1. Michele Hardiman Assistant Director of Nursing Clare Mental Health Service 3 nd Year Part-Time PhD student, Canterbury Christchurch University.

2. Cahill, O’Shea & Pierce,(2012) Creating Excellence in Dementia Care a Research Review for Ireland’s National Dementia Strategy  Few alternatives to nursing home model currently exists.  There is no definitive data on the numbers of persons with dementia in long term care.

3. HIQA dementia specific Supplementary standards stipulate that “staff are trained in and understand the communication needs of residents with dementia”. (83%) of dementia care nurses, have not received training in dementia care, (De Siún and Manning, 2010)

4. Training needs to happen quickly and in a consistent manner across all geographical areas. Training needs to be multidisciplinary There should be recognition within organisations that caring for people with dementia is highly skilled work that is emotionally and physically demanding and requires ongoing specialist training Cahill, O’Shea & Pierce,(2012) Creating Excellence in Dementia Care a Research Review for Ireland’s National Dementia Strategy

5.  National Dementia Education Programme introduction to dementia)- largely classroom based.  Internal HSEland e-learning programme on Early assessment of Memory Problems.  DSIDC (who deliver a nation-wide training programme)- classroom based.  Private consultant trainers - classroom based.  Academic programme HEI’s

6. National Practice Development Programme for Older person Services (McCormack et al 2010) Places to Flourish- A pattern-based approach to foster change in residential care. (HSE, 2011)  Largely Work -Based  Practice Development  Facilitation  Participatory

7. Work- based learning is an approach that can transform the culture and sustain the change by ensuring work based activity is the driver for learning and development (Manley et al 2009)

8. Benner (1984)and Titchen (1999), emphasises the experience of doing and the validation and development of tacit knowledge as a valuable source of knowledge toward expert practice.

9. Klob’s Experiential learning Cycle Describes a practitioner immersing themselves within the experience and then reflecting on that experience in a structure way, this differs from a focus of (HEI) academic type courses with a “practice component”. Concrete experience Observation and reflection Formation of abstract concepts and generalizations Testing implications of concepts in new situations

10. You have to feel it to understand!

11. Work based learning differs from traditional education in that it involves conscious reflection on actual experience. Work based learning merges theory with practice and knowledge with experience and it recognises that the workplace offers as many opportunities for learning as the classroom. (Raelin, 2008)

12. Role of Clinical leader Importance of the role of the clinical nursing leader identified as critical in Mid- Staffordshire inquiry. Recommends “each team to have a nursing leader who will lead by example, to support all members to perform to a high standard”

13. Developing expertise in person-centred practice with registered nurses by enhancing their work based leadership skills.

14. 1.What does a model of work based leadership for person-centred dementia care look like? 2.How do work based leadership skills enhance person-centred dementia care? 3.What are the implications for existing education/training frameworks in care services in Ireland should a work based learning leadership model be established and adopted?

15. Underpinned by Critical Social Science. Using a Participatory Action Research (PAR) and an adapted model of Critical Companionship (Titchen 2000) Develop leaders expertise and craft knowledge of person centred dementia care. Enable leaders to examine culture and context of care.

16. McCormack, B., Dewing, J., Breslin, L., Tobin, C., Manning, M., Coyne-Nevin, A., Kennedy, K., &Peelo- Kilroe, L., (2010) The Implementation of a Model of Person–Centred Practice in Older Person Settings. Final Report, Office of the Nursing Services Director, Health Service Executive, Dublin, Ireland. Manley, K., Titchen, A. and Hardy, S. (2009), Work- based learning in the context of contemporary health care education and practice: A concept analysis. Practice Development in Health Care, 8: 87–127 Titchen A. (2000) Professional Craft Knowledge in Patient-Centred Nursing and the Facilitation of its Development. Ashdale Press, Oxfordshire.