AGE Research – AGE

AGE Research


GPA content applies across virtually all health and community care sectors. Appraisal of its peer-reviewed and reference literature ensures materials remain current and evidence informed. The development of the curriculum, now in its 4th edition, was informed by Iwasiw & Goldenberg’s principles.


GPA was developed using the Promoting Action on Research Implementation in Health Services (PARiHS) framework, which provides a way to implement research into practice. GPA is also grounded in Bandura’s Theory of Self-Efficacy.


GPA’s adult learning techniques address individual learning styles. Care providers learn by doing and are prompted to reflect on their experience (See Kolb’s ELT). GPA includes empirically tested strategies that improve the life quality of persons living with dementia and the work life of their formal care providers.


Download the AGE Research FlyerAGE is committed to regular rigorous formal review and quantitative and qualitative evaluation of GPA. This process has resulted in an impactful education intervention that promotes sustainable organizational culture change, grounded in best practice and theoretical dementia care principles. Collaboration in research is important to our success and we are most grateful to all who contribute to GPA.

GPA Basics in Long-Term Care

Gentle Persuasive Approaches (GPA) was originally developed as a resource for long-term care, although the content applies across sectors. Participation in GPA and ongoing formal coaching in the care setting ensure care providers gain and retain immediately useful strategies for effective communication and safety practices in their work with older adults.

An educational intervention to build staff capacity to provide person-centred dementia care for residents experiencing responsive behaviour: Outcomes within long-term care homes from two Canadian provinces. Oral presentation at the 19th Biennial Conference of the Canadian Gerontological Nursing Association (CGNA), Ottawa, ON. McLelland, V.C., Schindel Martin, L., Boucher, P. (2017).

The development and pilot evaluation of an educational program to train long-term care front-line staff in the management of responsive behaviours of a more catastrophic nature associated with dementia. Schindel Martin, L., & Dupuis, S. (2005). Download Report

Teaching staff to respond effectively to cognitively impaired residents who display self-protective behaviours. Schindel Martin, L., Morden, P., Cetinski, G., Lasky, N., McDowell, C., & Roberts, J. (2003). Published in the American Journal of Alzheimer’s Disease and Other Dementias, 18(5), 273-281. Download PDF

GPA Basics in Acute Care

This report by the Canadian Federation of Nurses Unions (CFNU) highlights factors impacting violence toward staff in acute care: Inappropriate admissions of patients into facilities ill-equipped to deal with persons’ acuity/complexity, inadequate communications protocols/practices with respect to violence risks and lack of violence-prevention training. Learn (below) how GPA can be a successful solution/intervention in acute care.

The experience of hospital staff in applying the Gentle Persuasive Approaches to dementia care. Hung, L., Son, C., & Hung, R. (2019). Published in the Journal of Psychiatric & Mental Health Nursing, 26(1-2), 19-28. Read Article

An education intervention to enhance staff self-efficacy to provide dementia care in an acute care hospital in Canada: A non-randomized controlled study. Schindel Martin, L., Gillies, L., Coker, E., Pizzacalla, A., Montemuro, M., Suva, G., McLelland, V., (2016). Published in the American Journal of Alzheimer’s Disease and Other Dementias, 31(8), 664-677. Download PDF and/or Read Article

In 2016, the following paper received the Teresa Pellino Research Writers award for best paper from the editors of Orthopaedic Nursing.

Gentle Persuasive Approaches. Introducing an educational program on an orthopaedic unit for staff caring for patients with dementia and delirium. Pizzacalla, A., Montemuro, M., Coker, E., Schindel-Martin, L., Gillies, L., Robinson, K., Pepper, H., Benner, J., Gusciora, J., (2015). Published in Orthopaedic Nursing, 34(2), 101–107. Read the Article

Sustainability of an innovation to support and respond to persons with behaviours related to dementia and delirium. Gillies, L., Coker E., Montemuro, M., Pizzacalla A. (2015). Published in the Journal of Nursing Administration, 45(2): 70-73. Read the Abstract

Moving Forward: Evaluating a Curriculum for Managing Responsive Behaviours in a Geriatric Psychiatry Inpatient Population. Speziale, J., Black, E., Coatsworth-Puspoky, R., Ross, T., & O’Regan, T. (2009, March). Published in The Gerontologist, 49(4), 570-576. Read the Abstract

GPA eLearning for Healthcare Students

GPA eLearning, originally designed for healthcare students, is an adapted version of our traditional GPA Basics (7.5-hour) in-house curriculum. GPA eLearning is a 2 to 3-hour online independent learning format, also suitable for those with limited time or access to the full-day GPA Basics course or Integrated GPA (iGPA), a blended learning program.

