edelstein2001; Drinka, Reference Drinka2002; Dyer et al., Reference Dyer2003; Coogle et al., Reference Coogle, Parham, Cotter, Welleford and Netting2005). This approach is believed to result in improved patient outcomes (Baldwin, Reference Baldwin2007), quality of care (Tsukuda, Reference Tsukuda, Siegler, Hyer, Fulmer and Mezey1998; Hammick et al., Reference Hammick, Freeth, Koppel, Reeves and Barr2007), and cost efficiency (Zeiss and Steffen, Reference Zeiss, Steffen and Edelstein2001). With the continued explosion in the older adult population and associated complexity of health-related concerns, geriatric interdisciplinary teams may be better able to address the needs of these more complex patients than individual disciplines alone (Pfeiffer, Reference Pfeiffer, Siegler, Hyer, Fulmer and Mezey1998; Zeiss and Steffen, Reference Zeiss, Steffen and Edelstein2001; Clark et al., Reference Clark, Leinhaas and Filinson2002). More specifically, interdisciplinary teams are recommended in working with patients with dementia (American Psychiatric Association, 1997; Crooks and Gelmacher, Reference Crooks and Geldmacher2004; Wolfs et al., Reference Wolfs, Dirksen, Severens and Verhey2006; Reference Wolfs, Kessels, Dirksen, Severens and Verhey2008; Chapman and Toseland, Reference Chapman and Toseland2007).
Interdisciplinary team (IDT) membership varies based on the needs of the patient (Zeiss and Steffen, Reference Zeiss, Steffen and Edelstein2001; Dyer et al., Reference Dyer2003; American Psychological Association, 2007). Medicine, nursing, and social work are core disciplines of geriatric interdisciplinary teams (Dyer et al., Reference Dyer2003). Collaboration as a member of an interdisciplinary team has been identified as a key area of competence for nurses (Verma et al., Reference Verma, Paterson and Medves2006; Damron-Rodriguez, Reference Damron-Rodriguez2008), occupational therapists (Verma et al., Reference Verma, Paterson and Medves2006), and social workers (Damron-Rodriguez, Reference Damron-Rodriguez2008). Psychologists play a vital role in medical settings (Andersen and Haley, Reference Anderson and Haley1997) and on interdisciplinary teams in long-term care settings (Molinari, Reference Molinari2003); the American Psychological Association (2004; 2007) encourages psychologists to work in collaborative teams when working with older adults. Health care administrators are also members of the geriatric interdisciplinary team (Dyer et al., Reference Dyer2003). Moreover, occupational therapists (Keough and Huebner, Reference Keough and Huebner2000; Crooks and Geldmacher, Reference Crooks and Geldmacher2004), psychologists (Keough and Huebner, Reference Keough and Huebner2000), social workers (Crooks and Geldmacher, Reference Crooks and Geldmacher2004; Chapman and Toseland, Reference Chapman and Toseland2007) and nurses (Crooks and Geldmacher, Reference Crooks and Geldmacher2004) are essential members of interdisciplinary teams treating dementia.
There is an international consensus that health care students should receive interdisciplinary team training (Hall and Weaver, Reference Hall and Weaver2001; Taylor et al., Reference Taylor, Cook, Cunningham, King and Pimlott2004). Despite a lack of strong evidence indicating that such education is effective, pilot studies have indicated positive results (Begley, Reference Begley2008). Several recent reviews have assessed interprofessional (Barr et al., Reference Barr, Hammick, Koppel and Reeves1999; Hammick et al., Reference Hammick, Freeth, Koppel, Reeves and Barr2007) and interdisciplinary education (Cooper et al., Reference Cooper, Carlisle, Gibbs and Watkins2001; Hall and Weaver, Reference Hall and Weaver2001). Some earlier reviews (Barr et al., Reference Barr, Hammick, Koppel and Reeves1999; Hall and Weaver, Reference Hall and Weaver2001) did not provide decisive evidence that interdisciplinary education is effective. Cooper et al. (Reference Cooper, Carlisle, Gibbs and Watkins2001) indicated that interdisciplinary education research has focused primarily on participant reactions to the learning experience and learning outcomes (i.e. knowledge, skills, attitudes and beliefs). Moreover, few studies have evaluated the results of interdisciplinary education on professional practice (e.g. patient outcomes). Hall and Weaver (Reference Hall and Weaver2001) concluded their discussion by posing a number of unanswered questions, such as: “Which health professionals should learn how to work in an IDT?” and “What methods are most effective for teaching interdisciplinary teamwork?” More recently, Hammick et al. (Reference Hammick, Freeth, Koppel, Reeves and Barr2007) indicated that learners respond positively to interprofessional education and display knowledge and skills used in collaborative practice. Hence, there is a growing body of evidence regarding interdisciplinary education.
