Elissa Burton

Curtin University · Faculty of Health Sciences

Background: Promoting physical activity among people living with dementia is critical to maximise physical, cognitive and social benefits; yet the lack of knowledge, skills and confidence among health professionals, informal care partners and people with dementia deters participation. As the initial phase of a larger feasibility study, co-design wa...

Objectives: Older people with care needs are often supported by their older care-partners (50+). Over time, the increased demand in care needs can result in the care partner placing their own health needs aside. This study was aimed at establishing and piloting a novel co-designed Carer Health and Wellbeing Service (CHWS) that offers multidisciplin...

Local parks offer outdoor spaces for active play; they provide a common attractive space in which grandparents and grandchildren can interact and engage in physical activity. This study investigated how multigenerational active spaces within local parks were being used by older people, their grandchildren, and other age groups. Method : This study...

This study aims to address and improve the low physical activity levels among people with mild dementia by implementing a novel shared decision-making and motivational support program, named "Changing the Focus". It will utilise a pre-post mixed methods approach, aiming to recruit 60 community living older people with mild dementia and their care-p...

Background and Objectives Successful aging is a mainstay of the gerontological literature, but it is not without criticism, including the often-limited way that it is studied and measured as well as the exclusion of older adults’ voices in its formulation and understanding. This study sought to address these issues through a qualitative investigati...

Frail, older people receiving supportive care in the home are at high risk of falls and functional decline that leads to either unplanned hospital admissions or permanent residential care, making it difficult to safely remain at home. Community home care organisations are well positioned to deliver high quality falls prevention programs if staff ar...

Background More than 57 million people have dementia worldwide. Evidence indicates a change in dementia prevalence and incidence in high-income countries, which is likely to be due to improved life-course population health. Identifying key modifiable risk factors for dementia is essential for informing risk reduction and prevention strategies. We...

Background Studies of goal setting in later life tend to focus on health-related goal setting, are pre-determined by the researcher (i.e., tick box), and/or are focused on a specific geographical area (i.e., one country). This study sought to understand broader, long-term goals from the perspective of older adults (65 + years) from Australia, New Z...

Community-dwelling people with Mild Cognitive Impairment self-reporting not to be meeting recommended physical activity levels participated in this study to (a) determine compliance of wearing (thigh-worn) accelerometers, (b) describe physical activity levels and sedentary behavior, and (c) determine the validity of the Physical Activity Scale for...

Introduction Physical activity is known to positively influence cognitive performance. For adults with mild cognitive impairment (MCI), the relationship between physical activity levels and cognitive performance is unknown. This cross‐sectional study aimed to determine if cognitive performance [as measured by the Montreal Cognitive Assessment (MoCA...

Introduction The health benefits of physical activity are well established; however, most older people are not sufficiently physically active. Despite the availability of various physical activity interventions and programs, implementation of effective prevention strategies to reduce older people’s physical inactivity are lacking. The ENJOY IMP-ACT...

Participating in physical activity is beneficial for older people with dementia. Little is known however about the perceptions of people living with dementia undertaking an online-delivered exercise program. This study aimed to explore the experiences and perceptions of older people with dementia and their carers in Indonesia participating in an on...

Community-dwelling older people living with dementia are at increased risk of falls and injury that may impact their ability to remain at home. Fall prevention education programs have been effective in reducing falling risks in other older populations, but few studies have reported on programs specifically co-designed with this vulnerable cohort. T...

Numerous countries have been developing a reablement approach for several years. However, the stage of implementation, as well as the scaling up, differs across each country. The aim of this chapter is to consider key issues relating to the implementation of reablement to determine the shared issues for development, refinement, and spread. The chap...

This chapter discusses health-economic perspectives in reablement and describes evaluation methods such as cost analysis, cost-effectiveness, and cost-utility analysis. The aim is to provide a summary of existing evidence, and to discuss health economic perspectives of reablement from a clinical and future research perspective. Eight studies compar...

Introduction Older carers or ‘care partners’ of older people experiencing care needs often provide essential support, at times while neglecting their own health and well‐being. This is an increasingly frequent scenario due to both demographic changes and policy shifts towards ageing in place. Multiple community stakeholders within the care and supp...

Purpose: Physiotherapists working in hospitals have a key role in decisions about when a person with stroke is safe to walk independently. The aim of this study was to explore the factors influencing decision-making of physiotherapists in this situation. Methods: A qualitative design with semi-structured interviews and reflexive thematic analysi...

This poster presents the evidence of the effectiveness of exercise interventions on improving physical function and reducing behavioural symptoms of older people with dementia living in the community, and the impact on their informal carers in Asia.

