Understanding in the Australian aged care sector of reablement interventions for people living with dementia: a qualitative content analysis

Abstract

Background: Reablement has potential for enhancing function and independence in people with dementia. In order to enhance the use of evidence-based reablement in this population, this study sought to understand the current practices and needs of the sector around these interventions. Methods: A purposive sample of 22 Australian aged and community-care providers participated in a semistructured interview. Qualitative content analysis was applied to the data, with key themes interpreted within the context of the study aims: to explore (1) what reablement interventions are currently being offered to people living with dementia in Australia, and (2) what are key factors that will contribute to enhanced uptake of reablement interventions in dementia practice. Results: Four themes emerged: (1) 'what reablement interventions are being offered', outlined a range of exercise and cognitive/social interventions, with only a proportion generated from a clear evidence-base, (2) 'what's in a name', illustrated the range of terms used to describe reablement, (3) 'whose role is it', highlighted the confusion around the range of health professionals involved in providing reablement interventions, and (4) 'perceived barriers and enablers to providing reablement to people living with dementia', described a range of factors that both hinder and support current reablement practice. Conclusions: Reablement interventions currently provided for people living with dementia in Australia are variable, with confusion around the definition of reablement, and apparently limited use of evidence-informed interventions. A multifaceted approach involving an evidence-informed and freely-accessible resource, and taking into account the varied levels of influence within the aged care sector would support uptake and implementation of reablement interventions for people living with dementia.

The use of formal care for dementia from a professional perspective: a scoping review

“…Eleven of these studies focused [ 16 – 26 ] on the perspective of physicians (predominantly primary care physicians) and two studies [ 27 , 28 ] on the perspective of nurses (registered nurses, licensed practical nurses and assistant nurses). One study interviewed providers of care for the elderly [ 29 ] and another one examined the perspective of primary care dementia coordinators [ 30 ]. The remaining fourteen studies [ 6 , 31 – 43 ] included various professions without differentiating between them.…”

“…Seven studies [ 16 , 21 , 23 , 26 , 29 , 32 , 33 ] described regional influences on the use of care services, depending on where the people with dementia lived. The availability of services is mentioned as an important difference between rural and urban areas.…”

“…GPs in Ireland highlighted the need for uniform access to care regardless of region [ 26 ]. Appropriate support services were reported in urban areas of Canada [ 21 , 32 ], Switzerland [ 23 ], and Australia [ 29 ]. Canadian rural family physicians had varying opinions, i.e.…”

“…The competence of health-care professionals was mentioned in most of the included studies [ 6 , 17 – 20 , 24 , 29 , 30 , 32 , 34 – 37 , 39 , 42 , 43 ]. Competencies were described as dementia expertise, social competencies, cultural care skills, and coordination skills.…”

“Current dementia care: what are the difficulties and how can we advance care globally?”

“…Providing better support in re-enabling people with dementia is also vital and forms part of the post-diagnostic care (which also includes medication management [18]. In the Australian aged care sector, O'Connor and colleagues [19] showed that reablement interventions for people with dementia are varied, and to improve access to and usage of interventions, these should be multifaceted with a freely available resource outlining the different intervention components. This is supported to a degree by a recent meta-analysis by Backhouse et al [20], showing mixed evidence on the benefits of coordinated community interventions.…”