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Thijssen M, Dauwerse L, Lemmers F, der Sanden MNV, Daniels R, Graff M, Kuijer-Siebelink W. 'Practice what you preach'. Perspectives on the involvement of people with dementia and carers in community-based dementia friendly initiatives, a qualitative study. Front Psychiatry 2024; 15:1387536. [PMID: 38818024 PMCID: PMC11137317 DOI: 10.3389/fpsyt.2024.1387536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 04/29/2024] [Indexed: 06/01/2024] Open
Abstract
Introduction People with dementia and their carers experience social stigma and often refrain from social participation. Significant improvement might be achieved by creating Dementia Friendly communities (DFCs) for which dementia friendly initiatives (DFIs) are needed. DFIs are developed by a variation of stakeholders. However, people with dementia and their carers are often unrepresented herein. This study aims to get insight into the perspectives of stakeholders (e.g., health- and social care professionals, volunteers, people with dementia and their carers) about the involvement of people with dementia and their carers during the development and sustainment of DFIs. Methods Descriptive qualitative study, using a co-research design with a carer as co-researcher. Nineteen semi-structured interviews with stakeholders, including people with dementia and their carers, were performed. Inductive content analysis took place using Atlas Ti. Results Four themes were found: 1) the involvement of people with dementia and their carers is important for both people with dementia and their carers and other stakeholders; 2) personal character traits, life histories, and associated emotions evoke the need for involvement; 3) involvement requires an open, responsive stance and building relationships; and 4) the estimation of one's own and others' capacities influences perspectives on involvement. As such, practice what you preach means actively adopting an open, responsive approach and acknowledging the unique abilities and backgrounds of people with dementia and their carers. It emphasizes the importance of actually living by the values you advocate for. Conclusion Central to perspectives on involving people with dementia and their carers is the emphasis on working relationally, differing from service-led and pre-structured patient and public involvement (PPI). Working relationally calls for organizational shifts aligned with a rights-based perspective to avoid tokenism, and promotion of user-led organizations with genuine partnerships. Creative methods, problem-solving, and communication skills are essential for the development and sustainment of inclusive, supportive, person-centered DFIs. Future studies should explore the long-term impact of the involvement and working relationally on the well-being of people with dementia and their carers.
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Affiliation(s)
- Marjolein Thijssen
- Radboudumc Research Institute, Scientific Center for Quality of Health (IQ health), Radboud University Medical Center, Nijmegen, Netherlands
- Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen, Netherlands
- Department Occupational Therapy, School of Allied Health, HAN University of Applied Sciences, Nijmegen, Netherlands
| | - Linda Dauwerse
- Department of Primary and Community Care, Medical Centre, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Maria Nijhuis-van der Sanden
- Radboudumc Research Institute, Scientific Center for Quality of Health (IQ health), Radboud University Medical Center, Nijmegen, Netherlands
| | - Ramon Daniels
- Research Centre Assistive Technology in Care, Zuyd University of Applied Sciences, Heerlen, Netherlands
| | - Maud Graff
- Radboudumc Research Institute, Scientific Center for Quality of Health (IQ health), Radboud University Medical Center, Nijmegen, Netherlands
- Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen, Netherlands
| | - Wietske Kuijer-Siebelink
- School of Education, HAN University of Applied Sciences, Nijmegen, Netherlands
- Radboudumc Health Academy, Research on Learning and Education, Radboud University Medical Center, Nijmegen, Netherlands
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Matsumoto H, Hagiwara Y, Yamamoto-Mitani N, Igarashi A. A Randomized Control Trial for ReDeSign: A Dementia-Friendly Mobile Microlearning Training for Store Workers in Japan. THE GERONTOLOGIST 2023; 63:1300-1310. [PMID: 36508394 PMCID: PMC10474589 DOI: 10.1093/geront/gnac182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Dementia-friendly training should be incorporated in neighborhood stores for people living with dementia to maintain engagement in social activities. However, there is a lack of evidence of dementia-friendly training in these workplaces, and existing trainings have time constraints. We developed a mobile microlearning program based on stigma theory and the bystander intervention model. This study aimed to evaluate the microlearning program's effectiveness. RESEARCH DESIGN AND METHODS Convenience store workers in Tokyo were recruited for a randomized, waiting-list, and controlled trial. The intervention group completed a 50-min online course. The primary outcome was an attitude toward people living with dementia. The secondary outcomes were knowledge of dementia and helping behavior toward customers suspected of having dementia. Data were collected at baseline, after 1 month, and 4 months following the randomization. RESULTS Process evaluations confirmed satisfaction and high completion rates of the program. In total, 150 participants were included in the analysis. The intervention group showed significantly greater improvements in attitude (Hedge's g = 0.70) and knowledge (g = 0.59) after 1 month, compared to the control group. Helping behavior increased in the intervention group, although it did not differ significantly between the groups. All outcomes remained significantly improved after 4 months. DISCUSSION AND IMPLICATIONS The findings provide evidence that dementia-friendly training reduces the general public's stigma and increases helping behavior in stores. Mitigation of time constraints through mobile microlearning is expected to contribute to the dissemination and help people living with dementia maintain their social participation in the communities. Clinical Trials Registration Number: UMIN000043623.
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Affiliation(s)
- Hiroshige Matsumoto
- Department of Community Health Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yasuhiro Hagiwara
- Department of Biostatistics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Noriko Yamamoto-Mitani
- Department of Gerontological Home Care and Long-term Care Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ayumi Igarashi
- Department of Gerontological Home Care and Long-term Care Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Klein E, Goering S. Can I Hold That Thought for You? Dementia and Shared Relational Agency. Hastings Cent Rep 2023; 53:17-29. [PMID: 37963132 PMCID: PMC10688267 DOI: 10.1002/hast.1485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
Agency is talked about by many as something that people living with dementia lose, once they've lost much else-autonomy, identity, and privacy, among other things. While the language of loss may capture some of what transpires in dementia, it can obscure how people living with dementia and their loved ones share agency through sharing capacities for memory, language, and decision-making. We suggest that one consequence of adopting a framework of loss is that it makes the default response to changes in agency the substitution of a family member's agency for the purported lost agency of someone living with dementia. We argue for an alternative framework in which sharing agency is recognized as a central feature of living with dementia. Building on the work of relational theorists, we argue for the value of thinking about agency in dementia as fundamentally shared, and explore potential implications for treatment, caregiver support, and building dementia-friendly environments.