Purpose: This study investigated the (1) six-month outcomes of individuals with lateropulsion; (2) the relationship between baseline measures (from in-patient hospitalisation) and six-month functional abilities; and (3) recovery patterns for lateropulsion in stroke survivors. Materials and methods: Forty-one individuals with lateropulsion partic...

Objective: Mobility dysfunction can have an impact on safety, and this fact is particularly relevant to hospital settings. There are no clear standards for how health care professionals should approach the aim to encourage mobility without compromising safety. The objective of this scoping review was to identify factors that shape health care prof...

Introduction: Understanding the attitudes, competency, and awareness of those supporting older people who have an acquired combined vision and hearing loss is an important endeavor for this population. It can help guide aged care policy makers, leaders, and managers in the allocation of resources and training. This Australian study investigated the...

This study examined the potential for effect of a six-week gait aid training program for people with dementia on spatiotemporal gait outcomes, perception of use, and falls with gait aid use. The program utilised four 30-min physiotherapy home visits, scheduled at weeks 1/2/3/6, and was enhanced by carer-supervised practice. Falls and the physiother...

A third of older adults will fall each year and many will not be injured. Getting up from the floor in a timely manner is important, however it is unclear what technique older adults use to get themselves up off the ground unassisted, whether there are differences between men and women in getting up and what functional joint kinematics are used to...

1) Background: This study aimed to evaluate the feasibility of a telehealth home-based exercise program for older people with dementia living in Indonesia with support from their informal carers. (2) Methods: Pre-post intervention single group study with three assessment time-points (baseline, 12 and 18 weeks). Participants with dementia underwent...

Resistance training (RT) is beneficial for older adults, particularly to support living independently in their home. However, fewer than 25% of older adults in Australia participate in the recommended, twice-weekly sessions. Reasons older adults do not participate in RT include not having anyone to go with or not knowing what to do. Our study linke...

Background: There is a growing evidence on the benefits of exercise for older people living with dementia in developed countries. However, cultural, health-care systems and environmental differences may impact on the uptake of exercise and outcomes in different regions of the world. Objective: This study synthesised the available evidence examining...

Numerous countries have been developing a reablement approach for several years. However, the stage of implementation, as well as the scaling up, differs across each country. The aim of this chapter is to consider key issues relating to the implementation of reablement to determine the shared issues for development, refinement, and spread. The chap...

This chapter discusses health-economic perspectives in reablement and describes evaluation methods such as cost analysis, cost-effectiveness, and cost-utility analysis. The aim is to provide a summary of existing evidence, and to discuss health economic perspectives of reablement from a clinical and future research perspective. Eight studies compar...

This book introduces reablement, a radical new integrated care approach which seeks to empower older people to regain and maintain functioning and independence.

This book introduces reablement, a radical new integrated care approach which seeks to empower older people to regain and maintain functioning and independence.

Older adults with mild balance dysfunction can benefit from early intervention. This research explored the experiences of older adults with mild balance dysfunction participating in an 18-week supervised outdoors Seniors Exercise Park program and 6 weeks of unsupervised independent practice. Factors influencing attendance and independent practice w...

Purpose To determine gait aid use and decision-making related to usage in people with dementia, and examine factors influencing (1) gait aid use or not; and (2) falls in past year. Materials and methods A survey of informal carers of older people with dementia in the community. Closed questions on gait aid use, falls, timing and sources of gait ai...

Objectives To identify falls prevalence, falls risk factors and evaluate the effectiveness of falls prevention interventions for community-dwelling people with Mild Cognitive Impairment. Data sources Peer-reviewed articles (inception to 4 August 2022) from PubMed, CINAHL, PsycInfo, EMBASE, Scopus, SportDiscus and the Cochrane library. Review meth...

Objectives There is no standardisation of tasks or measures for evaluation of freezing of gait severity in people with Parkinson's disease. This study aimed to develop a clinician-rated tool for freezing of gait severity (i.e. Freezing of Gait Severity Tool), through determining clinicians’ ratings of the most important triggering circumstances to...

Background: Care to Move (CTM) provides a series of consistent ‘movement prompts’ to embed into existing movements of daily living. We explored the feasibility of incorporating CTM approaches in home care settings. Methods: Feasibility study of the CTM approach in older adults receiving home care. Recruitment, retention and attrition (three time po...

Purpose To evaluate the feasibility of a multimodal exercise program conducted at a Seniors Exercise Park among older adults with mild balance dysfunction. Methods Participants (aged ≥65 years) with mild balance dysfunction underwent 18 weeks of gradual reduction of supervised training followed by six weeks of independent training at the Seniors E...

