Gentle Persuasive Approaches

The Gentle Persuasive Approaches (GPA) program is just a little more than a decade old, but more than 300,000 Canadians have already been trained in this evidence-based dementia education curriculum.

“It’s a comprehensive, practical education program that equips caregivers with the skills, the knowledge and the confidence to deliver person-centred dementia care,” says Patti Boucher, executive director at Advanced Gerontological Education (AGE) Inc. in Hamilton, Ontario.

Volunteer stakeholders (comprising expert clinicians, educators, and researchers specializing in gerontology, nursing and health services) contribute to AGE, a not-for-profit social enterprise dedicated to enhancing the care of older adults. The team at AGE developed the Gentle Persuasive Approaches curriculum to help point-of-care staff “to develop their compassionate and effective techniques in order to assist people with dementia who may become upset or frustrated,” Boucher says. “It really is about safeguarding both the person with dementia, as well as the care provider.”

A 2008 study out of York University in Ontario revealed 90 per cent of front-line workers in Canada claimed to have experienced physical violence from residents and their families, and 43 per cent reported violence daily. Boucher says GPA teaches front-line caregivers, and anyone who regularly interacts with persons with dementia, to notice signs of agitation early, before responsive behaviour happens.

“It really gives care providers a sense that all behaviour has meaning. Most behavioural responses are time-limited and the result of an unmet need,” Boucher says. “If we understand that person and we understand their needs, we could minimize the potential for those responsive behaviours.”

Caregivers are trained to spot potential signs of agitation (such as restless movements, seeking to exit the facility and refusing care) and are also encouraged to stop and think about the potential causes of these responsive behaviours. Is it possible the person is hungry, scared or in pain, but is not able to express this feeling verbally? According to Boucher, addressing unmet needs while also understanding the individual’s personal preferences is important in defusing a potential situation.

“We really want care providers to know the person,” Boucher says. “What are their likes? What are their dislikes? Do they like music? What kind of bathing do they prefer? What hobbies do they have? You can use these things to keep them calm, steer the conversations and influence behaviour.”

At the end of a full-day GPA Basics education session, participants earn a certificate of participation. AGE also offers online courses in GPA. The course is broken down into four modules: an overview of the principles of person-centred care and understanding dementia’s impact on the brain; the relationship between the progress of the disease and dementia’s behavioural responses; strategies to safely manage responsive behaviours; and self-protection safeguards for both the care provider and the person with dementia.

Boucher says everything participants learn at these sessions is immediately useful, and this is partly why GPA continues to grow and improve. A fourth edition of the curriculum is being released in late 2019, and AGE also just signed an agreement to bring the GPA curriculum to China.

“We’re continually enhancing and reinvesting into dementia curricula because our mission is to advance learning and make a difference in the lives of people with dementia and care providers,” Boucher says. [ ] 

Three easy tips for implementing Gentle Persuasive Approaches methods from Dr. Patti Boucher:

1 | Understand the individual, their unique likes/dislikes and know them as a person — this will equip care providers with diversion ideas that will  interest the person with dementia to engage and decrease their agitation.

2 | Speak to the individual slowly and provide enough time for them to process the message.

3 | Adjust the care around the person; for example, alter bathing and eating times to fit their unique needs.

To learn more about Gentle Persuasive Approaches, contact the Alzheimer Society at alzheimercalgary.ca, or call 403.290.0110.