The motto of Xavier University's newly formed College of Social Sciences, Health, and Education (CSSHE) is “Collaborate, Innovate, Educate.” Departments within the College are encouraged to work collaboratively and innovatively with a focus on “educating men and women for others,” consistent with the Jesuit nature of the University. To this end, faculty from several departments within the College convened in the fall of 2008 to develop a brief interdisciplinary training experience focused on a non-pharmacological approach to care of older persons with dementia. This paper presents the results of a study that assessed student attitudes about health care teams before and after the symposium. It was expected that students would have more positive attitudes about health care teams after participating in the symposium.
Methods
Students from five health care disciplines (health services administration, nursing, occupational therapy, psychology, and social work) were required to participate in a five-hour symposium that focused on an interdisciplinary approach to working with patients experiencing dementia. All students were requested to complete a pre-test one to two weeks before and a post-test at the end of the symposium. The pre and post-tests were administered in April 2009. Students were read a consent document indicating that participation was voluntary, and advised that they could refuse to answer any or all questions. After students completed the pre-test, readings were assigned to prepare them for the symposium. All students were assigned a common article to read about the team approach to treatment of dementia; additional discipline-specific readings were also assigned (see Appendix A for the Reading List). Students prepared for the symposium in their respective courses in the class period prior to the symposium, via discussion of assigned readings. The study was approved by Xavier University's Institutional Review Board.
Symposium participants included undergraduate students in nursing (n = 87) and social work (n = 13), students in master's programs in health services administration (n = 30) and occupational therapy (n = 20), and clinical psychology doctoral students (PsyD; n = 7). Prior to the symposium, students were divided into18 interdisciplinary teams. Each team included students from various health care disciplines represented at the symposium. Not every team included a student from every discipline and some teams had multiple students from a discipline. A community partner knowledgeable about dementia care and a faculty member rounded out the teams. Community partners were individual professionals or persons from agencies with which the represented academic departments had active collaborative relationships. Faculty participating in the symposium were asked to assist by planning committee members because of their experience with interdisciplinary health care teams.
Each team, and therefore each student, was given a case study to review prior to the symposium. Case studies were real-world cases submitted by community partners and followed a recommended outline designed by the planning committee (see Appendix B). Six case studies were utilized, with three teams focusing on each case study. These case studies were selected due to their complexity and depth of concerns. The symposium began with a 90 minute didactic presentation on dementia care from a nationally recognized speaker, Teepa Snow, M.S., OTR/L, FAOTA. A meeting of each previously established interdisciplinary teams occurred following the aforementioned presentation. In this meeting, teams reviewed the case study and developed a plan for the case. A rich discussion among students from the various disciplines was facilitated by faculty and community partners, following a recommended outline for the team meeting (Appendix C). The symposium concluded with a brief presentation by each interdisciplinary team (2 hours, with 18 total presentations). No additional focused interdisciplinary training occurred.
The study utilized a previously validated instrument, the Attitudes Toward Health Care Teams Scale (ATHCTS; Heinemann et al., Reference Heinemann, Schmitt, Farrell and Brallier1999; Appendix D), which includes two subscales: the Quality of Care/Process Subscale and the Physician Centrality Subscale. The 20-item version of the scale was used, as recommended by the developers, because it explained more of the variance and was preferred by respondents (Heinemann et al., Reference Heinemann, Schmitt, Farrell and Brallier1999). The 14-item Quality of Care/Process Subscale assesses attitudes toward the quality of care provided by health care teams and quality of teamwork necessary to achieve this (Heinemann et al., Reference Heinemann, Schmitt, Farrell and Brallier1999). Scores on this subscale range from 0 to 70, with high scores indicating the perception of high quality of care and process from health care teams (Heinemann and Brown, Reference Heinemann, Brown, Heinemann and Zeiss2002). Cronbach's α for this subscale was 0.83, which is acceptable. The six-item Physician Centrality Subscale, which includes items 4, 6, 8, 12, 15, and 17, measures attitudes toward shared leadership on the team (Heinemann and Brown, Reference Heinemann, Brown, Heinemann and Zeiss2002). Scores on this subscale range from 0 to 30 with a high score indicating a positive view of physician authority in the team (Heinemann and Brown, Reference Heinemann, Brown, Heinemann and Zeiss2002). Cronbach's α for this subscale was 0.75, which is acceptable. Negatively worded ATHCTS items are reverse coded.
