Barriers, motivators and facilitators of physical activity in people with dementia and their family carers in England: dyadic interviews

Abstract

Introduction: Physical activity may have a number of physical and mental health benefits for people with dementia and their carers. However, there is limited evidence about factors that influence physical activity participation in these groups. This study therefore looks at the barriers, facilitators and motivators of physical activity in people with dementia, from both the perspective of the person with dementia and their carer. Method: Thirty participants (15 sets of community-dwelling people with dementia and their family carers) were recruited from the South East of England. The participants took part in semi-structured dyadic interviews about their views of physical activity. Interviews were analysed using inductive thematic analysis at an individual level and comparisons were made between the groups. Results: Common motivator themes across persons with dementia and family carers were emotional and physical wellbeing, and social connectedness. Physical health was seen as a common barrier in both groups. Physical activity in the person with dementia was encouraged and supported by the family carer. For the carer, their caring role, and limited time acted as barriers to their participation. Conclusion: Themes such as social connectedness, positive emotion and health were seen as key motivators to physical activity, which indicate that people with dementia and carers use physical activity as a means to maintain and improve their quality of life. Supporting family members to better facilitate such activities could encourage physical activity in people with dementia.

Types of leisure time physical activities (LTPA) of community-dwelling persons who have been screened positive for dementia

“…Given that we analysed cross-sectional data, we cannot make any conclusions about the causal relationship. There is evidence for both the functional health benefits of LTPA [45,46] and the limitations of LTPA due to functional impairment [16]. Furthermore, depression may mediate the relationship between LTPA and functional impairment [52,53].…”

“…In their systematic review van Alphen, Hortobagyi [15] showed that difficulties with guidance and organization of physical activities by caregivers is a prominent barrier to physical activity. Farina, Williams [16] reported, based on a qualitative study, that physical activity of persons with dementia can be promoted by supporting caregivers in general and by facilitating the caregiver's own physical activity. However, previous findings were mostly based on small samples and did not account for sex-specific effects.…”

Daughters’ experiences of shared caregiving to a parent with dementia

“…Braun and Clarke’s (30) thematic analysis method has been validated to answer a range of research questions (35) and has been used in other recent qualitative descriptive caregiver studies (e.g. 36, 37). Two authors immersed themselves in the data by independently reviewing the data, producing initial codes and grouping these codes to create themes.…”

A Systematic Review on the Prevalence of Physical Activity, and Barriers and Facilitators to Physical Activity, in Informal Carers in the United Kingdom

“…which include perception of aging (not wanting to push themselves physically), not wanting to leave their caree alone / leaving them for too long, their caree being unsafe to take part in activities (e.g. bike rides) or unable to participate socially in group activities, health conditions causing pain / risk of falling, feeling tired / lacking energy due to the PA associated with caring, lack of time due to caring role, difficulties in changing routine for their caree, and their own PA being inhibited through supporting the caree being active (29,30). Malthouse et al's (2014) study only involved a small sample of spousal carers of individuals with Alzheimer's disease, so it must be recognised that the barriers to PA for other groups of carers may differ (29).…”

“…Malthouse et al's (2014) study only involved a small sample of spousal carers of individuals with Alzheimer's disease, so it must be recognised that the barriers to PA for other groups of carers may differ (29). Farina et al's study included a slightly larger sample, but, again, only considered carers of individuals with dementia (30).…”