BACKGROUND:Residential aged care homes (RACHs) in Australia support a growing population with complex healthcare needs. General practitioners (GPs), supported by practice nurses (PNs) and practice managers (PMs), play a central role providing medical care. Care models vary widely in these settings, and evidence on provider satisfaction and workforce sustainability is fragmented. OBJECTIVE:To describe general practice care models in Australian RACHs, and examine satisfaction and workforce intentions among GPs, PNs, and PMs. METHODS:A national online survey of GPs, PNs, and PMs involved in RACH care was conducted between June and August 2023. Descriptive and bivariate analyses examined associations between demographic and practice characteristics, satisfaction across care elements, and GP intentions to continue working in aged care. RESULTS:Of 105 GP respondents, 87% were currently providing RACH care (58% aged 40-59 years; 53% female). Care was predominantly delivered through unstructured models (70%). Over half (53%) reported high satisfaction with their care model, while 59% were dissatisfied with remuneration; satisfaction did not differ by model type. Twenty-four PNs and 23 PMs participated, reporting high satisfaction with GP collaboration yet lower satisfaction with RACH staff relationships. Younger, less experienced GPs were more likely to plan to cease RACH work within one year (both P = .001, Cramér's V = 0.33-0.39), and metropolitan GPs were less likely to anticipate long-term involvement (P = .016, Cramér's V = 0.32). CONCLUSION:General practice remains central to aged care but faces persistent workforce and structural pressures. Addressing remuneration, workload, and cross-sector collaboration is critical to sustaining high-quality general practice in RACHs.

Objectives Many older Australians do not receive timely allied health support to maintain mobility and safety at home. An Australian Royal Commission highlighted the potential for integrating digital health programs into community aged care to improve service access, efficiency and reach. However, technology uptake remains limited. This study aimed to co-create a theory-informed implementation model for digital health solutions in community aged care. Methods A qualitative study, involving semi-structured interviews and focus groups, was conducted with healthcare professionals from three Australian community aged care providers. Using implementation frameworks and co-design, priorities, barriers and facilitators for delivering digital health in community aged care were identified. The Consolidated Framework for Implementation Research-Expert Recommendations for Implementing Change (CFIR-ERIC) matching tool informed selection of implementation strategies. Results Thirty-four healthcare professionals participated. Barriers and facilitators were mapped against the ‘Inner Setting’ and the ‘Individual’ domains of the CFIR 2.0 framework. Six strategies were selected to address identified barriers using the CFIR-ERIC tool: Identify and Prepare Champions, Promote Adaptability, Develop a Formal Implementation Blueprint, Build a Coalition, Conduct Ongoing Training and Develop Educational Materials. These strategies were integrated into a codesigned model, leveraging identified facilitators such as program adaptability and clinician engagement, to support effective implementation of digital health solutions into community aged care. Conclusions This study provides a structured, theory-informed implementation model to support integration of digital falls prevention into community aged care. The model offers practical guidance for embedding digital programs within existing funding, workforce and workflow structures.

BACKGROUND:Over half of older adults in long-term care (LTC) experience concern about falling (CaF), yet existing CaF measurement tools do not adequately capture concerns related to daily activities specific to LTC, limiting their usefulness for assessment and management. This study aimed to: (i) develop a co-designed LTC-specific scale by working directly with older residents, adapting relevant Iconographical Falls Efficacy Scale (IconFES) items and adding newly identified activities reflecting their daily lives and CaF (IconFES-LTC), and (ii) identify gaps in current CaF management practices in LTC. METHODS:Semi-structured interviews were conducted with 15 LTC residents (aged 60+ years) to identify daily activities associated with CaF and with 10 LTC staff members to explore resident experiences, barriers and facilitators to implementing a CaF scale, and gaps in current CaF management. Interviews were analysed using reflexive thematic analysis to identify patterns across resident and staff perspectives. The draft IconFES-LTC was pilot-tested with nine residents and further refined. RESULTS:The final IconFES-LTC comprises 20 items, including seven adapted from the original IconFES. Items reflect common activities of daily living, undertaken within and outside the facility. Interviews further identified key practice gaps, including the absence of a suitable CaF measure, low participation in exercise programmes, limited falls prevention knowledge and a lack of evidence-based programmes addressing CaF in LTC. CONCLUSION:Co-designed with LTC residents and staff, the IconFES-LTC offers a context-specific approach to assessing CaF in LTC settings and may inform targeted fall-prevention strategies, with further psychometric validation required in larger, more diverse populations.