Demographic information was also collected, including age, gender, ethnic background, class standing, and course of study. Students were asked to place a unique identifier on the pre and post-test to allow for paired analysis. Statistical analyses were completed using the Statistical Package for the Social Science (SPSS) version 17.0. Descriptive statistics were calculated. Pre- and post-test ATHCTS scores were compared using a paired t-test. Significance was set at p <0.05.
Results
A total of 157 students participated in the symposium. The number completing the ATHCTS pre-test was 154 (98% response rate). The pre-tests of five students were excluded due to incomplete answers to all questions. One hundred and thirty-five participants completed the ATHCTS post-test (86% response rate). Thirteen participants were excluded due to incomplete answers to all questions. Sixteen additional students were excluded because they used different identification codes for the pre and post-tests, which did not permit matching of their responses. The remaining 106 participants (68%) completed pre and post-tests, which were matched (Table 1). The final sample included 55 nursing, 19 health services administration, 19 occupational therapy, 7 social work, and 6 psychology students. The mean age of the final sample was 22.46 ± 4.25 years (range 19–46 years); 88% were white, 5% Asian, 4% Hispanic, and 3% African-American; 86% were female.
Pre- and post-test scores on the Attitudes Toward Health Care Teams Scale (ATHCTS)
A t-test for paired samples was conducted to compare the pre and post-test ATHCTS overall and the subscale scores. There was a statistically significant increase in the overall pre-post ATHCTS scores, t(105) = 3.93, p < 0.001, η2 = 0.13 (Table 1), indicating a moderate effect size (Cohen, Reference Cohen1988). There was a significant increase in the Quality of Care/Process Subscale scores, t(105) = 5.57, p < 0.001, η2 = 0.23, indicating a large effect size (Cohen, Reference Cohen1988). There was a significant decrease in the Physician Centrality Subscale scores, t(105) = 2.90, p = 0.007, η2 = 0.07, indicating a moderate effect size (Cohen, Reference Cohen1988).
To determine the impact of excluding the cases that could not be matched, the mean for the entire group completing the instrument at the pre- or post-test was examined. The mean score for the 149 complete pre-tests was 65.50, which is similar to the mean for the 106 used in the paired analysis (M = 65.69). The mean score of the 122 complete post-tests was 69.66, which is also similar to the mean of the 106 used in the paired analysis (M = 68.84). A χ2 indicated there were no significant differences in age, race/ethnicity, or gender between those used in the final comparison and those excluded.
Discussion
These findings suggest that after participating in a five hour symposium about an interdisciplinary team approach to treating older persons with dementia, students reported more positive overall attitudes about health care teams, and about the quality of care provided by such teams and teamwork to achieve good patient care. Moreover, from pre- to post-test, students displayed a decrease in their beliefs about how essential physicians are as leaders of health care teams. These results affirm the use of a brief interdisciplinary educational approach in changing student attitudes about the use of health care teams. Students who develop more positive attitudes about working on an interdisciplinary health care team recognize the team's value; they may therefore be more receptive to and effective in working as professional members of such teams in the future.
The mean post-test score for the ATHCTS Quality of Care/Process Subscale is comparable to that reported in Heinemann et al. (Reference Heinemann, Schmitt, Farrell and Brallier1999). Interestingly, the mean post-test score for the ATHCTS Physician Centrality Subscale is more consistent with that of practicing physicians than registered nurses or social workers from the study by Heinemann et al. (Reference Heinemann, Schmitt, Farrell and Brallier1999). The current results may be a reflection of participants being in training, rather than practicing in their field, as was the case in the Heinemann study.
Beyond this, the results of the current study are difficult to compare to those of other studies. Despite the recommendation of Heinemann and her colleagues (Reference Heinemann, Schmitt, Farrell and Brallier1999) that a 20-item, two-subscale form of the ATHCTS be used, researchers have continued to use the original 21-item, three-subscale form. Furthermore, studies that used the recommended form did not report mean scores (Taylor et al., Reference Taylor, Cook, Cunningham, King and Pimlott2004; Coogle et al., Reference Coogle, Parham, Cotter, Welleford and Netting2005). Hence, it is difficult to provide additional discussion regarding the comparability of the current results to other studies that have used the ATHCTS.