Background: Being physically active is important for maintaining function and independence in older age. However, there is insufficient knowledge about how to successfully promote physical activity (PA) among home-dwelling older adults with functional challenges in real-life healthcare settings. Reablement is an interdisciplinary, person-centered a...

Purpose Physical activity has been shown to improve older adults’ functional capacity, independence, and quality of life. In a feasibility study, we embedded a movement approach within older adults existing home care services through “Care to Move” (CTM). The aim of this qualitative study is to explore older adults’ experiences of CTM within their...

Background Reablement is a team-based person-centered health and social care model, most commonly available for community-dwelling older adults. Understanding the components of reablement and how it is delivered, received, and enacted facilitates best evidence and practice. Determining behavior change techniques (BCTs) or strategies is an important...

Purpose: Reablement is a health and social model of care gaining international prominence. It is included in some publicly funded healthcare systems in Australia, Canada, United Kingdom, Norway, Sweden and other European countries. To advance reablement research and practice, we aimed to synthesize expert opinion on opportunities and challenges to...

Introduction Exercise and physical activity have been shown to improve cognition for people living with mild cognitive impairment (MCI). There is strong evidence for the benefits of aerobic exercise and medium evidence for participating in regular strength training for people with MCI. However, people living with MCI fall two times as often as thos...

Introduction In Ireland, over 55,000 older adults are supported in their community by formal home support, amounting to an estimated 23 million care hours annually. There is a growing need to move beyond care, to more proactive approaches to maintain physical function. In a feasibility study, we delivered the “Care to Move” (CTM) program through ex...

This study described mobility care practice of nurses, physiotherapists and occupational therapists and gait aid use for hospital patients with dementia. Two surveys, tailored to staff mobility care roles were distributed in Australian hospitals. Physiotherapists and occupational therapists were asked additional questions regarding assessments and...

Millions of older adults across the world receive regular home care services to enable them to continue living independently in the community and avoid requiring admission into residential aged care. Older adults receiving home care services frequently have multiple chronic conditions, be they physical, cognitive, or psychosocial and hence health a...

Introduction Carers play a critical role in supporting older people with health problems to remain living at home. This study aimed to understand the role and quality of life of older carers of older people and identify strategies used to manage their own health and well-being. Methods Older carers (aged ≥50 years) of older people (aged ≥65 years)...

The aim of this study was to map evidence of how physical activity (PA) strategies are integrated and explored in research of interdisciplinary, time-limited reablement for community dwelling older adults and to identify knowledge gaps. Following an apriori protocol, we searched eight databases for eligible studies, in addition to citation and refe...

Embedding Care To Move into every day life for improving physical activity and frailty outcomes for people receiving care at home - barriers and facilitators

How do older people receiving care view Care To Move and whether it is acceptable and feasible to embed Care To Move into their care provision at home

Background In Ireland, over 53,000 older adults are supported in their community by formal home support, amounting to an estimated 19 million care hours annually. There is a growing need to move beyond care, to more proactive approaches to maintain physical function. In a feasibility study, we delivered the ‘Care to Move’ (CTM) programme through ex...

Background Physical activity programmes have been shown to improve older adults’ functional capacity, independence and quality of life. Research around structured exercise programmes has been completed in different groups of community-dwelling older people, however few studies have focused on the older population receiving formal home care. In a fe...

Objectives The aims of the study were to i) explore the current practice, roles, and perceptions of physiotherapists who treat older people with and without dementia in Indonesia, ii) identify the characteristics of physiotherapists associated with treating older people and older people with dementia, and iii) identify the level of knowledge and at...

Objectives Patient- or person-centered care (PCC) integrates people’s preferences, values, and beliefs into health decision-making. Gaps exist for defining and implementing PCC; therefore, we aimed to identify core elements of PCC and synthesize implementation facilitators and barriers. Methods We conducted an overview of systematic reviews (umbre...

Gait aid provision is a standard approach to improve mobility and balance for older people. This research aims to understand and compare community care staff practice (health vs. non-health professionals) for gait aid use by people with and without dementia. A cross-sectional survey was conducted with Australian community care staff between October...

Background Weight-bearing asymmetry biasing the non-paretic leg is common following stroke. However, little is known as to how lateropulsion impacts on the weight-bearing patterns adopted in standing by individuals following stroke. Research Questions (1) Are there differences in weight-bearing asymmetry patterns observed in standing in people wit...

Purpose To integrate the evidence of gait aid prescription for improving spatiotemporal gait parameters, balance, safety, adherence to gait aid use, and reducing falls in community-dwelling older people. Methods Seven health databases were searched to June 2021. Experimental studies investigating gait aid prescription (provision and instruction fo...

