S. SHAHWAN1, C.M.J GOH1, S. GUNASEKARAN1, S.F. GAY2, M. SUBRAMANIAM1
Institute of Mental Health1, Apex Harmony Lodge2
Dementia-care interventions play an essential role in allowing individuals with dementia to continue to live enriching lives. However, services are typically designed with older individuals in mind. To engage home-bound Young-onset and Early-stage dementia (YES) clients, the Therapy Through Work (TTW) program was introduced, whereby YES clients join in work-based activities at laundry services, urban farms, and a bakery. Given the novelty of this intervention, the present study aims to explore the factors influencing the implementation of the TTWYES using the Consolidated Framework for Implementation Research (CFIR).
Semi-structured interviews were conducted with 25 key informants who were TTWYES staff (n=10), worksite employers (n=5), and caregivers (n=10). The ethnographic component comprised repeated observations lasting clients’ entire day at work. Transcribed interview data and observation notes were coded deductively for CFIR constructs.
The CFIR constructs frequently identified as facilitators were ‘Relative advantage’, ‘Patient needs’ and ‘Staff attributes’; the intervention was preferred over alternative activities, clients benefited from the sessions, and staff were commended for their attentiveness to client’s needs. Constructs recurrently identified as barriers were, ‘Cost’ and ‘Planning’, owing to the manpower intensiveness, high unanticipated transport fees, and limited number of worksites to meet the intervention’s demand.
TTWYES addresses a service gap for a subgroup of clients with dementia, while shedding light on important implementation barriers. It is recommended that these barriers are reviewed, and strategies to overcome them are monitored so as to improve sustainability of this valuable program and its potential for scale-up.