Practice model for a dementia outreach service in rural Australia.

Abstract

To investigate the nature and delivery of service model in a rural dementia outreach service. Participatory action research was used to collect data through four focus groups. Data analysis was an iterative process. The Dementia Outreach Service of Northern NSW Local Health District. Twenty-one participants comprised staff of the service, representatives of the community dementia service sector, and medical and health staff with expertise in dementia. A visual representation of the service's practice model derived from the analysis. A practice model for a dementia outreach service is described. The target groups are not only people with dementia and their carers living in the community, but also the staff of the community service sector who support them. A theoretical framework of person-centred care and the biopsychosocial approach inform clinical practice. Five practice principles emerged: early intervention, outreach, clinical expertise, the multidisciplinary team and building a cohesive sector. Seven core activities were identified: sector leadership; flexible response; linking clients, clinicians and services; program innovation; building cohesion; clinical consultation; and case management. The practice model describes a clinically based, community-positioned dementia outreach service in rural Australia. The biopsychosocial approach, outreach, clinical expertise, the multidisciplinary team and building a cohesive community sector are aspects of the model valued by both clinicians and community sector staff. Flexibility and responsiveness within a rapidly changing environment are key for maintaining person-centred care.