Preliminary Implementation of a Dementia-Focused Risk Negotiation Conversation Tool Into Aged Care Practice

Area of Science:

• Implementation Science
• Gerontology
• Health Services Research

Background:

• Best practice dementia care emphasizes supporting decision-making for individuals with dementia.
• Integrating decision-support tools into routine care presents implementation challenges requiring strategic planning.
• The Enabling Choices tool was developed to facilitate risk negotiation conversations in dementia care.

Purpose of the Study:

• To utilize implementation science principles to embed the Enabling Choices tool into Australian community aged care.
• To explore contextual barriers and enablers for implementing a dementia-focused risk negotiation tool.
• To evaluate the feasibility, acceptability, appropriateness, reach, and adoption of the Enabling Choices tool.

Main Methods:

• A mixed-methods exploratory design was employed.
• Co-design workshops identified barriers, enablers, and behavior change strategies.
• Training was provided to aged care workers, followed by tool usage and evaluation through interviews and record audits.

Main Results:

• Sixty-two care managers were trained, with 31 using the Enabling Choices tool with people with dementia or care-partners.
• Key themes from care manager interviews included augmenting care, flexible training, defining the target audience, and overcoming hesitancy.
• Implementation support was found to be beneficial, impacting the feasibility, reach, and adoption of the tool.

Conclusions:

• Implementation of the Enabling Choices tool provided insights into contextual barriers and enablers in aged care.
• Addressing capability, opportunity, and motivation for behavior change is crucial for successful innovation adoption.
• The link between tool acceptability, feasibility, and appropriateness is vital for its reach and adoption in routine practice.