Health Professional Perspectives on Rehabilitation for People With Dementia

Abstract

Background and Objectives Multidisciplinary rehabilitation is not incorporated into the usual care pathway for dementia despite increasing demand from key advocates. Clinician views regarding the relevance of rehabilitation in dementia care are not well known. This qualitative study explored the perspectives of health professionals regarding barriers to provision of multidisciplinary rehabilitation programs for people with dementia. Research Design and Methods Sixteen health professionals from a variety of settings and professional backgrounds were purposively sampled using maximum variation sampling. Semi-structured interviews were conducted to explore attitudes toward the care of people with dementia and beliefs about the feasibility and value of multidisciplinary rehabilitation in this population. Thematic analysis was used to identify themes. Results Participating clinicians acknowledged problems with existing dementia care pathways in Australia but rarely conceptualized rehabilitation as relevant to this pathway. Analyses yielded two main and related themes: (i) difficulty defining worthwhile outcomes of a rehabilitation program for people with dementia and (ii) perceived barriers to participation in this population. Clinicians felt that achievable outcomes for people with dementia were not sufficiently worthwhile for investment. Discussion and Implications Broader acceptance of multidisciplinary rehabilitation as relevant to dementia care will require a reframing of practice that both educates emerging health professionals regarding the outcomes that may be achievable for people with dementia and persuades staff to appreciate that the investment is worthwhile.

Psychophysiological Responses in People Living with Dementia after an Art Gallery Intervention: An Exploratory Study

“…On a global scale, the arts should be encouraged as low-cost non-invasive interventions for PLWD, which should be embraced by community organizations and within dementia care. While acceptance of the potential for multidisciplinary rehabilitation in dementia care has several barriers [53], the present study supports a potential beneficial role of museum and art gallery-based programs in prolonging the QoL of PLWD within the usual care pathway. Art-and music-based interventions for PLWD may offer similar benefits to pharmacological treatments such as anti-depressants, and more studies with over 100 participants are required despite inherent methodological barriers [54,55].…”

Evaluation of an implementation project: The exercise physiology in aged care program

“…The ability of this type of program to change perceptions is likely a novel finding. Providing partners‐in‐care with an understanding that living with dementia is not a trajectory to decline and that adults living with dementia are suitable for rehabilitation, could be important in influencing opinions of the capabilities of older adults living with dementia. This may lead to partners‐in‐care engaging in exercise and activity with older adults living with dementia or seeking out opportunities for adults living with dementia to be involved in exercise.…”

Experiences of Community-Dwelling Older People With Dementia Participating In A Person-Centered Multidimensional Interdisciplinary Rehabilitation Program 

“…In contrast to availability for people with other neurodegenerative diseases, e.g. multiple sclerosis [19] and stroke [20], rehabilitation programs are not routinely available for people with dementia in clinical settings [21][22][23]. Reasons for this situation, in addition to limited resources, may include the challenges involved in managing the complex consequences of dementia, as well as rehabilitation staff's attitudes regarding the ability of people with dementia to participate in rehabilitation [22,24].…”

“…multiple sclerosis [19] and stroke [20], rehabilitation programs are not routinely available for people with dementia in clinical settings [21][22][23]. Reasons for this situation, in addition to limited resources, may include the challenges involved in managing the complex consequences of dementia, as well as rehabilitation staff's attitudes regarding the ability of people with dementia to participate in rehabilitation [22,24]. In addition, people with dementia seem to have less access to rehabilitation in clinical settings after events such as hip fracture or stroke in comparison with people without cognitive impairment [25,26].…”