Reablement for people with cognitive impairment or dementia living in the community: current approach to practice and practitioner-led targets for practice change through audit and feedback

Abstract

Purpose: To explore (1) current reablement practice for community-dwelling people living with cognitive impairment or dementia, and (2) allied health practitioner perspectives around implementing reablement. Materials and methods: Phase one: retrospective clinical file audit for people with cognitive impairment or dementia (n = 20) who had recently completed an allied health program with one of four participating Australian community aged care providers. An audit matrix facilitated evaluation of clinical audit outcomes against evidence-informed reablement criteria. Phase two: feedback and consultation via focus groups with the allied health workforce (n = 18) within each participating organisation. Qualitative content analysis identified barriers, facilitators, and targets for dementia reablement practice change. Results: Dementia reablement practice was variably aligned with evidence-informed recommendations. Allied health practitioner-identified barriers to implementation of dementia reablement related to the person with cognitive impairment or dementia, the person’s family, logistics and practicalities, and program sustainability. Enablers related to the client and their family, the team, and the system. Identified potential practice changes were around assessment, promoting reablement, the reablement approach, and improving documentation. Conclusions: A tailored implementation plan that addresses the barriers and enablers to reablement is needed to enhance practice and access to services for people living with cognitive impairment or dementia.