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Craig S, Mitchell G, Halloran PO, Stark P, Wilson CB. Exploring the experiences of people living with dementia in Dementia Friendly Communities (DFCs) in Northern Ireland: a realist evaluation protocol. BMC Geriatr 2023; 23:361. [PMID: 37296393 PMCID: PMC10251317 DOI: 10.1186/s12877-023-04090-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 06/02/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND The aim of this study is to 1) explore the experiences of people living with dementia interacting with DFCs and 2) identify factors that influence empower and support people living with dementia to live successfully in DFCs. The main elements of a DFC are related to people; communities; organisations and partnerships. There are over 200 organisations recognised as dementia-friendly in Northern Ireland (NI). This realist evaluation is to understand how DFCs work for people living with dementia, how positive outcomes are achieved, for whom and in what contexts do DFCs work best. METHODS A realist evaluation using case study methodology. The process evaluation includes a realist review of the literature, non-participant observation of people living with dementia in their local communities, semi-structured interviews to explore the facilitators and barriers to living well in DFCs and focus groups comprised of people living with dementia, family caregivers and people working in DFCs to support Context- Mechanisms and Outcomes (CMOs). This four-stage realist assessment cycle is used, including iterative rounds of theory development, data gathering, and theory testing. In the end, analysis will reveal context mechanisms that influence how dementia-friendly communities operate and present an initial theory of how people think, which, if adopted, may be able to alter current contexts so that "key" mechanisms are activated to generate desired outcomes. DISCUSSION To give confidence in moving from hypothetical constructions about how DFCs could function to explanations of possible or observable causal mechanisms, the realist evaluation of a complex intervention incorporates a variety of evidence and perspectives. Despite playing a significant role in a person with dementia's everyday life, it appears that little is known about how communities function to achieve intended results. Even though there has been a lot of work to pinpoint the fundamentals and crucial phases of building DFCs, it is still unclear how people living with dementia benefit the most from these communities. This study intends to advance our understanding of how outcomes are produced for people living with dementia by contributing to the underlying theory of DFCs as well as addressing the primary research objectives.
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Affiliation(s)
- Stephanie Craig
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland.
| | - Gary Mitchell
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland
| | - Peter O' Halloran
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland
| | - Patrick Stark
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland
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Alteren J, Johannessen A, Lyberg AM, Magnussen IL. Giving Voice to People with Dementia and Perspectives Regarding a Dementia-Friendly Society: A Synthesis of Qualitative Studies. J Multidiscip Healthc 2023; 16:851-861. [PMID: 37035259 PMCID: PMC10075266 DOI: 10.2147/jmdh.s398570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 03/09/2023] [Indexed: 04/03/2023] Open
Abstract
Introduction The World Health Organization [WHO] and governments worldwide envision the development of dementia-friendly societies that are based on a person-centered culture. A limited number of studies have described the features of dementia-friendly societies based on the viewpoints of people with dementia. Purpose To synthesize qualitative empirical research that expands the knowledge of what people with dementia consider to be essential for daily living in a dementia-friendly society. Methods The authors searched phrases in the databases AgeLine, CINAHL, EMBASE, MedLine, PsycINFO, PubMed, ORIA, SveMed+, and Cochrane Library. Research articles that involved people with dementia and were conducted in Western countries, written in English, published in peer-reviewed academic journals using qualitative methods, and published within the past decade were included. The research included was critically and systematically appraised using the critical appraisal skills program checklist for qualitative research, and the findings were analyzed according to Graneheim and Lundman's method of qualitative content analysis. Results Overall, 1122 records-561 from 2019 and 561 from 2021-were identified through the search, and nine studies were included in the final synthesis. The studies included were from the United Kingdom (five studies), Australia (three studies), and New Zealand (one study). Through the analysis process, the following main theme emerged: giving voice to people with dementia, which summarizes the essence of what people with dementia believe is essential for daily living in a dementia-friendly society. The main theme covered two themes: a sense of being valued and a sense of being safeguarded, each of which contained subthemes. Conclusion To meet the WHO's and the governments worldwide intention to develop dementia-friendly societies, further research should focus on the voices of people with dementia. By including those concerned, the political goals of a dementia-friendly society can be achieved.
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Affiliation(s)
- Johanne Alteren
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
- Correspondence: Johanne Alteren, Tel +47 71 19 58 93, Fax +47 71 21 40 00, Email
| | - Aud Johannessen
- Faculty of Health and Social Sciences, University of South-Eastern Norway, Horten, Norway
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Anne Marit Lyberg
- Faculty of Health and Social Sciences, University of South-Eastern Norway, Horten, Norway
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Tournier I, Orton L, Dening T, Ahmed A, Holthoff-Detto V, Niedderer K. An Investigation of the Wishes, Needs, Opportunities and Challenges of Accessing Meaningful Activities for People Living with Mild to Moderate Dementia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5358. [PMID: 37047971 PMCID: PMC10093974 DOI: 10.3390/ijerph20075358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 03/13/2023] [Accepted: 03/27/2023] [Indexed: 06/19/2023]
Abstract
Many people are keen to be actively involved in social life and activities, but even at an early stage, dementia can have a negative impact on social participation and access to leisure activities. As part of the IDoService project, this study has investigated people's needs and wishes, barriers and facilitators to identify opportunities for improving access to meaningful activities. Individual and focus group interviews were conducted with 5 people living with mild to moderate dementia, 2 familial and 2 professional care partners, as well as 12 people working in the field of dementia and/or community activities. Thematic analysis has highlighted the benefits of participating in meaningful activities, such as empowerment and pride, social contacts, and feeling useful to others. A number of barriers to participation relating to individual and environmental factors were reported. Even where participants praised dementia-friendly activities and facilities, they advocated activities inclusive for all and mentioned that some people might be reluctant to participate in dementia-labelled activities because they may not be suitable for their needs. These results indicate the need for developing tailored opportunities for people with mild to moderate dementia and provide valuable insights for researchers, service providers, policymakers and charities wanting to improve access.