Responsive behaviour: Meeting the learning needs of interprofessional post-secondary healthcare students. Schindel Martin, L., Woo, T., Cowan, D., McLelland, V.C., Miller, P., Newman, K., Rose, D., Ashbourne, J., Ashley, M., Julian, P., McNee, M., Vieira Zamora, F., Bliss, M., Boucher, P., & Mistry, J. (2017). Poster presented at the 9th Canadian Conference on Dementia, November 2-4, 2017, Toronto, ON.  Download Poster

2021 Geriatric Medicine Project, McMaster University, Hamilton, Ontario, Canada. GPA for McMaster Geriatric Medicine Residents: In collaboration with Dr. Tricia Woo, Associate Professor, Department of Medicine at McMaster University and Geriatrician at Hamilton’s St. Peter’s Geriatric Hospital, a pilot evaluation of GPA was implemented with a cohort of 8 medical residents from McMaster’s Geriatric Medicine Subspecialty Residency Program.

The aim of the pilot was to equip medical residents with the knowledge to recommend non-pharmacological interventions as first-line approaches for patients living with dementia and responsive behaviours, as well as to gather participant feedback on  how GPA might best be tailored to suit this group of healthcare providers.

Project Status: The participants completed GPA eLearning as well as a follow-up interactive discussion session jointly facilitated by GPA Master Coaches Michele Bliss and Lisa Wauchope. Participants completed quantitative and qualitative pre- and post-GPA eLearning measures of self-efficacy in dementia care, and attended one post-discussion focus group during which they provided qualitative feedback. A second focus group will invite them to report their experiences in applying GPA principles within their practice. Results to be posted.

Evaluation of an online dementia-specific education intervention in a baccalaureate collaborative nursing degree program. Schindel Martin, L., Newman, K., Romaniuk D., Purdy, N., Kenmir, A., Verkuyl, M., Hughes, M., Wisenthal, S., McLelland V.C., Boucher, P., Freeman, C., & Julian, P. (2017). Poster presented at the 32nd International Conference of Alzheimer’s Disease International, Kyoto, Japan, April 26-29, 2017.

Continued evaluation of an online dementia-specific educational intervention in a baccalaureate collaborative nursing degree program. Schindel Martin, L., Romaniuk D., Newman, K., Purdy, N., Kenmir, A., Wiesenthal, S., Verkuyl, M., Hughes, M., Julian, P., McLelland V.C., Boucher, P. (2016).  Poster Presented at the 45th Annual Scientific and Education Meeting of the CAG, Montreal, QC.

GPA eLearning in Acute Care

What is GPA eLearning? See column at  left for a synopsis.

Up to 45% of older adults living with dementia admitted to hospital exhibit responsive behaviours (Dewing & Dijk, 2016Keenan et al., 2011Nayton et al., 2014), risking injury for both patients and caregivers. Staff struggle to manage responsive behaviours without specific education.

Between 2016 and 2017, GPA eLearning was disseminated to interdisciplinary staff on five medicine units at London Health Sciences Centre, Ontario, Canada, as part of a broader dementia-care quality improvement project.

GPA eLearning participants were asked to complete online quantitative and qualitative questionnaires on self-efficacy, competence and dementia care knowledge at three points: before, immediately after and 6-8 weeks after their GPA elearning. Focus groups were conducted to further explore participants’ experiences with GPA eLearning.

In January 2022, findings were published in Dementia: The International Journal of Social Research and Practice. What were the findings? Read this article and others on GPA’s impact in acute care settings in the section below.

Implementing Gentle Persuasive Approaches dementia education for staff on in-patient medical units: A program evaluation. Crandall, J., Coatsworth-Puspoky, R., Schlegel, K., Beker, L., McLelland, V. C., Schindel Martin, L., (2022). Published in Dementia (London), 21(4) 1173–1199. Read the article.