Dementia reablement is globally recommended to support people living with dementia to maximise their independence. Despite this, dementia reablement is not broadly available and there is currently no consensus around how it should be implemented. This study aimed to develop a national strategy by reaching expert consensus on the barriers, enablers, and potential implementation strategies to promote uptake of evidence-informed dementia reablement. A modified online Delphi survey process was used to gain national consensus on the determinants and implementation strategies pertaining to implementing community-based dementia reablement in Australia. Purposive sampling and snowballing were used to recruit a range of knowledge and experience-based expert interest holders, including people living with dementia, informal/family carers, allied health professionals, program managers/referrers, policy makers, experts and thought leaders. Using the Consolidated Framework for Implementation Research (CFIR), round one sought consensus around a range of determinants (i.e. barriers and enablers) to implementing reablement for community dwelling people living with dementia across four domains: (1) the system, (2) service providers, (3) family, and (4) the person living with dementia. Using the Expert Recommendations for Implementing Change (ERIC) strategies compilation, round two sought consensus on a range of implementation strategies, presented across the same four domains. Across each domain in both survey rounds, participants were invited to provide written comments to supplement their ratings. Consensus for inclusion of each item was defined as ≥ 70

Background: Reablement programs are recommended for people living with dementia to maintain and improve independence and activities of daily living function, however worldwide, access to quality, evidence-informed programs remains limited. This scoping review aimed to explore barriers, facilitators and strategies when implementing reablement programs for community-dwelling people living with dementia. Methods: A comprehensive scoping review following PRISMA-ScR guidelines (from inception to February 2026) across five databases and grey literature was undertaken to identify publications that reported on implementation of reablement programs for community-dwelling people living with dementia. Two reviewers independently screened abstracts and full texts and independently completed quality appraisal. Thematic analysis using the Consolidated Framework for Implementation Research (CFIR) explored implementation barriers, facilitators, strategies, and stakeholder-specific factors. Results: Fifty papers were included in the review. A range of reablement approaches were reported, with six programs constituting 62% of the papers. Barriers and facilitators for implementing community-based dementia reablement programs were identified and fit within the CFIR domains. For example, barriers included lack of health professional confidence delivering reablement, workforce capacity within service providers, policy pressures, and challenges around maintaining intervention fidelity. Facilitators included health professional confidence and motivation from perceived reablement benefits, teams working together with good communication, interorganisational collaboration, and promoting awareness of the evidence-base for dementia reablement. Conclusion: This review highlighted that although barriers exist to implementing dementia reablement, there are a range of facilitators and strategies that can be leveraged to promote implementation. With reablement recommended as an important intervention to support people living with dementia, it is imperative that service providers take action towards implementation. Future research should explore the implementation of reablement programs across diverse settings, to bridge the gap between evidence and practice and contribute to accessible reablement programs for all people living with dementia.

BACKGROUND:Reablement is recommended to maximise functioning in people with dementia, yet in Australia, is not routinely available. This study aimed to provide insight into the implementation and program outcomes of reablement in real-world practice for a person living with dementia. METHODS:Reablement was implemented for a client with dementia. In parallel, a formative mixed-methods pilot evaluation was performed, using single-case experimental A-B-A design (n = 1), supplemented by routinely collected pre-post program clinical measures. Implementation was evaluated qualitatively via clinical notes for fidelity, feasibility and client engagement. RESULTS:Single-case experimental design outcomes indicated the program positively impacted the participant's physical functioning. Additionally, most routinely collected pre-post clinical measures demonstrated improvement. Intervention fidelity varied, with differences in length and client engagement. CONCLUSION:Implementation of evidence-informed reablement has been shown to be feasible in real-world practice for a community-dwelling person living with dementia. Larger implementation trials are needed to build on preliminary outcomes to ultimately improve access to these important programs.