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Affiliation(s)
- Isabelle Tournier
- Department of Design, Manchester School of Art, Manchester Metropolitan University, Manchester M15 6BR, UK
- Department of Psychology, Laboratoire Cliniques Pathologique et Interculturelle, Université Toulouse 2 Jean Jaurès, 31058 Toulouse, France
| | - Laura Orton
- Department of Design, Manchester School of Art, Manchester Metropolitan University, Manchester M15 6BR, UK
| | - Tom Dening
- Mental Health & Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK
| | - Anya Ahmed
- Department of Social Care and Social Work, Manchester Metropolitan University, Manchester M15 6GX, UK
| | - Vjera Holthoff-Detto
- Alexianer Krankenhaus Hedwigshöhe, 12526 Berlin, Germany
- Department of Psychiatry and Psychotherapy, Faculty of Medicine Carl Gustav Carus, University of Technology Dresden, 01307 Dresden, Germany
| | - Kristina Niedderer
- Department of Design, Manchester School of Art, Manchester Metropolitan University, Manchester M15 6BR, UK
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Thijssen M, Graff MJL, Lexis MAS, Nijhuis-van der Sanden MWG, Radford K, Logan PA, Daniels R, Kuijer-Siebelink W. Collaboration for Developing and Sustaining Community Dementia-Friendly Initiatives: A Realist Evaluation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4006. [PMID: 36901017 PMCID: PMC10001691 DOI: 10.3390/ijerph20054006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/18/2023] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Dementia-friendly communities (DFCs) are seen as key to the inclusion and participation of people with dementia and carers. Dementia-friendly initiatives (DFIs) are important building blocks for the growth of DFCs. The collaboration between different stakeholders is a central aspect in developing and sustaining DFIs. AIM This study tests and refines an initial theory about collaborating for DFIs with special attention for the involvement of people with dementia and their carers during the collaboration for DFIs. The realist approach is used for deepening contextual aspects, mechanisms, outcomes, and its explanatory power. METHODS A participatory case study design using qualitative data (focus groups, observations, reflections, minutes from meetings, and exit interviews) was executed in four Dutch municipalities that have ambitions to become dementia- friendly communities. RESULTS The refined theory on the collaboration for DFIs incorporates contextual aspects such as diversity, shared insights, and clarity. It draws attention to the importance of mechanisms such as the recognition of efforts and progress, informal distributed leadership, interdependency, belonging, significance, and commitment. These mechanisms resonate with feeling useful and feeling collectively powerful in the collaboration. The outcomes of collaboration were activation, getting new ideas, and fun. Our findings address how stakeholders' routines and perspectives impact the involvement of people with dementia and their carers during collaboration. CONCLUSION This study provides detailed information about collaboration for DFIs. The collaboration for DFIs is largely influenced by feeling useful and collectively powerful. Further research is needed to understand how these mechanisms can be triggered with the involvement of people with dementia and their carers in the heart of the collaboration.
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Affiliation(s)
- Marjolein Thijssen
- Radboud University Medical Center, Radboudumc Research Institute, Scientific Center for Quality of Healthcare (IQ Healthcare), 6525 GA Nijmegen, The Netherlands
- Radboud Alzheimer Center, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
- Department Occupational Therapy, School of Allied Health, HAN University of Applied Sciences, 6525 EN Nijmegen, The Netherlands
| | - Maud J. L. Graff
- Radboud University Medical Center, Radboudumc Research Institute, Scientific Center for Quality of Healthcare (IQ Healthcare), 6525 GA Nijmegen, The Netherlands
- Radboud Alzheimer Center, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Monique A. S. Lexis
- Research Centre Assistive Technology in Care, Zuyd University of Applied Sciences, 6419 DJ Heerlen, The Netherlands
| | - Maria W. G. Nijhuis-van der Sanden
- Radboud University Medical Center, Radboudumc Research Institute, Scientific Center for Quality of Healthcare (IQ Healthcare), 6525 GA Nijmegen, The Netherlands
| | - Kate Radford
- Centre for Rehabilitation and Ageing Research, School of Medicine, University of Nottingham, Nottingham NG7 2TU, UK
| | - Pip A. Logan
- Centre for Rehabilitation and Ageing Research, School of Medicine, University of Nottingham, Nottingham NG7 2TU, UK
- Nottingham City Care Partnership, Nottingham NG6 8WR, UK
| | - Ramon Daniels
- Research Centre Assistive Technology in Care, Zuyd University of Applied Sciences, 6419 DJ Heerlen, The Netherlands
| | - Wietske Kuijer-Siebelink
- School of Education, HAN University of Applied Sciences, 6525 EN Nijmegen, The Netherlands
- Radboudumc Health Academy, Research on Learning and Education, Radboud University MEDICAL Center, 6525 GA Nijmegen, The Netherlands
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Thijssen M, Kuijer-Siebelink W, Lexis MA, Nijhuis-van der Sanden MWG, Daniels R, Graff M. What matters in development and sustainment of community dementia friendly initiatives and why? A realist multiple case study. BMC Public Health 2023; 23:296. [PMID: 36759811 PMCID: PMC9909928 DOI: 10.1186/s12889-023-15125-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 01/24/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Dementia friendly communities (DFCs) are seen as key to participation of people with dementia and carers. Dementia-friendly initiatives (DFI) are important building blocks for the growth of DFCs. Therefore, it is essential to understand how DFIs are developed and sustained to secure the growth of DFCs. This study identifies contextual factors and mechanisms that influence the development and sustainment of Dutch DFIs. It also explains how these contextual factors and mechanisms are interrelated and the outcomes to which they lead. METHODS Mixed methods, namely interviews, observations, documentation and focus groups, were used for this realist multiple case study. Participants were professionals (n = 46), volunteers (n = 20), people with dementia (n = 1) and carers (n = 2) who were involved in development and sustainment of DFIs in four Dutch DFCs. RESULTS This study revealed three middle-range program theories as final outcomes: development of a support base, collaboration, and participation in DFIs by people with dementia and carers. These theories address institutional, organisational, interpersonal and individual levels in the community that are essential in development and sustainment of DFIs. CONCLUSIONS The development and sustainment of DFIs requires the development of a support base, collaboration, and participation in DFIs by people with dementia and their carers.
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Affiliation(s)
- Marjolein Thijssen
- Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare (IQ healthcare), Nijmegen, The Netherlands. .,Radboud University Medical Center, Radboud Alzheimer Center, Nijmegen, The Netherlands.
| | - Wietske Kuijer-Siebelink
- grid.450078.e0000 0000 8809 2093HAN University of Applied Sciences, School of Education, Nijmegen, The Netherlands ,grid.10417.330000 0004 0444 9382Radboud University Medical Center, Radboudumc Health Academy, Research on Learning and Education, Nijmegen, the Netherlands
| | - Monique A.S. Lexis
- grid.413098.70000 0004 0429 9708Zuyd University of Applied Sciences, Research Centre Assistive Technology in Care, Heerlen, the Netherlands
| | - Maria W. G. Nijhuis-van der Sanden
- grid.10417.330000 0004 0444 9382Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare (IQ healthcare), Nijmegen, The Netherlands
| | - Ramon Daniels
- grid.413098.70000 0004 0429 9708Zuyd University of Applied Sciences, Research Centre Assistive Technology in Care, Heerlen, the Netherlands
| | - Maud Graff
- grid.10417.330000 0004 0444 9382Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare (IQ healthcare), Nijmegen, The Netherlands ,grid.10417.330000 0004 0444 9382Radboud University Medical Center, Radboud Alzheimer Center, Nijmegen, The Netherlands
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Older adults' adaptations to life events: a mobility perspective. AGEING & SOCIETY 2022. [DOI: 10.1017/s0144686x22001283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Abstract
Mobility research tends to focus on physical movement and experiences in later life; however, changes in older adult mobility over time remains underexplored. Furthermore, older adults typically experience many life events, some of which result from cognitive and physical decline, and many of which impact mobility. This article aims to explore how life events affect the mobility of older adults over time. We conducted in-depth interviews with 22 older adults aged 55 years and over from Lancashire, United Kingdom. Of these participants, eight lived with memory problems. The findings show that both anticipated and unexpected life events play a profound role in the participants' mobility over time. Retirement, long-term illness and age-related illness were examples of anticipated life events, while the death of a loved one and developing memory problems were examples of unexpected life events. In both cases, participants' made external adaptations, such as moving home, or internal adaptations, such as self-awareness. The findings also emphasise the layered nature of life events and adaptations playing a role in the participants' mobility. Additionally, life events such as developing memory problems showed a domino effect, triggering further life events and adaptations which impacted the participants' mobility. This article emphasises how transition periods can occur before or after a life event, showing that adaptations can be pre-emptive to a life event. Our article contributes to calls for internal adaptations to be fully incorporated into age-related policy and also for age-related policy to be more inclusive for older adults who experience memory problems and dementia.
