Translating reablement research for dementia practice: development of a handbook using implementation science

Abstract

Purpose

Reablement is a strategy recommended in clinical practice guidelines that could maximise functioning and quality of life in people living with dementia. This project sought to develop a practical handbook for health professionals illustrating the best, currently available evidence via newly-developed composite reablement programs.

Materials and methods

Handbook development occurred over five phases, informed by Normalisation Process Theory: (1) literature review, (2) sector interviews to explore how handbook implementation may impact practice, (3) workshop to determine final handbook content, (4) reablement program synthesis and handbook development, and (5) dissemination and implementation planning to support optimal uptake and normalisation within the sector.

Results

Interviews (n = 22) identified sector support for development of the reablement handbook. Workshop (n = 24 participants) outcomes informed the final eight reablement programs sorted by functional outcomes (everyday living activities; mobility and physical function; and cognition and communication). A technical guide and consumer information booklet were developed to support the handbook. A comprehensive handbook implementation plan involving dynamic assessment and monitoring was developed.

Conclusions

The reablement handbook provides a practical and accessible avenue to support function in people with dementia. Robust, coordinated dissemination, implementation and assessment of the new resource across a range of practice settings is now required.

Implications for rehabilitation

• Dementia leads to disability and dependence, impacting the person with dementia, their family and society.

• Reablement, an approach consistent with rehabilitation, is a strategy recommended in clinical practice guidelines that could maximise functional performance and quality of life in people living with dementia.

• This study describes development of a freely available evidence-informed reablement handbook designed to support delivery of high-quality reablement programs by allied health/nursing professionals for people living with dementia.

• Outcomes have potential to inform future implementation work and to ultimately improve the quality of services offered within the dementia sector.

Keywords:

• Reablement
• rehabilitation
• dementia
• functional performance
• normalisation process theory
• implementation

Acknowledgement

The authors wish to thank the participants from the workshop, and in particular we wish to thank the Dementia Consumer Advocates for their valuable insights throughout the project. We also extend special thanks to Christina Maurice for her assistance with development of the reablement resources. The funding body had no role in the project design, data collection, and analysis, or in the writing of the manuscript.

Ethical approval

The study was approved by the University of New South Wales Human Research ethics committee. All participants were provided with a copy of the participant information sheet and consent form and then provided verbal consent prior to interview participation.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the National Health and Medical Research Council (NHMRC) Partnership Centre for Dealing with Cognitive and Related Functional Decline in Older People.