Physical activity and the ambulant person with dementia in long term care: influence of health care professionals

Background Recent literature suggests physical activity may improve the behavioural and psychological symptoms associated with dementia, however little attention has been given to current physical activity levels of the... [ view full abstract ]

Background
Recent literature suggests physical activity may improve the behavioural and psychological symptoms associated with dementia, however little attention has been given to current physical activity levels of the ambulant PWD in long-term care(LTC). Little is also known about how physical activity of the ambulant PWD may be influenced by factors such as health care professionals’(HCP) attitudes towards and own levels of physical activity.

Aim: To investigate if there is an association between HCPs’ attitudes and own level of physical activity and the perceived amount of physical activity undertaken by the ambulant PWD in the LTC.

Methods
LTC facilities in Co. Mayo were invited to participate in this cross-sectional survey. A four-part questionnaire was distributed to all HCPs in participating facilities.

Results
120 HCPs (42% response rate) from 8 facilities completed the questionnaire.The mean attitude of HCPs to physical activity was somewhat positive, but over half of HCPs were insufficiently physically active themselves to obtain adequate health benefits.A significant positive relationship was found between the HCPs attitude towards, and own levels of, physical activity and some aspects of the physical activity undertaken by PWD. HCPs considered that health care assistants (HCA)have the greatest influence over physical activity levels in LTC, but HCAs reported the lowest level of, and poorest attitudes towards, physical activity.

Opportunities for incorporating physical activity into the daily life of the PWD are being maximised at mealtimes, in toileting and walking indoors, although there is potential for improvement in other areas, including walking outside and getting dressed.

Conclusion
These results suggest targeting health promotion interventions at HCPs may be beneficial for them and may also improve the levels of physical activity for the ambulant PWD. Overall a pragmatic approach is recommended to increase the levels of physical activity in LTC including involving volunteer groups and back-to-work schemes.