The results may be interpreted in light of the more general literature about interdisciplinary and interprofessional education. Internationally, there is a consensus that students should be exposed to interdisciplinary team training (Hall and Weaver, Reference Hall and Weaver2001; Taylor et al., Reference Taylor, Cook, Cunningham, King and Pimlott2004). The current study supports this recommendation, as students endorsed more positive attitudes toward health care teams after the symposium. As indicated in the review by Cooper et al. (Reference Cooper, Carlisle, Gibbs and Watkins2001), attitude change is one primary result of interdisciplinary education.
The approach to learning and pedagogy utilized for the symposium was a combination of didactic presentation, problem-based learning (e.g. case studies), and small group work. The literature on interdisciplinary learning supports the use of practical experiences (Cooper et al., Reference Cooper, Carlisle, Gibbs and Watkins2001), problem-based learning (Parsell et al., Reference Parsell, Spalding and Bligh1998), such as case studies (Hall and Weaver, Reference Hall and Weaver2001; Owens et al., Reference Owens, Padula and Hume2002), and small group work (Hall and Weaver, Reference Hall and Weaver2001) in increasing participant understanding of one another's roles. Cooper et al. (Reference Cooper, Carlisle, Gibbs and Watkins2001) identified only one previous study that utilized a variety of teaching methods, despite the prevalence of experiential methods and traditional didactic methods in interdisciplinary training. Hammick et al. (Reference Hammick, Freeth, Koppel, Reeves and Barr2007) stated: “the unique nature of IPE [interprofessional education] demands authenticity from the learning experience” (p. 748). The use of real case studies and small group work facilitated by faculty and community partners likely contributed to the authenticity of this symposium. Finally, Parsell et al. (Reference Parsell, Spalding and Bligh1998) emphasized the importance of teachers as role models for interdisciplinary activities. The planning committee for the symposium was comprised of faculty members from the health care disciplines represented. These faculty were also actively involved in the case discussions during the symposium.
Participation in this symposium was required. Hall and Weaver (Reference Hall and Weaver2001) discussed the positive impact voluntary involvement in interdisciplinary education may have on the outcomes of research. Hammick et al. (Reference Hammick, Freeth, Koppel, Reeves and Barr2007) addressed the importance of active student involvement in the actual interdisciplinary training, despite obligatory attendance. Hence, regardless of the mandatory nature of symposium attendance, the positive change in attitudes toward health care teams may be related to the active role that students played within their interdisciplinary teams.
Fulmer et al. (Reference Fulmer2005) also reported that greater geriatric experience was associated with less change in ATHCTS scores from pre to post-test. Although the amount of clinical experience with older adults was not specifically assessed, it is believed that most students participating in the current symposium had minimal experience with older adults and the significant increase in the ATHCTS scores may be a reflection of this lack of experience.
Finally, the duration of interprofessional education is an important consideration. Clark et al. (Reference Clark, Leinhaas and Filinson2002) posed the question: “What is the proper ‘dose’ of training necessary to achieve the desired effect?” Longer courses have been associated with positive effects on student beliefs about interprofessional services (Hammick et al., Reference Hammick, Freeth, Koppel, Reeves and Barr2007). Cooper et al. (Reference Cooper, Carlisle, Gibbs and Watkins2001) reported that among the studies reviewed, the duration of most training was up to one month. Moreover, Coogle et al. (Reference Coogle, Parham, Cotter, Welleford and Netting2005) reported that more than four hours of training were required to show improvements in attitudes about the costs of team health care. Hence, the interdisciplinary training presented in the current study was relatively brief (five hours).
Dyer et al. (Reference Dyer2003) identified health care administrators as members of the geriatric interdisciplinary team. Yet, the current study appears to be the first to include health services administration students in interdisciplinary education. The involvement of these students is logical as they are often conveners of geriatric interdisciplinary teams in institutional settings.
The results of this study may be reflective of the sample. Of all health professions, nurses have been reported to be most receptive to interdisciplinary learning (Begley, Reference Begley2008). The over-representation of future nurses in the current sample may have positively influenced the outcome of the study. Older and more professionally experienced students have been found to hold more negative views (Pollard et al., Reference Pollard, Miers and Gilchrist2004; Hammick et al., Reference Hammick, Freeth, Koppel, Reeves and Barr2007), whereas entry level students have shown positive attitudes toward interprofessional interaction (Pollard et al., Reference Pollard, Miers and Gilchrist2004). Conversely, Coogle et al. (Reference Coogle, Parham, Cotter, Welleford and Netting2005) reported that individuals who have worked longer in the health care system were more likely to see greater value of teams in the pursuit of quality care. Again, the younger and less professionally experienced sample used in this study may have positively influenced the results. Finally, women reportedly hold more positive attitudes toward interprofessional education than men (Hammick et al., Reference Hammick, Freeth, Koppel, Reeves and Barr2007). The current sample was predominantly female, which also may have influenced the results.
