Evaluating the impact of a nurse practitioner-led outpatient memory clinic for people living with dementia and their carers/families: a feasibility and pilot study.

Enhance is a nurse practitioner (NP)-led multidisciplinary clinic with the aim of supporting independence, wellbeing and function of people living with dementia. Both people living with dementia and their carers/ families will be able to clients at the clinic. The clinic is aiming to offer person-centred and individual care. Currently, most programs supporting people living with dementia and their carers/ families usually have a one-size fits all approach and rarely take into consideration the individual needs of the clients. The clinic consists of a clinic room, meeting room, activity space and gym area. The programs will be designed to meet the needs of the clients following an initial clinical interview with the NP. The clinical interview determine the person’s goals, likes and focus areas (such as balance, strength, socialisation, quality of life etc.) to assist in allocating them to the clinics various programs (as described below). Programs will consist of the following face-to-face sessions held at the clinic: • Carer support group delivered by a mental health registered nurse in the meeting room (RN) (60 minutes, every month). The carer support group focuses on topics such as carer stress, grief, dementia, transitions of care. The conversation is directed by the carers and facilitated by the mental health registered nurse, • Group yoga delivered by a trainer yoga instructor and RN in the gym area (30 minutes). The yoga is a low intensity class, with the instructor modifying the exercises to suit individual participant, • Group and individual art therapy delivered by an NP and RN in the activity room (60 minutes). The art therapy includes painting, clay, craft and drawing materials, • Group and individual cognitive stimulation delivered by an NP and RN in the activity room (60-120 minutes). The cognitive stimulation therapy includes activities such as puzzles, Lego and, games, • Group and individual exercise interventions delivered by an exercise physiologist in the gym area (30- 60 minutes). The exercise sessions range from low to medium intensity (based on the individual). Exercises ranges from body weight exercises, resistance bands, treadmill, exercise bike, weights. The exercises are modified to suit individual participants, • As required appointment with the nurse practitioner to discuss health and wellbeing issues (30-90 minutes) held in the clinic room as requested by the participants The NP will design cognitive rehabilitation and cognitive simulation programs tailored to match the cognitive abilities of the individual. Participants will attend the clinic weekly, for 1-2 hours, for up to 12-months. Participants are free to choose which sessions they attend and how often they would like to attend during the 12-month period.