People living with dementia have a range of functional, physical, cognitive, and behaviour needs. Reablement (and/or ‘rehabilitation’) is an important multidisciplinary approach, such as using occupational therapy and exercise, to address each person’s needs. People with dementia in Australia are being referred to community aged care teams for everyday living support, and an evidence-informed reablement handbook is freely available ( www.hammond.com.au/reablement ). Despite this, evidence-informed reablement is still not routinely available. This project aims to explore how reablement is currently provided for people with dementia in the community, and to identify practitioner perspectives around potential goals and targets for practice change. The preliminary outcomes from this research (presented here) will feed into a broader project that seeks to understand how to implement evidence-informed reablement for people with dementia in Australia. To explore how reablement is currently provided for people with dementia, a retrospective file audit was conducted with two community aged care providers in New South Wales, Australia. At the time of data collection, the providers had not implemented the evidence-informed reablement handbook into practice. Data from the clinical file notes from each provider were compared against the reablement handbook. Site-specific outcomes were then presented back to the respective allied health teams from each provider via focus groups; through this process, practitioners identified potential goals and targets for practice change. Data from 10 clients with cognitive impairment or dementia were included in the audit. There was partial alignment with the handbook in terms of interventions delivered (e.g. personally prescribed multicomponent exercises; provision of compensatory strategies), and some areas where discrepancies existed (e.g. very few written support plans provided to clients). Twelve allied health professionals (occupational therapy, physiotherapy, social work, dietetics) participated in the focus groups. A range of potential targets for practice change were identified, such as better tailored information for clients’ cognitive/physical functioning, and more structured functional cognition assessment. Although some alignment with the reablement handbook existed, there was room for improvement in provision of reablement for people with dementia. Moving forward, broad consultation with a range of stakeholders is needed to determine the best implementation approach on a national scale.

The growing population of older adults residing in Australian residential aged care homes (RACHs) is driving an increased demand for general practitioner (GP) involvement to meet their complex healthcare needs. This scoping review sought to synthesise the evidence on general practice care models implemented within RACHs over the past decade (2013–2023), assessing their structure, effectiveness and implications for Australia’s future healthcare strategies. Employing the Joanna Briggs Institute Scoping Review Methodology, the review systematically searched for English‐language studies from five major databases (MEDLINE, EMBASE, CINHAL, Scopus, and PsycINFO) and grey literature, focussing on preventive, management and acute care services for RACH residents aged ≥ 65 and Aboriginal and Torres Strait Islander peoples aged ≥ 50 within comparable healthcare contexts. Following screening, 10 studies were identified, with half conducted in Australia. Models primarily included government or provider‐employed GPs and team‐based approaches led by registered nurses or nurse practitioners. Despite structural variations, common elements across models were regular GP consultations, co‐located services and multidisciplinary partnerships. Three studies reported differing impacts of general practice models on resident health outcomes; provider‐based GPs generally reduced unplanned hospital and emergency visits, whereas nurse practitioner–led teams resulted in a slight increase. Both GP‐led and team‐based models reported broad adoption and acceptance, though cost‐effectiveness varied. Despite identifying several promising models, the existing evidence is insufficient for a comprehensive evaluation of their long‐term effects on patient health and the broader healthcare system. This underscores the urgent need for further research to develop effective, culturally sensitive and economically sustainable aged care practices, ensuring high‐quality care for Australia’s rapidly ageing population.

