Exploring why there is limited physical rehabilitation for people living with dementia: a qualitative study.

Abstract

People with dementia have worse balance and more falls than older adults with no cognitive impairment. Despite potential benefits, few physical rehabilitation programs exist for people with dementia. This study investigated people who support individuals with dementia's experiences and perspectives with physical rehabilitation. In this qualitative descriptive study, 9 family members, 8 staff, 7 clinicians, and 6 researchers (<i>n</i> = 30) attended interviews or focus groups discussing balance, falls, rehabilitation, exercise, and cognitive impairment. Qualitative data were analyzed using reflexive thematic analysis, through an inductive and semantic approach. Physical rehabilitation for people with dementia may be lacking due to low expectations of abilities; safety concerns driving and limiting rehabilitation; and existing resources being inadequate. Low expectations of people with dementia's abilities to participate in rehabilitation led to exclusion. Safety concerns drove family members to pursue rehabilitation for the person with dementia, whilst risk aversion made staff and professionals hesitant to deliver rehabilitation to this population. Limited rehabilitation prompted family members to seek resources (exercises) provided by staff and professionals, which were viewed as not tailored or challenging enough for the person with dementia. This study highlights the need for increased awareness about physical rehabilitation for people with dementia.