There are several limitations to this study. The sample was one of convenience and no control group was included. Hence, while it is believed that the change in attitudes toward health care teams was a result of the symposium, this is not a definitive conclusion. Consistent with the methodology of most previous studies, an immediate post-intervention assessment was conducted (Cooper et al., Reference Cooper, Carlisle, Gibbs and Watkins2001). No longer-term follow up assessment was undertaken; it is unknown if the change in attitudes will be sustained over a longer time period. Barr et al. (Reference Barr, Hammick, Koppel and Reeves1999) described the ultimate outcome of interprofessional education as a positive impact on patient outcomes. However, Barr et al. (Reference Barr, Hammick, Koppel and Reeves1999) also recognized that IPE directed toward students lays the groundwork for collaboration by modifying attitudes and collaborative competence, rather than directly affecting patient care. Hence, it is not possible to assess this distal patient care outcome or to apply the results to a change in knowledge or behavior, since the current study assessed a change in attitudes toward health care teams. As previously indicated, there were a disproportionate number of nursing students in the sample, which may have influenced the results. Moreover, the students had varying levels of interest in geriatrics; for example, psychology students were enrolled in a geropsychology concentration within the doctoral program. Hence, the sample was somewhat heterogeneous, making it difficult to generalize to a larger population.
Conclusion
The use of interdisciplinary health care teams has grown in recent years. The use of these teams will be increasingly helpful as the world's population ages and presents for treatment with more complex needs, such as those associated with dementia. Therefore, it is imperative that we prepare health care students from a variety of disciplines for this growing area of professional practice.
This paper described a brief symposium focused on training students to engage in interdisciplinary treatment of older adults with dementia. Consistent with the composition of most geriatric interdisciplinary teams, students in nursing and social work programs were included. Graduate students in occupational therapy and psychology were also included, despite the tendency for the involvement of these disciplines to be considered more tertiary. Finally, for the first time reported in the literature, graduate students in health services administration were included in this interdisciplinary training.
A strength of this study is the use of the ATHCTS to assess changes in student attitudes. In a systematic review about interdisciplinary learning by Cooper et al. (Reference Cooper, Carlisle, Gibbs and Watkins2001), only 35% of studies used validated instruments. Hammick et al. (Reference Hammick, Freeth, Koppel, Reeves and Barr2007) reported that longer interprofessional education courses were associated with more positive effects on student perceptions of interprofessional health care services. Hence, the five-hour intervention described herein may have had a positive impact on student attitudes toward health care teams without a large time commitment from them. The students involved in this symposium are more positive about their involvement with health care teams. Therefore, they may be more receptive and better prepared to serve the needs of older adults with dementia within an interdisciplinary context, which is indicative of the pedagogical significance of the symposium.
Conflict of interest
None.
Description of authors’ roles
Dr. Zucchero generated the literature review, developed the abstract, article introduction, and discussion, supervised data entry, and was primarily responsible for the revision of the overall paper. Dr. Hooker conducted the data analysis, developed the method and results sections, and participated in revision of the overall paper. Ms. Larkin developed the Wheeler Grant proposal that underwrote the costs of the symposium and assisted in the revision of the paper.
Acknowledgments
Professional contributions from the following were imperative in the planning and implementation of the Symposium: Joan Tunningley, Symposium Convener; and Barbara Harland, Susan Namei and Carol R. Scheerer, Planning Committee Members. The authors gratefully acknowledge Dr. Gloria Heinemann for allowing us to use the ATHCTS and for providing a copy of the instrument. The authors are appreciative of the financial support of a Wheeler Grant from Xavier University which underwrote the costs of the symposium.
Appendix A: Interdisciplinary Symposium Reading List
1. Common reading for all students
Slone, D. G. (2002). A team effort for treating depression in dementia. Clinical Gerontologist, 25, 173–196.
2. Health services administration
Bellantonio S. et al. (2008). Efficacy of a geriatrics team intervention for residents in dementia-specific assisted living facilities: effect on unanticipated transitions. Journal of the American Geriatrics Society, 56, 523–528. doi: 10.1111/j.1532-5415.2007.01591.x.
