A study to explore influences on acceptance and rejection of psychosocial interventions by people with early dementia

Background: Health policy promotes post-diagnostic support for people affected by dementia. Evidence suggests psychosocial interventions can support people with dementia. Yet what influences people with dementia accept interventions is poorly understood. This research aimed to identify influences on acceptance or rejection of psychosocial interventions by people with early dementia. Methods: Sixteen face-to-face semi-structured interviews with people with early dementia (either alone or with a family member/s). Twelve staff participate in semi-structured interviews or a focus group. Thematic analysis and triangulation enabled integration of findings and identification of themes across all data sources. Findings, along with key themes from literature reviewed, informed a summary framework of influences on acceptance and rejection of psychosocial interventions by people with early dementia. Main Findings: Five overarching themes were identified. Individual responses to diagnosis, experiences of dementia and dementia services influenced uptake. Adjustment and awareness affected whether people felt they needed interventions. Whether activities offered appealed and benefit was influenced uptake. Interventions offering social contact, peer support, information, enjoyable activities and mental stimulation were valued. Group interventions or interventions specifically aimed at people with dementia did not appeal to all. Continuing with community activities was valued. Ability to travel and convenience of locations was important Stigma seemed to discourage uptake. Emotional and practical support from family was key to facilitating uptake and relationships between people affected by dementia and staff were also important. Conclusion: A complex interplay of individual, service and societal influences affect uptake of psychosocial interventions by people with early dementia. How interventions, and which services, should enable people with early dementia remain engaged in their everyday lives needs consideration. Further research to examine acceptance and rejection of specific interventions commonly offered to those with early dementia is needed. Involving people with early dementia in the design of interventions aiming to support them is paramount.