Interdisciplinary Dementia Rehabilitation Programs

Improving dementia outcomes through rehabilitation approaches to care

Our interdisciplinary dementia rehabilitation programs (I-HARP and I-CHARP) combine a range of proven health care and rehabilitation strategies to help older people with dementia remain healthy and independent.

Interdisciplinary Home-bAsed Reablement Program (I-HARP)

I-HARP is a unique model of care, funded by the Australian government, that aims to help older people with dementia remain healthy and independent in their own homes.

The program combines a range of proven health care strategies into a comprehensive intervention delivered at home. I-HARP clinicians work closely with the person with dementia and their carer to provide client-directed and client-centred care and support.

The program is delivered over a four-month period by an occupational therapist and registered nurse with the involvement of other allied health professionals as needed.

I-HARP includes a maximum of 12 home visits for the person with dementia, three information and support sessions for their carer, and provision of minor home modifications/assistive devices to improve home safety and reduce the risk of falls.

Pilot study and clinical trial outcomes

A pilot study conducted between 2015 and 2016 with 18 people with dementia and their carers showed potential benefits of the program in terms of individual goal attainment, mobility, independence, well-being and confidence. Within 12 months of taking part in the study, participants who received I-HARP had fewer falls and hospital admissions, and none had moved into residential aged care.

Following the pilot study, a multi-centre randomised controlled trial was conducted between 2018 and 2022 with 232 community-dwelling people living with dementia and their carers. The trial compared the I-HARP program, based on a 4-month model of care incorporated into community aged care services and hospital-based community services, to usual care in their respective settings.

Clients with mild dementia who received the I-HARP program were shown to have significantly better functional independence at both 4 months and 12 months compared to the usual care group.

Investigators

Acknowledgements

Funded by the National Health and Medical Research Council (NHMRC) under the Boosting Dementia Research Grants Scheme (APP1137050: 2016 Priority 1 Implementation of Dementia Research into Clinical Practice and Care).

We thank our study participants and our partner organisations: Anglicare, BaptistCare, Concord Hospital, Canterbury Hospitals, Royal North Shore Hospital, Ryde Hospital.

Interdisciplinary Care Home-bAsed Reablement Program (I-CHARP)

Improving outcomes for people living with mild cognitive impairment and dementia in residential care.

I-CHARP uses the same principles and procedures as I-HARP, delivering a 20-week program by registered nurses and occupational therapists integrated into residential aged care services.

Using the principles of rehabilitation and person centred and reablement approaches to care, the goal is to improve independence, safety, and overall health and wellbeing of residents with mild cognitive impairment and dementia, and reduce avoidable costs.

The delivery of the I-CHARP program is supported through an implementation strategy known as the Research Enabled Aged Care Homes (REACH) Network. REACH is a digital portal providing resources and linking communities of practice for rehabilitation in dementia care with the aim of translating knowledge to improve the skills and capabilities of aged care home providers, managers and staff.

Implementation and evaluation trial

Following the success of I-HARP, funding has been awarded by the National Health and Medical Research Council to conduct an implementation and evaluation trial of I-CHARP with the following aims:

To co-design and implement I-CHARP in the real-world setting
To co-design and deploy a new knowledge translation network for aged care (REACH)
To examine whether (and, if so, how) I-CHARP implementation produces its intended effects and determine how this program can be adapted, sustained and scaled up across aged care homes
To develop a tool for the delivery of reablement care that can be used as routine practice across aged care homes in Australia (Agile Implementation Playbook).

In partnership with Calvary and Whiddon aged care providers, the trial will involve residents with mild cognitive impairment or mild to moderate dementia and their care staff and regular visitors across 16 care homes.

The I-CHARP intervention strategy will involve residents within half of the care homes, with the remaining half receiving care as usual. The project is taking place between 2023 and 2027.

Our people

Chief investigators

Associate investigators

Professor Lindy Clemson
Mr John Quinn, Consumer Involvement
Ms Glenys Petrie, Consumer Involvement
Dr Jennie Hewitt
Ms Judith Fethney
Dr Karen Watson
Associate Professor Fiona O'Leary
Associate Professor Margaret MacAndrew
Dr Jacqueline Wesson
Dr Jane Conway, Workforce Development Consultant

Partner investigators

Dr Tony Hobbs, Senior Medical Advisor, Calvary Health Care
Ms Karn Nelson, Executive General Manager Strategy and Innovation, Whiddon
Dr David Sykes, Director, Centre for Dementia Learning, Dementia Australia
Ms Anne Liddell, Senior Policy Manager, Aged & Community Care Providers Association (ACCPA)