Qualitative findings of a study to evaluate dementia education for emergency department staff. Schindel Martin, L., McLelland, V.C., Wilding, L., Ryan, D.P., Lee, J., Cowan, D., Julian, P. (2017). Oral presentation at the 19th Biennial Conference of the Canadian Gerontological Nursing Association (CGNA), Ottawa, ON.

Bridge the gap: Participant voices support the need for online dementia education for emergency department staff. Julian, P., Schindel Martin, L., McLelland V.C., Ryan, D., Lee, J., Cowan, D., Wilding, L. (2017). Poster presented at the 19th Biennial Conference of the Canadian Gerontological Nursing Association (CGNA), Ottawa, ON.

Effects of a dementia educational intervention for emergency departments on staff knowledge, confidence, and self-efficacy in providing person-centred care. McLelland, V.C., Schindel Martin, L., Julian, P., Ryan, D., Lee, J., Cowan D., Wilding, L. (2017). Poster presented at the 19th Biennial Conference of the Canadian Gerontological Nursing Association (CGNA), Ottawa, ON and at the 45th Annual Scientific and Education Meeting of the CAG, Montreal, QC. Download Poster

Managing behaviours associated with dementia: Tailoring an educational intervention for emergency department staff. Julian P., Schindel Martin, L., McLelland, V.C., Ryan, D., Lee, J., Cowan, D., Wilding, L. (2016). Poster presented at the 45th Annual Scientific and Education Meeting of the CAG, Montreal, QC.
Download Poster

Blended Learning for Healthcare Students

Integrated GPA (also known as iGPA) combines independent eLearning (Part 1) with a half-day classroom session (Part 2) that is facilitated by a GPA Certified Coach. iGPA gives organizations and post-secondary institutions a convenient and flexible option for accessing and scheduling dementia education to accommodate large groups and busy schedules, while reducing backfill costs.

“All behaviour has meaning”: A qualitative exploration of dementia training of healthcare assistant students.” Christianson, T.M., Hoot, T.J., McLelland, V., & Morris, K. (2021). Published in Journal of Nursing Education and Practice, 11(2). Read the Article

Effects of the Gentle Persuasive Approaches Dementia Educational Intervention on Postsecondary Health Care Assistant and Personal Support Worker Students’ Learning in Two Canadian Provinces. McLelland, V.C., Christianson, T., Cooper, R., Hoot, T., Mayer, K., Morris, K., & Schindel Martin, L. (2019). Poster presented at the 48th Annual Scientific and Educational Meeting of the Canadian Association on Gerontology, October 24-26, 2019, Moncton, NB.

Dementia Education Via a Not-for-Profit Social Enterprise Model

A social enterprise uses a not-for-profit framework to generate revenues to advance its social mission and objectives. AGE’s mission is to enhance the care of older adults living with dementia and responsive behaviour through dementia education products and services, with profits reinvested to further advance its social mission.

Evidence-based dementia education: Advancing best practice using a not-for-profit social enterprise model. Boucher, P., Schindel Martin, L., McLelland, V.C. (2017). Oral presentation at the 19th Biennial Conference of the Canadian Gerontological Nursing Association (CGNA), Ottawa, ON.

Bathing in a Dementia Context

Coming in 2022!  The GPA Bathing Program.

Learn more about the new  GPA Bathing curriculum here. Please note, we are currently inviting  Expressions of Interest in this curriculum from GPA Certified Coaches and their organizations. If you are a GPA Certified Coach, please check your email inbox for our invitation.

Learn more about our purpose, process, results and conclusions from the integration of evidence and stakeholder feedback informing GPA Bathing in the information provided below.

