Dissertation

Physiotherapy and the Care of People Living with Dementia

Quick, Stephen M

2024

Overview

Background:Dementia is a major cause of disability and is associated with adverse events such as falls. Physiotherapists play an important role in dementia care. However, symptoms such as cognitive impairment can make delivering treatments more challenging. The overall aim of the thesis is therefore to understand the challenges and needs of physiotherapists and students to ensure they are equipped to provide effective dementia care.Aims:Study 1: Determine the knowledge, confidence, attitudes and beliefs of physiotherapists and students' working with people with dementia.Study 2: 1) Explore physiotherapist students' experiences and their perceived preparedness to work with people with dementia upon graduation. 2) Identify opportunities to improve dementia education from the perspective of students.Study 3: To determine 1) what education is being provided to entry-to-practice physiotherapy students regarding dementia in Australia and Canada and 2) how this education is being delivered.Study 4: 1) Understand what the components of effective physiotherapy care for people with dementia are, and 2) what can be done to ensure effective physiotherapy care is provided.Methods:Study 1. A mixed-methods systematic review following the Joanna Briggs Institute methodology, and a convergent integrated approach for data synthesis.Study 2. Qualitative interviews with 17 physiotherapy students. Data were thematically analysed.Study 3. Survey of lecturers working in Canadian and Australian universities. Descriptive statistics were used for quantitative data and content analysis for qualitative data.Study 4. Qualitative interviews with 16 physiotherapists experienced in dementia care. Data were thematically analysed.Results:Study 1. Physiotherapists and students lack knowledge and confidence in key areas, notably cognition, communication, behavioural and psychological symptoms. Working with people with dementia was considered complex, and dementia care was seen as a specialised area of practice.Study 2. Physiotherapy students' experiences with people with dementia were variable. They experienced many challenges that resulted in a range of emotions. The scope of dementia education opportunities was perceived as mostly inadequate, with students seeking more 'real-life' training opportunities.Study 3. A median of less than four hours of dementia education was provided across courses, with most delivered as lectures and tutorials. There were varying amounts of education on topics such as cognition, communication and behavioural symptoms and strategies. Dementia was acknowledged as a difficult topic to teach.Study 4. Effective physiotherapy dementia care involved engaging the person with dementia and working collaboratively with an interdisciplinary team and care partners. Greater advocacy and opportunities for mentoring and dementia education are needed.ConclusionPhysiotherapists and students lack knowledge and confidence when working with people with dementia. For the physiotherapy profession to provide effective care to people with dementia, physiotherapy students may benefit from more \"real-life\" scenario training at university, and current physiotherapists will benefit from specialised dementia training and mentoring by more experienced physiotherapists, as well as other allied professionals with expertise in cognitive and communication strategies. Further research into the best educational approaches is warranted. In addition, there is a need for physiotherapists and the profession to advocate for their role in dementia care.

• Publisher: ProQuest Dissertations & Theses
• Subject: Aging / Cognition & reasoning / Cognitive psychology / Communication / Dementia / Education / Neurosciences / Physical therapy