BACKGROUND:Restorative care is a goal-oriented, time-limited, multidisciplinary approach to address functional decline in older adults. Within Australia, one form of restorative care available to community-dwelling older adults is the Short-Term Restorative Care (STRC) Programme. Australian government expenditure on such services is high, yet research on programme outcomes is scarce. The primary aim of this study was to provide a descriptive analysis of STRC participant and outcome data from clients' first STRC episode with a large, aged care provider in New South Wales (NSW), Australia. Secondary aims were: (i) examine any associations between client demographic and outcome measures routinely collected, and (ii) consider the suitability for broader sector use of the clinical and outcome measures routinely collected by the provider. METHODS:A retrospective, cohort study of STRC client data routinely collected between 1 March 2021 and 28 February 2023 from a large, not-for-profit aged care provider in NSW, Australia. Client demographic data and routinely used clinical and outcome measures (modified Barthel Index, Mini Nutritional Assessment short form, Clinical Frailty Scale, Patient-Reported Outcomes Measurement Information System 10-Question short form - global health, and Goal Attainment Scale light) were collected. Descriptive and inferential analyses were completed to explore available data. RESULTS:Four hundred and eighty-four STRC clients were included in this study. The mean age of clients was 81.5 (7.6) and majority were female (56%), born in Australia (49%), had a normal nutritional status on entry (54%), and classified as either pre-frail or mildly frail on entry (66%). The modified Barthel Index, Patient-Reported Outcomes Measurement Information System 10-Question short form - global health, and Goal Attainment Scale light all showed statistically significant improvements. Almost all clients remaining in their own home after exit of the STRC Programme (99%). CONCLUSIONS:This study looked at detailed data from the STRC Programme in Australia with a large sample over multiple years from a single aged care provider, and the findings suggest it is an effective program for older adults. The data provide insights into different clinical and outcome measures used, identify those that work well with this population, and those that need further consideration.

PURPOSE:To explore (1) current reablement practice for community-dwelling people living with cognitive impairment or dementia, and (2) allied health practitioner perspectives around implementing reablement. MATERIALS AND METHODS:Phase one: retrospective clinical file audit for people with cognitive impairment or dementia (n = 20) who had recently completed an allied health program with one of four participating Australian community aged care providers. An audit matrix facilitated evaluation of clinical audit outcomes against evidence-informed reablement criteria. Phase two: feedback and consultation via focus groups with the allied health workforce (n = 18) within each participating organisation. Qualitative content analysis identified barriers, facilitators, and targets for dementia reablement practice change. RESULTS:Dementia reablement practice was variably aligned with evidence-informed recommendations. Allied health practitioner-identified barriers to implementation of dementia reablement related to the person with cognitive impairment or dementia, the person's family, logistics and practicalities, and program sustainability. Enablers related to the client and their family, the team, and the system. Identified potential practice changes were around assessment, promoting reablement, the reablement approach, and improving documentation. CONCLUSIONS:A tailored implementation plan that addresses the barriers and enablers to reablement is needed to enhance practice and access to services for people living with cognitive impairment or dementia.

ISSUE ADDRESSED:This study explores experiences of people with dementia and family carers who participated in an Arts on Prescription at Home (AoP@Home) program, artists who delivered the AoP@Home program and the managers who coordinated the AoP@Home programs. METHODS:Semi structured interviews were conducted with the three stakeholder groups to explore experiences around implementation of AoP@Home. Interview questions were specific to each stakeholder group, and designed to capture the varied experiences around coordinating, delivering and participating in AoP@Home programs when delivered as a standard service offering. Qualitative content analysis was applied to evaluate the transcripts. RESULTS:A total of 13 stakeholders participated in interviews: four people living with dementia and four family carers, three artists and two AoP program managers. Three overarching themes emerged across the stakeholder groups: 'what worked well', 'challenges' and 'moving forward'. CONCLUSIONS:AoP@Home has potential as an important offering for community-dwelling people with dementia who may no longer be able to access group-based community programs. As AoP@Home is expanded, ongoing implementation monitoring and quality improvement will be essential to ensure maximal applicability of the program across the community aged care sector. SO WHAT?: The implementation of a new AoP@home service has been examined, and finds consumer satisfaction (person with dementia and their carer), and support from staff (artists and program managers). The novel nature of the service, however, requires considerable work to educate service referrers about the service and its benefits.

