Experiences of community-dwelling older people with dementia participating in a person-centred multidimensional interdisciplinary rehabilitation program

Abstract Background There is great need for development of feasible rehabilitation for older people with dementia. Increased understanding of this population’s experiences of rehabilitation participation is therefore important. The aim of this study was to explore the experiences of community-dwelling older people with dementia participating in a person-centred multidimensional interdisciplinary rehabilitation program. Methods Sixteen older people with dementia were interviewed about their experiences of participation in a person-centred multidimensional interdisciplinary rehabilitation program. The program comprised assessments by a comprehensive team of rehabilitation professionals followed by a rehabilitation period of 16 weeks, including interventions based on individualized rehabilitation goals conducted with the support of the rehabilitation team. The rehabilitation was performed in the participants’ homes, in the community and at an outpatient clinic, including exercise with social interaction in small groups offered twice a week to all participants. The interviews were conducted at the end of the rehabilitation period and analysed with qualitative content analysis. Results The analysis resulted in one overarching theme: Empowered through participation and togetherness and four sub-themes: Being strengthened through challenges; Gaining insights, motives, and raising concerns about the future; Being seen makes participation worthwhile; and Feelings of togetherness in prosperity and adversity. The participants increased their self-esteem by daring and coping in the rehabilitation. The insights about themselves and their condition motivated them to continue with their prioritized activities, but also raised concerns about how the future would play out. Collaboration in the group and being seen and acknowledged by staff strengthened their own motivation and self-efficacy. Conclusion According to community-dwelling older people with dementia, a person-centred multidimensional interdisciplinary rehabilitation program was experienced as viable and beneficial. The participants seemed empowered through the rehabilitation and expressed mostly positive experiences and perceived improvements. Providers of interdisciplinary rehabilitation programs for this group should consider aspects raised by the participants e.g. the positive experience of being challenged in both exercise and daily activities; the importance of being seen and feeling secure; the benefits and challenges of collaboration with others in the same situation; and the generation of new perspectives of current and future situation.

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

10.21203/rs.3.rs-94537/v1 ◽

2020 ◽

Author(s):

Anna Sondell ◽

Josefine Lampinen ◽

Mia Conradsson ◽

Håkan Littbrand ◽

Undis Englund ◽

...

Keyword(s):

Older People ◽

Qualitative Content Analysis ◽

Rehabilitation Program ◽

Community Dwelling ◽

Rehabilitation Programs ◽

People With Dementia ◽

Interdisciplinary Rehabilitation ◽

The Future ◽

Future Situation ◽

Community Dwelling Older People

Abstract Background: There is a great need for the development of feasible rehabilitation interventions for older people with dementia. An increased understanding of this population’s experiences of rehabilitation program participation is therefore important. The purpose of this study was to explore how community-dwelling older people with dementia experienced their participation in a person-centered multidimensional interdisciplinary rehabilitation program.Methods: Sixteen older people with dementia were interviewed about their experiences of participation in a person-centred multidimensional interdisciplinary rehabilitation program. The program comprised assessments by a comprehensive team followed by a rehabilitation period of 16 weeks among people with dementia and their informal primary caregivers. The interviews were conducted in close conjunction with the rehabilitation visits and analysed with qualitative content analysis.Results: The analysis resulted in one overarching theme: Empowered through participation and togetherness and four sub-themes: Being strengthened through challenges; Gaining insights, motives, and raising concerns about the future; Being seen makes participation worthwhile; and Feelings of togetherness in prosperity and adversity. The participants increased their self-esteem by daring and coping in the rehabilitation. The insights about themselves and their condition motivated them to continue with their prioritized activities, but also raised concerns about how the future would play out. Collaboration in the group and being seen and acknowledged by staff strengthened their own motivation and self-efficacy. Conclusion: A person-centered multidimensional interdisciplinary rehabilitation program seems feasible among community-dwelling older people with dementia according to reported experiences. The participants seemed empowered through the rehabilitation and reported mostly positive experiences and perceived improvements, which seemed to affect their wellbeing and daily life. Providers of interdisciplinary rehabilitation programs for this group should consider aspects raised by the participants e.g. the positive experience of being challenged in both exercise and daily activities; the importance of being seen and feeling secure; the benefits and challenges of collaboration with others in the same situation; and the generation of new perspectives of current and future situation. Trial registration: ISRCTN, ISRCTN59155421.http://www.isrctn.com/ISRCTN59155421. Registered November 3 2015.

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Evaluation of a person-centred multidimensional interdisciplinary rehabilitation program for community dwelling older people with dementia and their informal primary caregivers

http://isrctn.com/ ◽

10.1186/isrctn59155421 ◽

2015 ◽

Author(s):

Håkan Littbrand

Keyword(s):

Older People ◽

Primary Caregivers ◽

Rehabilitation Program ◽

Community Dwelling ◽

People With Dementia ◽

Interdisciplinary Rehabilitation ◽

Community Dwelling Older People

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Medication Management for Community-dwelling Older People with Dementia and Chronic Illness

Australian Journal of Primary Health ◽

10.1071/py08004 ◽

2008 ◽

Vol 14 (1) ◽

pp. 25 ◽

Cited By ~ 4

Author(s):

Debbie Kralik ◽

Kate Visentin ◽

Geoff March ◽

Barbara Anderson ◽

Andrew Gilbert ◽

...

Keyword(s):

Chronic Illness ◽

Older People ◽

Medication Management ◽

Community Dwelling ◽

Consumer Involvement ◽

Future Research ◽

Coordination Of Care ◽

Health Providers ◽

People With Dementia ◽

Community Dwelling Older People

The purpose of this paper is to report the findings of an integrative review of the literature on medication management for individuals who live in the community and have both chronic illness and mild to moderate dementia. The aim of the review was to summarise what is known about this topic, evaluate and compare previous research on the topic of medication management for people with dementia, and locate gaps in current work, thus pointing to directions for future research. Dementia is a national health priority for Australia. A significant component of community care for people with dementia is the management and administration of the medications required for other chronic conditions. Medication management is a broad term that encompasses several aspects, such as client-centred medication review, rational prescribing and support, repeat prescribing, client information/education, capacity to communicate with multiple health providers and having access to medicines. Cognitive impairment has been associated with medication management issues so it is important to ensure quality outcomes of medicine use by community-dwelling older people with dementia. The literature revealed a number of issues, such as the importance of person-centred care, the need for the coordination of care, and consumer partnerships in medication management. These are all important considerations in planning primary care services to support people with dementia and chronic illnesses. People with dementia who have chronic illness require coordinated, tailored, and flexible care processes in the community. There exists a range of services and programs such as home medicine reviews to support people living in the community with chronic illness and dementia; however, there is little coordination of care and evaluation of interventions is, at best, inconsistent. Currently, Australia lacks an integrative primary health care (PHC) framework, within which consumer involvement in decision-making and/or care planning is valued and sought. Current services are limited in the degree to which there is collaboration between key partners and Australian PHC initiatives are fragmented and have limited impact on service delivery.

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