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To explore how perceptions of fall risk influence decisions to undertake activities in people with Parkinson's disease who have fallen, along with their care-partners. This qualitative study used semi-structured interviews to collect data from eight people with moderate to severe Parkinson's Disease and freezing of gait (including those with cognitive impairments) and their care-partners. An inductive approach to thematic analysis was used to analyse the data. Four main, interconnected themes emerged, and a framework was developed to illustrate these connections. Weighing up the risks and benefits reflected the constant tension between assessing the likelihood of falling and potential benefit of any activity; Being fearful heightened the perceived risk resulting in a tendency to avoid or modify activities; Desire to lead a normal life heightened the perceived benefit of any activity, leading towards risk taking behaviour; It's a part of Parkinson's provided the context in which the decision-making process took place, with the reality of a progressive disorder influencing choices and contributing to a belief that falls were inevitable. There is a complex interaction between perceptions of fall risk and behaviour. An understanding of these interactions will assist therapists to tailor individualised fall prevention interventions. People are constantly weighing up the risks and benefits of activities while balancing fear of falling and a desire to lead a normal life in the context of Parkinson's disease. The resulting activity choices vary along a continuum from avoiding activities to taking risks, with a common approach to minimise the risk and then embrace the activity. Therapists can help people with Parkinson's and their care-partners to determine what level of risk is acceptable for them when balancing risk with quality of life. Understanding how people decide if they will undertake an activity that poses a risk of falling will allow therapists and patients to co-design fall prevention and management interventions based on the patient's values and priorities. [ABSTRACT FROM AUTHOR]

Reablement is a strategy recommended in clinical practice guidelines that could maximise functioning and quality of life in people living with dementia. This project sought to develop a practical handbook for health professionals illustrating the best, currently available evidence via newly-developed composite reablement programs. Handbook development occurred over five phases, informed by Normalisation Process Theory: (1) literature review, (2) sector interviews to explore how handbook implementation may impact practice, (3) workshop to determine final handbook content, (4) reablement program synthesis and handbook development, and (5) dissemination and implementation planning to support optimal uptake and normalisation within the sector. Interviews (n = 22) identified sector support for development of the reablement handbook. Workshop (n = 24 participants) outcomes informed the final eight reablement programs sorted by functional outcomes (everyday living activities; mobility and physical function; and cognition and communication). A technical guide and consumer information booklet were developed to support the handbook. A comprehensive handbook implementation plan involving dynamic assessment and monitoring was developed. The reablement handbook provides a practical and accessible avenue to support function in people with dementia. Robust, coordinated dissemination, implementation and assessment of the new resource across a range of practice settings is now required. Dementia leads to disability and dependence, impacting the person with dementia, their family and society. Reablement, an approach consistent with rehabilitation, is a strategy recommended in clinical practice guidelines that could maximise functional performance and quality of life in people living with dementia. This study describes development of a freely available evidence-informed reablement handbook designed to support delivery of high-quality reablement programs by allied health/nursing professionals for people living with dementia. Outcomes have potential to inform future implementation work and to ultimately improve the quality of services offered within the dementia sector. [ABSTRACT FROM AUTHOR]

To investigate stakeholders' perspectives of fall prevention programs for older adults with vision impairment. Twenty-two stakeholders (client facing professionals, service managers, and policy makers), with expertise in fall prevention or vision impairment, from organisations in south-eastern Australia, participated in this study. Individual semi-structured interviews were conducted over-the-phone (n = 19) and face-to-face (n = 3), and analysed deductively using content analysis into the following system level factors for health promotion interventions seen within the behaviour change wheel: Fiscal measures; Guidelines; Communication and marketing; and Service provision. Five key themes were identified: (1) insufficient guidelines or referral pathways; (2) ongoing funding to secure service delivery and best practice implementation; (3) marketing approach: honouring consumer's perceptions of themselves; (4) practical suggestions for program delivery; and (5) incorporation into existing services. Stakeholders considered fall prevention for those with vision impairment as essential in preventative healthcare, but did not have a clear understanding of where to refer or how to deliver a fall prevention service for this population. This study supports the delivery of fall prevention programs in older adults with vision impairment, but highlights the need to incorporate stakeholder perspectives into the design and delivery of such programs to ensure barriers to implementation in real world settings. Older adults with vision impairment are at a high risk of falls but currently have very little access to fall prevention programs. Results support the delivery of fall prevention programs to older adults with vision impairment through existing services, as long as professionals are provided with adequate service delivery guidelines, referral pathways, and fall prevention specific education and professional development opportunities. A variety of service provision, such as group and home-based programs, or using technology, may be cost-effective and improve older adults with vision impairments' adherence to fall prevention programs. [ABSTRACT FROM AUTHOR]