Background and Objectives Meaningful engagement is essential for aged care residents living with dementia . Our knowledge pertaining to caring presence for residents living with dementia is limited. This study aims to understand care workers’ experiences of providing care to residents , the challenges they face in being present with residents and support that enable them to be more present and provide person-centred care. Research Design and Methods A mixed-methods approach using surveys and semi-structured interviews with care workers from three Australian residential aged care homes (RACHs) was adopted. Surveys were analysed using descriptive statistics. Open-ended survey responses and interviews were analysed using thematic analysis. Results Twenty-six care workers completed surveys and a subset (n = 8) participated in interviews. Survey participants were largely positive about their role and reported that they loved caring for and making a difference in the lives of residents. Three themes emerged from interviews: (1) Trust, connection and the complexities of maintaining engagement; (2) Time as gift and challenge; (3) Organisational culture, structure and resources and enabling carer presence. Discussion and Implications Care workers in our study expressed their desire to be present with residents and stated that enablers such as meaningfully engaging with residents was one of the most enjoyable aspects of their work. Barriers such as staff shortages, competing demands of the role and time-related impediments to being present were reported. Addressing challenges to being present with residents living with dementia is key to help avoiding poor care practices and resident outcomes.

Background The number of older people experiencing homelessness in Australia is rising, yet there is a lack of specialised residential care for older people subject to homelessness with high care and palliative needs. To address this significant gap, a purpose-built care home was recently opened in Sydney, Australia. Methods This qualitative study explores the experiences of both residents and staff who were living and working in the home over the first twelve months since its opening. Residents were interviewed at baseline ( n = 32) and after six months ( n = 22), while staff ( n = 13) were interviewed after twelve months. Interviews were analysed using a reflexive thematic analysis approach informed by grounded theory. Results Three main themes emerged: (1) Challenges in providing care for older people subject to homelessness with high care needs; (2) Defining a residential care service that supports older people subject to homelessness with high care needs, and (3) Perception of the impact of living and working in a purpose-built care home after six months (residents) and twelve months (staff) since its opening. A key finding was that of the complex interplay between resident dependency and behaviours, referral pathways and stakeholder engagement, government funding models and requirements, staff training and wellbeing, and the need to meet operational viability. Conclusion This study provides novel insights into how the lives of older people subject to homelessness with high care needs are affected by living in a specifically designed care home, and on some of the challenges faced and solved by staff working in the care home. A significant gap in the healthcare system remains when it comes to the effective provision of high care for older people subject to homelessness.

Background Inpatient rehabilitation services are challenged by increasing demand. Where appropriate, a shift in service models towards more community-oriented approaches may improve efficiency. We aimed to estimate the hypothetical cost of delivering a consensus-based rehabilitation in the home (RITH) model as hospital substitution for patients requiring reconditioning following medical illness, surgery or treatment for cancer, compared to the cost of inpatient rehabilitation. Methods Data were drawn from the following sources: the results of a Delphi survey with health professionals working in the field of rehabilitation in Australia; publicly available data and reports; and the expert opinion of the project team. Delphi survey data were analysed descriptively. The costing model was developed using assumptions based on the sources described above and was restricted to the Australian National Subacute and Non-Acute Patient Classification (AN-SNAP) classes 4AR1 to 4AR4, which comprise around 73% of all reconditioning episodes in Australia. RITH cost modelling estimates were compared to the known cost of inpatient rehabilitation. Where weighted averages are provided, these were determined based on the modelled number of inpatient reconditioning episodes per annum that might be substitutable by RITH. Results The cost modelling estimated the weighted average cost of a RITH reconditioning episode (which mirrors an inpatient reconditioning episode in intensity and duration) for AN-SNAP classes 4AR1 to 4AR4, to be A$11,371, which is 28.1% less than the equivalent weighted average public inpatient cost (of A$15,820). This represents hypothetical savings of A$4,449 per RITH reconditioning substituted episode of care. Conclusions The hypothetical cost of a model of RITH which would provide patients with as comprehensive a rehabilitation service as received in inpatient rehabilitation, has been determined. Findings suggest potential cost savings to the public hospital sector. Future research should focus on trials which compare actual clinical and cost outcomes of RITH for patients in the reconditioning impairment category, to inpatient rehabilitation.

