Acceptability of personal contact interventions to address loneliness for people with dementia: An exploratory mixed methods study

Abstract

Background: Personal contact interventions involve routine visits with a person or animal to address loneliness. Research supports the promise of these interventions to address loneliness among cognitively intact older adults, but little is known about their use with people with dementia. Objective: To assess the acceptability of personal contact interventions for use to address loneliness with older people with dementia, according to formal and informal care providers. Design: Cross-sectional, mixed methods complementarity design. Setting: Ontario, Canada Participants: A purposive sample of 25 family members, friends, and health care providers of people with dementia. Methods: Participants attended a face-to-face interview to discuss the acceptability of personal contact interventions. Participants completed questionnaires to rate acceptability (adapted Treatment Perception and Preference measure). A semi-structured interview followed to discuss the ratings and features of personal contact (with another person or animal) in more detail. The analysis involved descriptive statistics (quantitative data) and conventional content analysis (qualitative data). During the interpretation of the results, the qualitative findings were compared to the quantitative results to provide context and understand participants’ perceptions of intervention acceptability in more depth; these are presented together in the results to demonstrate their distinct and complementary contributions to the findings. Results: Personal contact with a person or animal was rated as effective, logical, suitable, and low risk to address loneliness by over 80% of participants. Participants’ willingness to engage in this type of contact, for example as a visitor or as a facilitator of animal contact, was 72%. Participants emphasized the benefits of personal contact. The findings highlight that individualized, flexible interventions that include appropriate facilitation are needed. Conclusions: Future studies to develop and test personal contact interventions should involve flexible delivery, assess the feasibility and acceptability of these interventions (as in a Phase 2 trial of a complex intervention), and focus on the experiences of people with dementia.Tweetable Abstract: Tailored, routine, and facilitated contact with a person or animal shows promise to address loneliness for people with dementia.What is already known about this topic:• Loneliness is emotionally painful and harms the health and quality of life of those that experience it.• Personal contact interventions refer to routine visits with another person or animal and have been found effective in addressing loneliness among cognitively intact older adults.What this paper adds:• Friends, family members and health care providers of people with dementia view personal contact interventions as logical, suitable and effective to address loneliness of older adults with dementia.• Personal contact interventions are not always easy to implement and do not automatically promote meaningful connection and prevent loneliness for people with dementia.• Strategies to tailor and facilitate personal contact interventions are needed to promote their effectiveness when used with people with dementia.

Keywords

• Dementia
• Intervention development
• Loneliness
• Acceptability
• Mixed methods