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Chadwick C, Hussain A, Carone L, Yates J, Dening T. Going for gold: Sports and exercise groups for people with dementia and carers contribute to their well-being. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:953822. [DOI: 10.3389/fresc.2022.953822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/15/2022] [Indexed: 11/11/2022]
Abstract
BackgroundInterventions involving exercise appear to have positive effects, both for people with dementia and for their carers. Quality of life and well-being are especially important outcomes. This study investigated how a sports and exercise group for people with dementia and their carers could contribute to the well-being of those attending the group.MethodsThe study was a qualitative investigation, comprising semi-structured interviews, a focus group and observations. Participants included people with dementia and carers attending the group sessions, as well as staff providing the programme. The group sessions were provided weekly by the charitable trust of a leading sports venue. Data were analysed using thematic analysis.ResultsA total of 16 participants were interviewed, including four people with dementia, eight carers, and four members of staff. Five main themes were identified: “Support to keep active and engaged is highly valued by people with dementia and carers”; “The challenges of being a carer are significant but sharing the experience really helps”; “People with dementia can have flourishing social lives”; “The group helps to maintain identity despite physical and role changes”; and “There are practical aspects of the group that make it appealing”.DiscussionPeople with dementia enjoy physical activity and experience the benefits of it. The sports and exercise group had an important role in providing access to activities that people with dementia and their carers value and enjoy, but would be difficult to undertake without a facilitated and safe environment. The group benefited the well-being of both people with dementia and carers in various ways, with peer support being of particular importance for carers.
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Liu HY, Huang HL, Chiu YC, Tang LY, Hsu JL, Wu SM, Lin YH, Lin HY, Su IC, Shyu YIL. Perceptions of community dementia friendliness: A cross-sectional study of people with dementia, family caregivers, service providers, and the general public in Taiwan. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:1578-1588. [PMID: 34254381 DOI: 10.1111/hsc.13490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 05/27/2021] [Accepted: 06/16/2021] [Indexed: 06/13/2023]
Abstract
Promoting dementia-friendly communities is an important strategy for improving quality of life for people with dementia and dementia-family caregivers. The process of building dementia-friendly communities should include all people living in the community. The objective of this study was to compare perceived dementia friendliness in the community among people with dementia, family caregivers, service providers, and the general public. In Taiwan, we surveyed 60 people with dementia, 140 family caregivers, and 200 members of the general public face to face, with 200 service providers surveyed by mail. Participants completed the Perceived Community Dementia Friendliness measure, consisting of seven subscales: care services, community members, community environment, community interactions, transportation, hospitals, and stores and organisations. This measure has acceptable convergent validity, construct validity, and internal consistency reliability for use in Taiwan. Differences in perceived dementia friendliness were examined by chi-square tests/analysis of variance. Among the seven subscales, hospitals were rated with good dementia friendliness by 70% of people with dementia (n = 42); however, care services were rated poor by 23.3% of people with dementia (n = 14). Hospitals were also rated with good dementia friendliness by 39.2% of family caregivers (n = 54). Care services were rated as having good dementia friendliness by 43.5% of service providers (n = 87) and 47% of the general public (n = 86). Furthermore, community interactions were rated as good by small percentages of family caregivers (11.4%, n = 16), service providers (22.2%, n = 44), and the general public (30.9%, n = 58). Family caregivers, service providers, and the general public rated hospitals with the highest mean dementia-friendliness score and community interactions with the lowest. Perceived community-dementia friendliness among participants with dementia differed from that of participants without. People with dementia prioritised improving care services, while people without dementia rated facilitating community interactions as more vital. These differences provide vital insights into understanding the policies and administration of dementia-friendly communities.
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Affiliation(s)
- Hsin-Yun Liu
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan (ROC)
| | - Hsiu-Li Huang
- Department of Long-Term Care, College of Health Technology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan (ROC)
| | - Yi-Chen Chiu
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan (ROC)
| | - Li-Yu Tang
- Taiwan Alzheimer's Disease Association, Taipei, Taiwan (ROC)
| | - Jung-Lung Hsu
- Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan (ROC)
- College of Medicine, Chang Gung University, Taoyuan, Taiwan (ROC)
- Graduate Institute of Humanities in Medicine and Research Center for Brain and Consciousness, Taipei Medical University, New Taipei City, Taiwan (ROC)
| | - Suh-Mian Wu
- Department of Nursing, Yuanpei University of Medical Technology, Hsinchu, Taiwan (ROC)
| | - Yi-Hui Lin
- Department of Nursing, Far Eastern Memorial Hospital, New Taipei City, Taiwan (ROC)
| | - Hsin-Yi Lin
- Department of Nursing, Far Eastern Memorial Hospital, New Taipei City, Taiwan (ROC)
| | - I-Ching Su
- Department of Pediatrics, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan (ROC)
| | - Yea-Ing L Shyu
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan (ROC)
- Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan (ROC)
- Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (ROC)
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12
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Tsuda S, Inagaki H, Okamura T, Sugiyama M, Ogawa M, Miyamae F, Edahiro A, Ura C, Sakuma N, Awata S. Promoting cultural change towards dementia friendly communities: a multi-level intervention in Japan. BMC Geriatr 2022; 22:360. [PMID: 35461211 PMCID: PMC9034585 DOI: 10.1186/s12877-022-03030-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 03/28/2022] [Indexed: 11/13/2022] Open
Abstract
Background Effective strategies to develop dementia-friendly communities (DFCs) are needed in aging societies. We aimed to propose a strategy to develop DFCs from a Japanese perspective and to evaluate an intervention program that adopted the strategy. Methods This study implemented a multi-level intervention that emphasized nurturing community social capital in a large apartment complex in the Tokyo metropolitan area in 2017. We offered an inclusive café that was open for extended hours as a place to socialize and a center for activities that included monthly public lectures. Individual consultation on daily life issues was also available for free at the café. Postal surveys were sent out to all older residents aged 70 years and older in 2016 and 2019. With a one-group pre-test and post-test design, we assessed changes in the proportion of older residents who had social interaction with friends and those who were confident about living in the community, even if they were living with dementia. Results Totals of 2633 and 2696 residents completed the pre and post-intervention surveys, respectively. The mean age of the pre-intervention respondents was 77.4 years; 45.7% lived alone and 7.7% reported living with impaired cognitive function. The proportion of men who had regular social interaction and were confident about living in their community with dementia increased significantly from 38.8 to 44.5% (p = 0.0080) and from 34.1 to 38.3% (p = 0.045), respectively. Similar significant increases were observed in the subgroup of men living with impaired cognitive function, but not in the same subgroup for women. Conclusions The intervention benefitted male residents who were less likely to be involved in the community’s web of social networks at baseline. A strategy to create DFCs that emphasizes nurturing community social capital can form a foundation for DFCs. Trial registration This study was retrospectively registered in the University hospital Medical Information Network (UMIN) Clinical Trial Registry (registry number: UMIN000038193, date of registration: Oct 3, 2019).