Arts on prescription at home (AoP@Home) is a participatory art-based approach involving a professional artist engaging a person with dementia (and their family carer) in art-making in their own home. This study evaluated the implementation of AoP@Home within a real-world community aged care context. A hybrid effectiveness-implementation design was used to simultaneously test both the AoP@Home intervention and the implementation process. AoP@Home program outcomes included person with dementia and family carer (dyad) health and wellbeing, and personal goal attainment. Implementation outcomes were evaluated according to feasibility, fidelity, acceptability, uptake, and costs via routinely collected data, artist notes, and interviews with program managers, artists, and participant dyads. Four dyads completed an AoP@Home program during the study period. All participants with dementia reported improvements in their overall health and wellbeing, and wellbeing scores improved for all carers from baseline to post-program. Implementation was feasible using existing government funding mechanisms, and programs were acceptable to all stakeholders. It is possible to deliver participatory arts programs for community-dwelling people with dementia and their family, in their home, using sustainable and available funding models. Programs such as AoP@Home should be made more accessible alongside broader allied health and care services.

PURPOSE:To explore the views of healthcare professionals and patients about the advantages and disadvantages of rehabilitation in the home (RITH) for reconditioning, and identify factors that should contribute to the successful implementation of a consensus-based RITH model for reconditioning. MATERIALS AND METHODS:Interviews with 24 healthcare professionals and 21 surveys (comprising Likert scale and free text responses) of inpatients undergoing rehabilitation for reconditioning provided study data. Interpretive thematic analysis was used to analyse interview data; descriptive statistics analysed Likert scale responses; patient written responses assisted with the interpretation of themes developed from the interview data. RESULTS:Two major themes were elicited in this study: the home is a physical setting and the home is a lived space. Advantages and disadvantages of RITH for patients, carers and healthcare professionals were identified within these themes. Appropriate patient selection; effective communication with patients and carers, and within RITH teams; adequate patient and carer support; ensuring the safety of patients and staff; and education of patients, carers and healthcare professionals are essential for the satisfactory implementation of RITH. CONCLUSION:The concept of home shapes the delivery of RITH. Recognising the advantages and disadvantages of RITH highlights important considerations needed to successfully implement RITH for reconditioning.

The World Health Organization (WHO) recognizes the right of individuals with dementia and their family caregivers to access interventions that enhance their participation in society. Reablement is an approach that enables older people to participate in meaningful daily and social activities. Over the past decade, a growing body of evidence has underscored reablement as a promising approach within dementia care, including positive outcomes for people with dementia and their family caregivers, and cost-effectiveness. However, the dissemination of knowledge about and practical implementation of reablement remain slow. This position paper, authored by the ReableDEM research network, aims to address key issues related to implementing reablement in dementia care. To expedite the adoption of reablement within dementia care, we propose five critical areas of focus: 1) Changing the attitudes and expectations of stakeholders (eg health and social care staff, policy makers, funders) - encouraging people to think about dementia as a disability from a biopsychosocial perspective; 2) Disrupting health and social care - A radical change is needed in the way services are organized so that they are more holistic, personalized and resource-oriented; 3) Investing in capacity-building and creating a supportive environment - the workforce needs to be trained and supported to implement reablement in dementia care; 4) Involving, educating and supporting family caregivers - services and staff that are equipped to provide reablement will be better able to involve family caregivers and the person's social network; 5) Providing robust evidence about reablement in dementia care by conducting high-quality research with long-term follow-up.

