Exploring the physiotherapy and exercise needs and preferences of nursing home residents with dementia: A qualitative study

Background: Exercise is widely employed to prevent functional decline in individuals with Alzheimer's disease and other forms of dementia. Exercise interventions are often supervised by physiotherapists, particularly in Western countries. However, adherence to exercise-based interventions remains suboptimal, particularly among nursing home residents.

Objective: To investigate the needs and preferences of nursing home residents with mild to moderate dementia concerning physiotherapy and exercise interventions.

Methods: Semi-structured individual interviews were conducted with 12 residents from various nursing homes who had been diagnosed with mild to moderate dementia, were proficient in Dutch, and capable of providing informed consent. Data from the interviews were analyzed using thematic analysis.

Results: Four key themes were identified: perceptions of physiotherapy and preferences for physiotherapy sessions, defining physiotherapy and exercise, exercise without physiotherapist supervision, and communication. In general, residents preferred physiotherapy that incorporated exercise and guidance aimed at preserving their independent physical functioning. Physiotherapy was perceived as more intensive than general exercise classes, and not necessarily suitable for all residents. Participants indicated that, provided safety and quality were maintained, they were willing to perform exercises independently. Residents expressed a desire for their family caregivers to be kept informed about their therapy, although they largely preferred to exercise with another person.

Conclusions: Nursing home residents with mild to moderate dementia expressed distinct preferences regarding physiotherapy sessions, communication, and family caregiver involvement. Addressing these preferences may improve adherence to and the effectiveness of exercise interventions. Additionally, the findings suggest a potential shift toward a more supervisory role for physiotherapists, rather than the traditional hands-on approach.