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Affiliation(s)
- Shuji Tsuda
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-Cho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Hiroki Inagaki
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-Cho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Tsuyoshi Okamura
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-Cho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Mika Sugiyama
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-Cho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Madoka Ogawa
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-Cho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Fumiko Miyamae
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-Cho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Ayako Edahiro
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-Cho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Chiaki Ura
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-Cho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Naoko Sakuma
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-Cho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Shuichi Awata
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-Cho, Itabashi-ku, Tokyo, 173-0015, Japan.
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Matsumoto H, Igarashi A, Hagiwara Y, Yamamoto-Mitani N. Relational Design for Dementia and Job Significance (ReDeSign): Study protocol for a randomized controlled trial of an online dementia training for retail workers. Contemp Clin Trials Commun 2022; 26:100896. [PMID: 35112011 PMCID: PMC8789593 DOI: 10.1016/j.conctc.2022.100896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 01/03/2022] [Accepted: 01/18/2022] [Indexed: 11/05/2022] Open
Abstract
Background The need for dementia training for retail workers has been recognized by dementia-friendly initiatives. However, evidence for dementia training in non-healthcare workplaces is lacking, and dissemination is challenging due to constraints on private companies' time and finances. The online training program ReDeSign (Relational Design for Dementia and Job Significance) applies mobile micro-learning methods and Relational Design Theory against time and financial constraints, respectively, and is designed to improve work-related outcomes. Methods This study will evaluate the effectiveness of ReDeSign with a randomized controlled trial. One hundred and twenty-four convenience store workers in Tokyo will be recruited and randomly assigned to the intervention or control groups. ReDeSign consists of four contents relevant to the job: simulation games, lectures and quizzes, virtual contacts, and information about benefits to others. Self-reported surveys will be conducted for individual workers at baseline, one month later, and three months later. ReDeSign will be delivered to workers in the intervention (n = 62) and control (n = 62) groups immediately after the baseline survey and after the one-month survey, respectively. The primary outcome is the change of attitude toward people with dementia, and the secondary outcomes are dementia knowledge, helping behavior, job satisfaction, workers’ intention to stay, and persistence. Discussion ReDeSign provides dementia training to convenience store workers and contributes to developing an inclusive community for people with dementia. The results of this study may provide a new strategy for the dissemination of dementia training in non-healthcare workplaces.
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Thijssen M, Daniels R, Lexis M, Jansens R, Peeters J, Chadborn N, Nijhuis‐van der Sanden MWG, Kuijer‐Siebelink W, Graff M. How do community based dementia friendly initiatives work for people with dementia and their caregivers, and why? A rapid realist review. Int J Geriatr Psychiatry 2022; 37:10.1002/gps.5662. [PMID: 34825742 PMCID: PMC9299867 DOI: 10.1002/gps.5662] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 11/18/2021] [Indexed: 01/02/2023]
Abstract
OBJECTIVES To describe and explain the outcomes of community dementia friendly initiatives (DFIs) for people with dementia and their caregivers to inform the development and tailoring of DFIs. METHODS Literature searches on DFIs were performed through two systematic online database searches of PubMed, Embase, ASSIA, CINAHL and Google scholar. Papers were only included if they evaluated outcomes using empirical data from people with dementia or caregivers. Data collection and analysis were guided by the categorization in the DEM-FACT taxonomy and RAMESES guidelines for realist reviews. RESULTS Of 7154 records identified, 22 papers were included with qualitative, mixed method and quantitative study designs. The synthesis led to a description of programme theories addressing caring, stimulating and activating communities. Outcomes for people with dementia and caregivers included having contact with others, enjoyment and decrease of stress and, lastly, support. This synthesis also indicated how people with dementia participated in a specific role in DFIs, such as patient, team member or active citizen. CONCLUSIONS DFIs generate different outcomes for people with dementia and caregivers, depending on the kind of initiative and the specific role for people with dementia. These findings could be a catalyst for initiation and further development of DFIs in a dementia friendly community (DFC). This draws attention to the multiple aspects of DFCs and supports reflection on their essential principles.