Background: Extensive research supports the use of goal-directed reablement and rehabilitation interventions to address a range of physical, functional, cognitive and behavioural needs of people living with dementia. Despite this, evidence-informed multidisciplinary reablement and rehabilitation interventions are not being offered in usual dementia care across Australia. An examination is needed of how best to implement reablement and rehabilitation interventions within the community-based dementia care sector.Methods: Drawing on implementation science, this study uses a four-phase mixed-methods retrospective and prospective approach: (1) clinical audit to evaluate current clinical practice, and through focus groups with practitioners, identify practitioner-led goals and targets for practice change; (2) Delphi survey to converge opinions from the diverse stakeholders involved in reablement in dementia, to reach national consensus around an implementation strategy; (3) hybrid pragmatic effectiveness-implementation pilot will facilitate testing of the implementation strategy in parallel with exploring effectiveness of the reablement intervention specifically within a real-world Australian community aged care context; (4) implementation capacity building.Discussion: This study will result in a freely available, nationally relevant implementation protocol, designed and tailored via input from key stakeholders over a series of iterative project activities. By testing this protocol via a pilot implementation-effectiveness study, we will generate national information about effectiveness of evidence -informed reablement programs for people living with dementia across various community aged care settings. Outcomes have potential to influence policy and drive widespread practice change, increasing access to evidence-informed reablement and rehabilitation for people living with dementia across Australia.

ISSUE ADDRESSED:Arts on Prescription at Home (AoP@Home) involves a professional artist visiting a person with dementia and their informal carer(s) in their own home to engage them in participatory art making. While there is evidence for the use of these programs, more work is needed to facilitate effective implementation. This study explored contextual barriers and enablers to implementation of AoP@Home within a real-world community aged care service.METHODS:Two remote focus groups were conducted at a community aged care provider in Sydney, Australia. Key stakeholders (n = 14) were recruited, representing: people with dementia, informal (family) carers, AoP artists, service referrers and community service managers. Focus group transcripts were analysed using qualitative content analysis and mapped onto the Consolidated Framework for Implementation Research (CFIR). Outcomes were reviewed against the Expert Recommendations for Implementing Change (ERIC) strategy compilation to inform development of a tailored implementation strategy.RESULTS:Four overarching themes described the range of barriers and enablers to AoP@Home implementation: (1) "I don't know enough about it" (awareness and engagement within the sector), (2) artists delivering programs, (3) awareness and engagement of people impacted by dementia, (4) practicalities of implementation. All five domains of the CFIR were represented across the four themes. The ERIC compilation provided a list of practical strategies for implementation of AoP@Home.CONCLUSIONS:The implementation of psychosocial interventions for people living with dementia within a community aged care service is complex and multifactorial. So what?: Organisations planning implementation should consider conducting their own pre-implementation analysis to identify context-specific strategies.

Background and objectivesVisual impairment (VI) and dementia both increase with age, and it is likely that many older people are living with both conditions. This scoping review aims to investigate the prevalence and types of VI among older people living with dementia, and the impact of VI on older people living with dementia and their caregivers.MethodsThis scoping review used Arksey and O'Malley's methodological framework. Studies in any setting involving people living with dementia and some assessment of either VI, eye diseases causing VI or the impact of VI were included.ResultsThirty-six studies were included. Thirty-one studies reported the prevalence of VI in older people living with dementia, while ten studies reported on impacts of VI on people living with dementia. Only one study reported on impacts on caregivers. The prevalence of VI or specific eye diseases among older people living with dementia ranged from 0.2 to 74%. The impacts of VI on older people living with dementia included increased use of hospital services, increased disability and dependency, reduced social engagement, negative emotions, increased abnormal behaviours, loss of hobbies, difficulty in using visual aids or memory aids, and greater Neuropsychiatric Inventory symptoms. And the impacts on caregivers included increased conflict and physical exhaustion.ConclusionVI is common in older people living with dementia and is associated with negative impacts on those with dementia and their caregivers. However, heterogeneity between studies in terms of setting and method for assessing and defining VI make it difficult to compare findings among studies. Further research is needed, particularly assessing the impact on caregivers.