report of elderly care training in...

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


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


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


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


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


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


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



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




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)


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


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


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




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


Krishna M.Gautam

2:45 – 3:40 Module 7g: Home Safety/ Environment

Home safety for people with Alzheimer’s and dementia

55 minutes



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


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


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


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


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

report of elderly care training in...

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