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Affiliation(s)
- Marjolein Thijssen
- Radboud Institute for Health SciencesScientific Center for Quality of Healthcare (IQ Healthcare), Radboud University Mmedical CenterNijmegenThe Netherlands,Radboud Alzheimer CenterRadboud University Medical CenterNijmegenThe Netherlands
| | - Ramon Daniels
- Academy of Occupational TherapyResearch Centre Assistive Technology in CareZuyd University of Applied SciencesHeerlenThe Netherlands
| | - Monique Lexis
- Academy of Occupational TherapyResearch Centre Assistive Technology in CareZuyd University of Applied SciencesHeerlenThe Netherlands
| | - Rianne Jansens
- Academy of Occupational TherapyResearch Centre Assistive Technology in CareZuyd University of Applied SciencesHeerlenThe Netherlands,Department of Occupational Science & Occupational TherapyUniversity College CorkCorkIreland,Department of Health, Education and TechnologyUniversity of TechnologyLuleåSweden
| | - José Peeters
- Radboud Institute for Health SciencesScientific Center for Quality of Healthcare (IQ Healthcare), Radboud University Mmedical CenterNijmegenThe Netherlands,Faculty of Health and Social StudiesHAN University of Applied SciencesNijmegenThe Netherlands
| | - Neil Chadborn
- School of MedicineUniversity of NottinghamNottinghamUK
| | - Maria W. G. Nijhuis‐van der Sanden
- Radboud Institute for Health SciencesScientific Center for Quality of Healthcare (IQ Healthcare), Radboud University Mmedical CenterNijmegenThe Netherlands
| | - Wietske Kuijer‐Siebelink
- Research Department of Public AffairsHAN University of Applied SciencesNijmegenThe Netherlands,Faculty of HealthHAN University of Applied SciencesNijmegenThe Netherlands
| | - Maud Graff
- Radboud Institute for Health SciencesScientific Center for Quality of Healthcare (IQ Healthcare), Radboud University Mmedical CenterNijmegenThe Netherlands,Radboud Alzheimer CenterRadboud University Medical CenterNijmegenThe Netherlands
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15
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Dementia-friendliness - A matter of knowledge, responsibility, dignity, and illusion. J Aging Stud 2021; 59:100970. [PMID: 34794715 DOI: 10.1016/j.jaging.2021.100970] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 09/07/2021] [Accepted: 09/09/2021] [Indexed: 11/24/2022]
Abstract
Worldwide, dementia-friendly initiatives are being developed primarily based on and driven by political strategies. Health professionals, local government officials, and initiators alike are working to create dementia-friendly communities, but little is known about how professionals discursively construct dementia-friendliness and how their various interpretations affect current practices in the field. This study aimed to explore how those involved in establishing dementia-friendly initiatives, nursing homes, and dementia villages ascribe meaning to and construct dementia-friendliness. Three focus groups were conducted, including two with five health professionals each from two nursing homes for people with dementia and one with seven initiators involved in the development and establishment of nursing homes and dementia villages. We further conducted a small-group interview with a consultant and a project worker representing a local authority. Seeing dementia-friendliness as a discursive construction, we conducted a critical discourse analysis, taking inspiration from the work of Norman Fairclough. The surveyed professionals reported relying on knowledge, responsibility, dignity, and illusion discourses to construct dementia-friendliness. Our results also indicated that the construct of dementia-friendliness fosters discursive battles indicated by dilemmas concerning the adequate and dignified treatment of people with dementia and health professionals' critical stances toward the construct of dementia-friendliness.
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Quinn C, Hart N, Henderson C, Litherland R, Pickett J, Clare L. Developing supportive local communities: Perspectives from people with dementia and caregivers participating in the IDEAL programme. J Aging Soc Policy 2021; 34:839-859. [PMID: 34629015 DOI: 10.1080/08959420.2021.1973341] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Communities play an important role in supporting people living with dementia. The aim of this study was to explore what could be changed in the local community to enable those with dementia to live well. People with dementia and carers taking part in the IDEAL programme responded to open-ended questions. Responses from 1,172 people with dementia and 702 caregivers were analyzed using thematic analysis. Four themes were identified: raising awareness, improving access to support services, providing social events and activities, and supporting people to engage in the community. These highlight the role of individuals, resources and the environment in supporting those with dementia. Longer-term investment in services is needed to underpin dementia-inclusive communities.
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Affiliation(s)
- Catherine Quinn
- Associate Professor, Centre for Applied Dementia Studies, Faculty of Health Studies, University of Bradford, Bradford, UK.,Wolfson Centre for Applied Health Research, Bradford, UK
| | | | - Catherine Henderson
- Assistant Professorial Research Fellow, Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | | | - James Pickett
- Hub Development Manager, Health Data Research, London, UK
| | - Linda Clare
- Professor of Clinical Psychology of Ageing and Dementia, REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter, Exeter, UK.,Dementia Theme Lead, NIHR Applied Research Collaboration, Exeter, South-West Peninsula
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17
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Hung L, Hudson A, Gregorio M, Jackson L, Mann J, Horne N, Berndt A, Wallsworth C, Wong L, Phinney A. Creating Dementia-Friendly Communities for Social Inclusion: A Scoping Review. Gerontol Geriatr Med 2021; 7:23337214211013596. [PMID: 34036118 PMCID: PMC8127744 DOI: 10.1177/23337214211013596] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/14/2021] [Accepted: 04/09/2021] [Indexed: 11/16/2022] Open
Abstract
Aims: This scoping review explores key strategies of creating inclusive dementia-friendly communities that support people with dementia and their informal caregiver. Background: Social exclusion is commonly reported by people with dementia. Dementia-friendly community has emerged as an idea with potential to contribute to cultivating social inclusion. Methods: This scoping review follows the Joanna Briggs Institute scoping review methodology and took place between April and September 2020. The review included a three-step search strategy: (1) identifying keywords from CINAHL and AgeLine; (2) conducting a second search using all identified keywords and index terms across selected databases (CINAHL, AgeLine, MEDLINE, PsycINFO, Web of Science, ProQuest, and Google); and (3) hand-searching the reference lists of all included articles and reports for additional studies. Results: Twenty-nine papers were included in the review. Content analysis identified strategies for creating dementia-friendly communities: (a) active involvement of people with dementia and caregivers (b) inclusive environmental design; (c) public education to reduce stigma and raise awareness; and (d) customized strategies informed by theory. Conclusion: This scoping review provides an overview of current evidence on strategies supporting dementia-friendly communities for social inclusion. Future efforts should apply implementation science theories to inform strategies for education, practice, policy and future research.
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Affiliation(s)
- Lillian Hung
- University of British Columbia, Vancouver, Canada
| | - Allison Hudson
- Resident Physician with the University of British Columbia Psychiatry Program, Vancouver, Canada
| | - Mario Gregorio
- Vancouver Coastal Health, Community Engagement Advisory Network, BC, Canada
| | - Lynn Jackson
- Vancouver Coastal Health, Community Engagement Advisory Network, BC, Canada
| | - Jim Mann
- Vancouver Coastal Health, Community Engagement Advisory Network, BC, Canada
| | - Neil Horne
- Vancouver Coastal Health, Community Engagement Advisory Network, BC, Canada
| | - Annette Berndt
- Vancouver Coastal Health, Community Engagement Advisory Network, BC, Canada
| | | | - Lily Wong
- Vancouver Coastal Health, Community Engagement Advisory Network, BC, Canada
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18
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Dementia-Friendly Neighborhood and the Built Environment: A Scoping Review. THE GERONTOLOGIST 2021; 62:e340-e356. [DOI: 10.1093/geront/gnab019] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and Objectives
There has been a proliferation of research on dementia-friendly communities in recent years, particularly on interpersonal and social aspects. Nonetheless, the neighborhood built environment remains a co-constituent of the lived experience of people living with dementia (PLWD) that is amenable to interventions for health and well-being in the community. This scoping review presents a narrative synthesis of empirical research on dementia-friendly neighborhoods, with a focus on the built environment and its associated sociobehavioral aspects. Planning and design principles are distilled to identify research and policy implications.
