Exploring Factors for Inclusive Occupational Therapy for People With Dementia in Australia: A Qualitative Study.

Abstract

Importance: Occupational therapy interventions are a crucial part of dementia care and have been shown to be effective in research trials. However, the acceptability and inclusivity of occupational therapy interventions to treat dementia for people from diverse groups are unclear.

Objective: To explore factors contributing to the delivery of acceptable and inclusive community-based occupational therapy interventions for people with dementia from diverse groups in Australia.

Design: Exploratory qualitative study in which interviews and focus groups were used. Data were analyzed with reflexive thematic analysis.

Setting: Community-based occupational therapy in Australia.

Participants: Purposive sampling was used to recruit 26 participants. Eight people with experience of dementia from diverse groups (ethnic minority, sexual minority, and socially or economically disadvantaged groups) participated in individual interviews; occupational therapists participated in focus groups (n = 10) and interviews (n = 8).

Results: Three key themes were developed to support inclusivity: (1) knowing the person at the center of the care, (2) collaboration, and (3) perception of occupational therapy for people with dementia. Acceptable and inclusive occupational therapy interventions for dementia occurred when people from diverse groups felt valued and received tailored interventions, were confident in and partnered with the therapist, and understood the purpose of therapy.

Conclusions and relevance: Therapists require support to apply cultural humility and to build skills to overcome barriers to providing culturally safe and acceptable care. Plain-Language Summary: People from diverse groups include ethnic minority, sexual minority, and socially or economically disadvantaged groups as well as Indigenous populations. We know community-based occupational therapy interventions improve function and quality of life for people with dementia and their families, but we do not know whether they work for people from diverse groups. We asked people with experience of dementia from diverse groups and occupational therapists in Australia what they thought. We found that occupational therapy interventions for dementia are acceptable to diverse groups when the therapist works in partnership, providing an intervention that is meaningful to them. To be inclusive, therapists need to empower people from diverse groups to participate equally in the intervention. They need to make sure families understand the purpose of the intervention. Some occupational therapists may need training to build skills and knowledge as well as support to overcome barriers and to provide acceptable and inclusive interventions.