Kenny, A. M. et al. (2008). Factors associated with skilled nursing facility transfers in dementia-specific assisted living. Alzheimer Disease and Associated Disorders, 22, 255–260. doi: 10.1097/WAD.0b013e31816c92d5.
3. Nursing 1
Potter, P. A. and Perry, A. G. (2009). Older adult. In Fundamentals of Nursing (7th edn, pp. 196–213). St. Louis, MO: Elsevier.
Sutor, B., Rummans, T. A. and Smith, G. E. (2001). Assessment and management of behavioral disturbances in nursing home patients with dementia. Mayo Clinic Proceedings, 76, 540–50. doi: 73251123.
4. Nursing 2
Gade, G. et al. (2008). Impact of an inpatient palliative care team: a randomized controlled trial. Journal of Palliative Medicine, 11, 180–190. doi: 10.1089/jpm.2007.0055.
5. Occupational therapy
Glantz, C. and Richman, N. (2007). Occupation-based, ability-centered care for people with dementia. OT Practice, 12, 12–16.
Haak, M., Fange, A., Hosrstmann, V. and Iwarsson, S. (2008). Two dimensions of participation in very old age and their relations to home and neighborhood environments. American Journal of Occupational Therapy, 62, 77–86.
Mahaffey, L. (2009). Using theory and the therapeutic reasoning process to guide the occupational therapy process for older adults with mental illness. AOTA OT Practice, 14, CE1–CE8.
Siebert, C. (2007). Aging in place and occupational therapy. Gerontology Special Interest Section Quarterly/American Occupational Therapy Association, 30(4), 2–4.
6. Psychology
Knight, B. G. (2004). Psychotherapy and the person with dementia. Psychotherapy with Older Adults (3rd edn., pp. 187—203). Thousand Oaks, CA: Sage Publications.
Logsdon, R. G., McCurry, S. M. and Teri, L. (2007). Evidence-based psychological treatments for disruptive behaviors in individuals with dementia. Psychology and Aging, 22, 28–36. doi: 10:1037/0882–7974.22.1.28
Slone, D. G. and Gleason, C. E. (1999). Behavior management planning for problem behaviors in dementia: a practice model. Professional Psychology: Research and Practice, 30, 27–36.
Zarit, S. H. and Zarit, J. M. (2006). Disorders of aging: dementia, delirium, and other cognitive problems. In Mental Disorders in Older Adults: Fundamentals of Assessment (2nd edn, pp. 40–77). New York: The Guilford Press.
Zarit, S. H. and Zarit, J. M. (2006).Treatment of dementia. In Mental Disorders in OlderAdults: Fundamentals of Assessment (2nd ed., pp. 299–320). New York: The Guilford Press.
Zarit, S. H. and Zarit, J. M. (2006). Consultation in institutional settings. In Mental Disorders in Older Adults: Fundamentals of Assessment (2nd edn, pp. 40–77). New York, NY: The Guilford Press.
7. Social Work
Atwal, A. and Cladwell, K. (2005). Do all health and social care professionals interact equally: a study of interactions in multidisciplinary teams in the United Kingdom. Scandinavian Journal of Caring Science, 19, 268–273. doi: 10.1111/j.1471-6712.2005.00338.x.
Damron-Rodriguez, J. and Corley, C. (2002). Social work education for interdisciplinary practice with older adults and their families. Journal of Gerontological Social Work, 39, 37–55. doi: 10.1300/J083v39n01_05.
Appendix B: Recommended outline for case studies
Demographic information
Diagnoses
Current living setting
Insurance/Payor
Medical history
Family and social history
Current medical interventions, including current medications
Behavioral/Emotional functioning
Current functioning for daily living and instrumental daily living tasks
Spirituality/Routines/Rituals
Recent changes in status
Current concerns or issues
Appendix C: Recommended outline for the interdisciplinary team meeting
The small group meetings will be a time to develop an interdisciplinary team consensus to include the following areas:
1. Clearly state the major problem/concern that probably leads to the requested meeting
2. Identify the patient's strengths and problems
3. Identify the needed assessments or concern areas
4. Develop multidisciplinary patient goals
5. Write a plan of care or intervention plan for each discipline
Appendix D: The 20-item version of the Attitudes Toward Health Care Teams (ATHCT) instrument
Please use the following scale in answering the next 20 questions.