Introduction Reablement is an interdisciplinary, multifactorial, and individualized intervention aimed at improving function and maintaining the independence of community-dwelling older adults who receive home care services. Physical activity (PA) is important for functional ability in older adults, but it is unclear how PA is promoted through reab...

Objective: The Community Balance and Mobility Scale (CBMS) has been shown to be a valid and reliable outcome measure for evaluating balance and mobility among older adults; however, some items cannot be conducted in all home environments, limiting its use in home-based assessments. The purpose of this study was to evaluate the accuracy and selecte...

Objective To explore physical activity changes and participation among physically active older adults living in retirement villages during the coronavirus (COVID-19) pandemic. Methods Semi-structured interviews were conducted over the telephone. The interviews were recorded and transcribed verbatim. Reflexive thematic analysis was conducted. Resu...

Objective To determine the re‐test reliability of the Health Literacy Questionnaire (HLQ) with carers of older adults discharged from hospital or attending the outpatient clinic. Methods Carers completed the HLQ twice by telephone and rated the acceptability of completing the tool. Tool completion time was recorded. Correlations were calculated be...

The objective of this systematic review was to examine the effectiveness of outdoor exercise park equipment on physical activity levels, physical function, psychosocial outcomes, and quality of life of older adults living in the community and to evaluate the evidence of older adults’ use of outdoor exercise park equipment. A search strategy was con...

Background High health literacy (HL) is important to optimise health outcomes, particularly for older people (who are substantial consumers of health services) and their adult caregivers. The aim of this systematic review was to evaluate measurement properties of HL instruments tested with these population groups. Materials and methods Six databas...

Background Reablement is a rehabilitative intervention provided to homecare receivers with the aim of improving function and independence. There is limited evidence of the effectiveness of reablement, and the content of these interventions is variable. Physical activity (PA) is known to be important for improving and maintaining function among olde...

Background: Lateropulsion is a common problem following stroke. Whilst the Burke Lateropulsion Scale (BLS) is recommended in the literature as the outcome measure of choice for measuring lateropulsion, the internal validity of the BLS has not been investigated. Objectives: To evaluate the internal validity of the BLS for use in evaluating the ef...

With an ageing society, the demand for health and social care is increasing. Traditionally, staff provide care for their clients rather than with them. In contrast, reablement aims to support people to maximise their competences to manage their everyday life as independently as possible. There is considerable variation between and within countries...

Millions of older people world‐wide receive community care services in their home to assist them to live independently. These services often include personal care, domestic assistance and social support which are delivered by non‐university trained staff, and are frequently long term. Older people receiving community care services fall 50% more oft...

Fewer than 20% of older adults participate in strength training (ST). Barriers to ST participation include not knowing where to go or not having someone to go with. To address these barriers, the authors provided older adults with a peer (older person already participating in ST) to support their engagement. The aim of this pilot randomized control...

An increasing ageing population leads to greater demand for care services to help maintain people in their own homes. Physical activity programmes have been shown to improve older adults’ functional capacity, enabling the older adult to live independently and maintain functional status. There has been a lack of quality research conducted around phy...

The aim of this qualitative exploratory study was to investigate older adults’ perceptions of having a peer to encourage their participation in resistance training. The participants were recruited from a retirement village to undergo a 6-week resistance training program. Some participants attended a center; others participated in their home. Data w...

Introduction: Reablement is a rehabilitative intervention provided to homecare receivers (mostly older adults) with the aim of improving function and independence. There is limited evidence of the effectiveness of reablement and the content of these interventions is variable. Physical activity (PA) is known to be important for improving and maintai...

The aims of this study were to (1) externally validate the accuracy of the Falls Risk for Older People in the Community (FROP-Com) falls risk assessment tool in predicting falls and (2) undertake initial validation of the accuracy of the FROP-Com to predict injurious falls (requiring medical attention) in people aged ≥ 60 years presenting to emerge...

Objective: The Residents in Action Trial (RiAT; ACTRN12616001177448) was a 16-week motivationally-embellished peer-led walking intervention designed to increase walking, reduce sitting, and improve mental health and well-being in insufficiently active residents in retirement villages. In this paper we report on 1) trial feasibility and acceptabilit...

The proportion of older adults is increasing around the world and most wish to live in their home until they die. To achieve this, many will require services in the home to remain living independently. To maintain function (ie, strength, balance, and endurance), physical activity needs to be undertaken on a regular basis, and is essential as a pers...

Resistance training (RT) can maintain and improve physical and mental health in older adults, but this population has low levels of RT participation. Linking older people participating in RT (i.e., peers) with those who have not may promote and maintain adherence. This qualitative study explored the experience of peers in encouraging RT participati...