Research Design and Methods
We reviewed 29 articles identified through a systematic search of AgeLine, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Global Health, Medical Literature Analysis and Retrieval System Online, and Scopus. Peer-reviewed articles that employed quantitative and/or qualitative methods in community settings were included.
Results
An equal number of studies focused on behavioral/psychosocial aspects of the built environment and assessment of specific environmental features. The former often used qualitative methods, whereas statistical methods were common in studies on discrete features of the neighborhood built environment. Few studies focused on rural contexts. Emerging research areas include interactions between dementia risk factors and neighborhood environments to support primary and secondary prevention.
Discussion and Implications
The body of literature needs expansion into planning and design fields to foster community participation of PLWD by optimizing environmental stimuli, minimizing environmental barriers, and engaging PLWD in dementia-friendly community initiatives. While evidence has accumulated on landmarks and social participation at the individual level, research at the community and policy levels is limited. This requires advanced mixed methods.
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19
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Wayfinding in People with Alzheimer’s Disease: Perspective Taking and Architectural Cognition—A Vision Paper on Future Dementia Care Research Opportunities. SUSTAINABILITY 2021. [DOI: 10.3390/su13031084] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Based on a targeted literature review, this vision paper emphasizes the importance of dementia-sensitive built space. The article specifically focuses on supporting spatial orientation and wayfinding for people living with dementia. First, we discuss types of wayfinding challenges, underlying processes, and consequences of spatial disorientation in the context of dementia of the Alzheimer’s type. Second, we focus on current efforts aimed at planning and evaluating dementia-sensitive built space, i.e., environmental design principles, interventions, evaluation tools, strategies, and planning processes. Third, we use our findings as a starting point for developing an interdisciplinary research vision aimed at encouraging further debates and research about: (1) the perspective of a person with dementia, specifically in the context of wayfinding and spatial orientation, and (2) how this perspective supplements planning and design processes of dementia-sensitive built space. We conclude that more closely considering the perspective of people with dementia supports the development of demographically sustainable future cities and care institutions.
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Mitchell G, McTurk V, Carter G, Brown-Wilson C. Emphasise capability, not disability: exploring public perceptions, facilitators and barriers to living well with dementia in Northern Ireland. BMC Geriatr 2020; 20:525. [PMID: 33272207 PMCID: PMC7713159 DOI: 10.1186/s12877-020-01933-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 11/26/2020] [Indexed: 11/21/2022] Open
Abstract
Background Improving public knowledge and understanding about dementia has been identified as a priority area by people living with the condition, researchers, educators, and policymakers for several years. Societies that have a better understanding of the condition are more likely to enable people living with dementia to enjoy a better quality of life. The aim of this study was to explore current public perceptions of dementia along with the facilitators and barriers to living well from the perspective of people living with the condition in Northern Ireland. Methods Four focus group interviews were conducted with a total of 20 people living with dementia across three Northern Irish Counties in June 2019. These interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis. Ethical approval was obtained for this study prior to data collection. Findings Following thematic analysis, three themes emerged in relation to barriers and facilitators to living well with dementia. These were: ‘Emphasis on Disability NOT Capability’, which highlighted societal misconceptions about the activities and modes of life which people with dementia could or could not do; ‘Normalise Dementia – We Don’t Want a Fool’s Pardon’, which focused on how the public could encourage people living with the condition to enjoy greater independence, and ‘Dementia isn’t a Death Sentence’, which considered how professionals, family members and friends treated the person after diagnosis. Conclusions Public perceptions about dementia have the potential to act as both facilitators and barriers to living well with dementia. People with dementia stated that they are more likely sustain wellbeing when they are valued and can maintain independence. On the contrary, poor public and professional attitudes to dementia had the potential to disempower people living with dementia.
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Affiliation(s)
- Gary Mitchell
- School of Nursing and Midwifery, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, County Antrim, Northern Ireland, BT9 7BL.
| | - Victoria McTurk
- School of Nursing and Midwifery, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, County Antrim, Northern Ireland, BT9 7BL
| | - Gillian Carter
- School of Nursing and Midwifery, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, County Antrim, Northern Ireland, BT9 7BL
| | - Christine Brown-Wilson
- School of Nursing and Midwifery, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, County Antrim, Northern Ireland, BT9 7BL
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Sturge J, Nordin S, Sussana Patil D, Jones A, Légaré F, Elf M, Meijering L. Features of the social and built environment that contribute to the well-being of people with dementia who live at home: A scoping review. Health Place 2020; 67:102483. [PMID: 33254054 DOI: 10.1016/j.healthplace.2020.102483] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 11/11/2020] [Accepted: 11/12/2020] [Indexed: 10/22/2022]
Abstract
This scoping review summarizes findings from 23 qualitative articles on how social and built environments contribute to the well-being of people with dementia who live at home. Through thematic analysis, two themes were identified: i) connection to society and supportive relationships and ii) interaction with natural environments and public space. Features of the social and built environment contribute to well-being both positively and negatively. Future research should explore how these features intersect in an urban-rural context as a basis to inform the development of dementia-friendly initiatives. Moreover, involving people with dementia in the design of features of built environments, such as infrastructure, will result in more inclusive communities.
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Affiliation(s)
- Jodi Sturge
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Netherlands.
| | - Susanna Nordin
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
| | - Divya Sussana Patil
- Transdisciplinary Centre for Qualitative Methods, Department of Health Information, Prasanna School of Public Health (PSPH), Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Allyson Jones
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - France Légaré
- Centre De Recherche Sur Les soins et Les Services de Première Ligne de S'Université Laval (CERSSPL-UL), Department of Family Medicine and Emergency Medicine, Université Laval, Canada
| | - Marie Elf
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
| | - Louise Meijering
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Netherlands
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Novak LS, Horne E, Brackett JR, Meyer K, Ajtai RM. Dementia-Friendly Communities: a Review of Current Literature and Reflections on Implementation. CURRENT GERIATRICS REPORTS 2020. [DOI: 10.1007/s13670-020-00325-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Abstract
PURPOSE OF REVIEW To identify recent advances in the field of dementia care in high-income countries. RECENT FINDINGS New national and international initiatives identified support the notion of an increased commitment to face the challenge of dementia care. Recent research has documented barriers and facilitators to provide good care, and provided data on the specific needs of caregivers; the needs for better training of general practitioners; the negative influence of behavioural and psychological symptoms of dementia (BPSD); the palliative care needs; and the increased risk of dementia associated with anxiety (the population-attributable fraction of Alzheimer's risk was 6.1%). Significant advances in new technologies applicable in the care of dementia have also been reported. SUMMARY The increased awareness of the needs in dementia care is promising, although the Organisation for Economic Co-operation and Development has alerted about the limited implementation of the programmes. Barriers and facilitators identified have implications for both clinical practice and research. Particular implications for psychiatric action have the findings on BPSDs and on the preventive potential of the treatment of anxiety detected in the community. The data on palliative care needs and particularly on the advances of new technologies also have clinical implications.
