Implementing a post-diagnostic allied health program run by a rural aged care provider for people in the community with dementia

The SPICE program for people with dementia and their care partners was delivered by Harbison’s existing staff including occupational therapists, physiotherapists, a dietitian, a psychologist, and allied health assistants. Two groups participated in the SPICE program, with a total 14 dyads (28 participants total). Data were collected from program participants (pre and post outcome measures), focus groups and interviews with participants and staff at Harbison, alongside other implementation metrics. The project was overseen by a Steering Group and a Community Advisory Group that included people with lived experience of dementia. 

The project demonstrated that an aged care provider can safely and effectively deliver a multicomponent post-diagnostic support program to people with dementia living in the community. 

Key outcomes included: 

• High participant engagement, with 100% retention of participants across two groups and a total of 14 people living with dementia and their 14 care partners (from Session 1 – 20). 
• No serious adverse events the program was delivered safely in an aged care setting to community-dwelling participants. The development of materials to support delivery, including screening forms and delivery materials. 
• 12 staff members were trained in post-diagnostic dementia support using the SPICE model, group facilitation, and program evaluation. 
• Evidence that a residential aged care provider in a regional area with limited specialist services can effectively deliver post-diagnostic dementia support to people living in the community, providing access to specialist allied health care that would otherwise be unavailable. 
• Qualitative feedback highlighted strong satisfaction, with care partners particularly valuing being included as active participants. While measures of quality of life, cognitive function and physical function did not show statistically significant change, this was expected given the project’s focus on feasibility and implementation.

The project demonstrates that the aged care workforce can effectively deliver post-diagnostic care to people living with dementia in the community and their care partners. 

This included: 

• Staff applied the use of evidence-based interventions including Cognitive Stimulation Therapy and COPE, building familiarity with approaches not previously delivered by Harbison to people living independently within the community. 
• Staff developed skills that increased capacity to deliver post-diagnostic support to people with dementia including practical skills in communicating with people living with dementia and care partners, facilitating group sessions, providing individualised support, supporting physical activity, engaging care partners as active participants, and conducting structured outcome assessments. This investment in the aged care workforce positions Harbison to continue delivering the program independently and to train new staff as the program expands. 
• Practical insights into how a residential aged care provider can contribute to community-based dementia care, including referral pathways, staffing models, infrastructure and logistical requirements when delivering a multi-component program to community-dwelling participants. 
• Demonstrates how residential aged care providers can bridge the gap in regional areas by leveraging existing infrastructure and staff, to provide access to specialist allied health support to people living in the community.

Based on implementation findings, plans are underway to continue to examine the delivery of the SPICE program in new settings including: 

• Further adaptation to resources to support broader delivery within other similar settings in the community. 
• Trialling of an adapted once-weekly delivery model to aim to reduce travel burden for rural participants and improve workforce efficiency, with plans to conduct the program within a community centre in in 2026. 

• Longer term tracking of outcomes through continued data collection beyond the funded period. Further, a planned comparison of the once-weekly model against the original twice-weekly format will test implementation and outcome data. 

  Overall, the project demonstrates that post-diagnostic dementia support can be successfully delivered by an aged care provider using existing workforce and infrastructure. The SPICE model offers a practical and potentially sustainable approach for improving access to specialist dementia support in regional communities.