During 2020 and 2021, AGE Inc. developed two Gentle Persuasive Approaches (GPA) Bathing eLearning units to strengthen care providers’ knowledge, confidence and skill in providing person-centred, evidence-informed bathing care. The suitability and effectiveness of these units was pilot-tested with Mississauga Halton Behavioural Supports Ontario staff in long-term and community care

Professional Practice Development: GPA Bathing eLearning Improved Staff Confidence for Person-Centred Bathing Care. McLelland, V.C.1, Bliss, M.1, Penko, M.2, Tsokas, M.3, O’Leary, J.1, & Schindel Martin, L.4 (1Advanced Gerontological Education, 2St. Joseph’s Healthcare Hamilton, 3University Health Network-Toronto Rehab, 4Daphne Cockwell School of Nursing, Ryerson University.) Presented at the 21st Biennial Conference of the Canadian Gerontological Nursing Association (CGNA — virtual format), Niagara Falls, ON, April 2021. View the poster and our full presentation here.

Responsive Behaviour Related to Bathing in the Dementia Context: A Literature Review of Evidence-Based Best Practice Interventions. Schindel Martin, L., Julian, P., McLelland, V.C., Bliss, M., Boucher, P., (2017)  Oral presentation at the 19th Biennial Conference of the Canadian Gerontological Nursing Association (CGNA), Ottawa, ON.

Informing the GPA Bathing Program. Integration of Evidence and Stakeholder Feedback. Palial, R. (2017). Poster presented at the 2017 Graduate Student Symposium, Ryerson University, Toronto, ON. Download Poster

Affiliated Research

AGE engages in research with partners within the community, including healthcare organizations and post-secondary institutions. 

NEW RESEARCH! “There are very few interventions that have shown consistent effectiveness in improving nursing care of people with dementia in hospital and been found to be sustainable over time. GPA shows potential for creating sustainable change.” (Details below.)

A 2021 research study by Dr. Elaine Moody of Dalhousie University, Canada, found Gentle Persuasive Approaches (GPA) is one of the few interventions to improve the nursing care of people living with dementia that had significant evaluation research on the intervention’s effectiveness and sustainability. Learn more about this study and other research, below.

Dr. Elaine Moody, Assistant Professor, School of Nursing, Dalhousie University, and her research team, assessed interventions to improve the nursing care of people living with dementia in Canadian hospitals. We thank Dr. Moody for allowing us to post the team’s research to help disseminate the findings. See below.

Interventions to Improve the Nursing Care of People with Dementia in Canadian Hospitals: An Environmental Scan. Moody, E.1,  Jamieson, H.1, Bradbury, K.1, Rothfus, M.2,  Khanna, I.1, Weeks, L.1,  Belliveau, A.3, Bilski, T.4 1. School of Nursing, Dalhousie University. 2. W.K Kellogg Health Science Library, Dalhousie University. 3. Dementia Family Advisor, Halifax, NS, Canada. 4 Professional Practice Lead-Interprofessional Practice & Learning, Nova Scotia Health, Canada. Read the Executive Summary. View the Poster. 


Reliability of Nurses’ Use of a Direct Behavioural Observation Tool in the Dementia Context: Implications for Development of Predictive System of Behavioural Assessment. Newman, K., Schindel Martin, L., McLelland, V., Wang, A., Au Duong, J., Khan, S.S., Ye, B., Spasojevic, S., Iaboni, A., Mihailidis, A.,  (2021).  Perspectives. Journal of the Canadian Gerontological Nursing Association (CGNA). vol. 42, no. 3, pp. 13-21. Read the PDF.


Personal support workers’ perception of safety in a changing world of work. Denton, M., Zeytinoglu, I.U., Brookman, C., Davis, S., & Boucher, P. (2018).  Safety in Health, 4(2). doi:10.1186/s40886-018-0069-x Read the Article and/or Download PDF


Building on enduring capabilities to enhance the spiritual wellbeing of those living with dementia

Declining communication skills in dementia threaten a person’s sense of self. Building on enduring capabilities, pastoral visitors can significantly enhance spiritual wellbeing through the use of individualized, person-centred strategies. The following article outlines the primary spiritual needs of older adults with dementia and some general strategies to improve communication based on enduring abilities. Detailed examples illustrate how these personhood-centred strategies can meet spiritual needs by connecting with individuals with dementia through life stories and helping them participate in religious life.

Communication Strategies to Promote Spiritual Well-Being among People with Dementia. Ryan, E.B., Schindel Martin, L., Beaman, Amanda (2005). Journal of Pastoral Care & Counselling, vol. 59, 1-2, pp. 43-55. Read Abstract