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Abstract
PURPOSE OF REVIEW As awareness of dementia increases, internationally derived knowledge and information about dementia care and practice can be helpful to improve the care of people with dementia and their families. It can serve as a stimulus to develop new ideas for the provision of such care. RECENT FINDINGS An international survey of 47 countries has shown a high degree of national interest and commitment to dementia treatment and care. In each, a local dementia expert provided a bespoke narrative about the care and treatment of people with dementia, a review of national policies and a glimpse as to what the future holds. The detailed results have been published in book form and are summarized here. SUMMARY The majority of countries have made national attempts to estimate the number of people with dementia, have licenced antidementia drugs and have the support of a national Alzheimer's association with a website containing independent advice. More than half have a national plan targeted at the development of care and in a further quarter, the development of such plans is in progress. There appears to have been a great increase in interest and awareness of dementia in the last few years.
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25
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Shannon K, Bail K, Neville S. Dementia‐friendly community initiatives: An integrative review. J Clin Nurs 2019; 28:2035-2045. [DOI: 10.1111/jocn.14746] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 10/22/2018] [Accepted: 11/30/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Kay Shannon
- Department of NursingAUT University Auckland New Zealand
| | - Kasia Bail
- University of Canberra Canberra Australian Capital Territory Australia
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Abstract
The importance of better care integration is emphasized in many national dementia plans. The inherent complexity of organizing care for people with dementia provides both the justification for improving care integration and the challenges to achieving it. The prevention, detection, and early diagnosis of cognitive disorders mainly resides in primary care, but how this is best integrated within the range of disorders that primary care clinicians are expected to screen is unclear. Models of integrated community dementia assessment and management have varying degrees of involvement of primary and specialist care, but share an emphasis on improving care coordination, interdisciplinary teamwork, and personalized care. Integrated care strategies in acute care are still in early development, but have been a focus of investigation in the past decade. Integrated care outreach strategies to reduce transfers from long-term residential care to acute care have been consistently effective. Integrated long-term residential care includes considerations of end-of-life care. Future directions should include strategies for training and education, early detection in anticipation of disease modifying treatments, integration of technological developments into dementia care, integration of dementia care into general health and social care, and the encouragement of a dementia-friendly society.
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Affiliation(s)
- Brian Draper
- a School of Psychiatry , University of NSW , Sydney , NSW , Australia
| | - Lee-Fay Low
- b Faculty of Health Sciences , University of Sydney , Sydney , NSW , Australia
| | - Henry Brodaty
- c Centre for Healthy Brain Ageing , University of NSW Sydney , Sydney , NSW , Australia
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Hobden T, Swallow M, Beer C, Dening T. Swimming for dementia: An exploratory qualitative study: Innovative practice. DEMENTIA 2018; 18:776-784. [DOI: 10.1177/1471301218768372] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Swimming is a non-weight bearing form of exercise that can be enjoyable and promote physical fitness. This qualitative study investigated a local group established as part of a national dementia swimming initiative. Semi-structured interviews with people with dementia (N = 4), carers or companions (N = 4) and the organisers and facilitators of the group (N = 6) were analysed using thematic analysis. This revealed four main themes: (1) the pleasure of swimming and its benefits as a form of exercise and for building confidence and empowering participants, (2) the importance of insight and empathy in creating a safe and secure experience, (3) the impact of dementia and (4) how participants valued being part of a group ‘all in the same boat’. ‘Dementia friendly swimming’ appears to be a valuable form of exercise, but it requires considerable preparation and support to make it happen.
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Affiliation(s)
- Tanya Hobden
- Division of Psychiatry & Applied Psychology, University of Nottingham, UK
| | - Mary Swallow
- Division of Psychiatry & Applied Psychology, University of Nottingham, UK
| | - Charlotte Beer
- Division of Psychiatry & Applied Psychology, University of Nottingham, UK
| | - Tom Dening
- Division of Psychiatry & Applied Psychology, University of Nottingham, UK
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Abstract
Background Dementia friendly initiatives share similarities with the age-friendly movement in a focus on active engagement and creating a good quality of life for older adults. Dementia friendly initiatives offer a welcoming optimistic narrative in dementia studies by embracing dignity, empowerment, and autonomy to enable well-being throughout the dementia trajectory. Purpose The purpose of this review is to explore the current science of dementia friendly initiatives, identify gaps, and inform future research. Method Quantitative, qualitative, and conceptual/theoretical peer-reviewed dementia friendly research literature were evaluated for their current evidence base and theoretical underpinnings. Results The dementia friendly initiatives research base is primarily qualitative and descriptive focused on environmental design, dementia awareness and education, and the development of dementia friendly communities. Person-centered care principles appear in dementia friendly initiatives centered in care settings. Strong interdisciplinary collaboration is present. Research is needed to determine the effect of dementia friendly initiatives on stakeholder-driven and community-based outcomes. Due to the contextual nature of dementia, the perspective of persons with dementia should be included as dementia friendly initiatives are implemented. Theory-based studies are needed to confirm dementia friendly initiative components and support rigorous evaluation. Dementia friendly initiatives broaden the lens from which dementia is viewed.
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Affiliation(s)
| | - Kezia Scales
- PHI (Paraprofessional Healthcare Institute), Bronx, NY, USA
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29
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Abstract
PURPOSE OF REVIEW This review discusses the concept of 'dementia-friendly communities' and summarizes the latest research and practice around such communities. This review also highlights important topic areas to be considered to promote dementia friendliness in healthcare settings. RECENT FINDINGS Definitions of 'dementia-friendly communities' reflect the contemporary thinking of living with dementia (e.g., dementia as a disability, equal human rights, a sense of meaning). Existing research has covered a wide range of topic areas relevant to 'dementia-friendly communities'. However, these studies remain qualitative and exploratory by nature and do not evaluate how dementia-friendly communities impact health and quality of life of people living with dementia and their caregivers. In healthcare settings, being dementia friendly can mean the inclusion of people with dementia in treatment discussion and decision-making, as well as the provision of first, adequate and appropriate service to people with dementia at an equivalent standard of any patient, second, person-centered care, and third, a physical environment following dementia-friendly design guidelines. SUMMARY Research incorporating more robust study designs to evaluate dementia-friendly communities is needed. Being dementia-friendly in healthcare settings requires improvement in multiple areas - some may be achieved by environmental modifications while others may be improved by staff education.
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Sims J. Partnering to promote healthy ageing. Australas J Ageing 2016; 35:155. [PMID: 27605466 DOI: 10.1111/ajag.12350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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