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Craig S, Halloran PO, Mitchell G, Stark P, Wilson CB. Dementia Friendly communities (DFCs) to improve quality of life for people with dementia: a realist review. BMC Geriatr 2024; 24:776. [PMID: 39304830 DOI: 10.1186/s12877-024-05343-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 08/29/2024] [Indexed: 09/22/2024] Open
Abstract
BACKGROUND Currently, there are more than 55 million people living with dementia worldwide. Supporting people with dementia to live as independently as possible in their communities is a global public health objective. There is limited research exploring the implementation of such interventions in the community context. The aim of the review was to create and refine programme theory - in the form of context mechanism-outcome configurations - on how the characteristics of dementia-friendly communities (DFCs) as geographical locations interact with their social and organisational contexts to understand what works for whom and why. METHODS This realist review sourced literature from 5 electronic databases: Cochrane Library, CINAHL, Medline, Scopus, PsychINFO and Google Scholar, as well as relevant websites such as Alzheimer's Society to identify grey literature. Methodological rigour was assessed using the Joanna Briggs Institute critical appraisal tool. RESULTS Seven papers were included in this realist review that focused on DFCs in a geographical context The implementation of DFC interventions emerged as a process characterised by two pivotal implementation phases, intricately linked with sub-interventions. The first intervention, termed Hierarchy Commitment (I1a/b), involves the formalisation of agreements by businesses and organizations, along with the implementation of dementia-friendly action plans. Additionally, Educational Resources (I1c) play a significant role in this phase, engaging individuals with dementia and their caregivers in educational initiatives. The second phase, Geographical/Environmental Requirements (I2), encompasses the establishment of effective dementia-friendly signage, accessible meeting places, and community support. CONCLUSIONS This realist review highlighted a theoretical framework that might guide the development of dementia-friendly communities to enhance the experiences of individuals with dementia and their caregivers within DFCs. Emphasising the need for a theoretical framework in developing geographical DFCs, the review outlines contextual elements, mechanisms, and outcomes, providing a foundation for future studies. The ultimate goal is to establish a robust body of evidence for the sustainable implementation of dementia-friendly communities, thereby improving the quality of life for those with dementia. STUDY REGISTRATION This study is registered as PROSPERO 2022 CRD42022317784.
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Affiliation(s)
- Stephanie Craig
- 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
| | - Gary Mitchell
- 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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Desai S, Mutsuddi R, Astell AJ. Enhancing prompt perception in dementia: a comparative study of mixed reality cue modalities. Front Sports Act Living 2024; 6:1419263. [PMID: 39184033 PMCID: PMC11344262 DOI: 10.3389/fspor.2024.1419263] [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: 04/18/2024] [Accepted: 07/22/2024] [Indexed: 08/27/2024] Open
Abstract
Introduction Dementia impacts millions worldwide and is challenging individuals' ability to engage in daily activities. Active living is crucial in mitigating dementia's neurodegenerative effects, yet people with dementia often struggle to initiate and complete tasks independently. Technologies offer promising solutions to engage people with dementia in activities of active living and improving their quality of life through prompting and cueing. It is anticipated that developments in sensor and wearable technologies will result in mixed reality technology becoming more accessible in everyday homes, making them more deployable. The possibility of mixed reality technologies to be programmed for different applications, and to adapt them to different levels of impairments, behaviours and contexts, will make them more scalable. Objective The study aimed to develop a better understanding of modalities of prompts that people with dementia perceive successfully and correctly in mixed reality environments. It investigated interactions of people with dementia with different types of visual (graphics, animation, etc.) and sound (human voice, tones, etc.) prompts in mixed reality technologies. Methods We used the Research through Design (RtD) method in this study. This paper describes the findings from the user research carried out in the study. We conducted observation studies with twenty-two people with dementia playing games on off-the-shelf mixed reality technologies, including both Augmented Reality (HoloLens, ArKit on iPhone) and Augmented Virtuality (Xbox Kinect and Osmo) technologies. The interactions with the technologies during the gameplay were video recorded for thematic analysis in Noldus Observer XT (version 16.0) for successful and correct perception of prompts. Results A comparison of the probability estimates of correct perception of the prompts by people with dementia suggests that human voice, graphic symbols and text are the most prominently perceived modalities of prompts. Feedback prompts for every action performed by people with dementia on the technology are critical for successful perception and should always be provided in the design. Conclusion The study has resulted in recommendations and guidelines for designers to design prompts for people with dementia in mixed-reality environments. The work lays the foundation for considering mixed reality technologies as assistive tools for people with dementia, fostering discussions on their accessibility and inclusive design in technology development.
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Affiliation(s)
- Shital Desai
- Department of Computational Arts, School of Arts Media Performance and Design, York University, Toronto, ON, Canada
- Social and Technological Systems (SaTS) Lab, School of Arts Media Performance and Design, York University, Toronto, ON, Canada
| | - Rupsha Mutsuddi
- Social and Technological Systems (SaTS) Lab, School of Arts Media Performance and Design, York University, Toronto, ON, Canada
- Department of Design, School of Arts Media Performance and Design, York University, Toronto, ON, Canada
| | - Arlene J. Astell
- Department of Occupational Sciences & Occupational Therapy, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Psychology Department, Northumbria University, Newcastle, United Kingdom
- KITE Research Institute, University Health Network, Toronto, ON, Canada
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Hadley R, Mathie E, Pike E, Goodman C. Physical Activity Inclusion in Dementia-Friendly Communities: A Mixed Methods Study. J Aging Phys Act 2024; 32:376-386. [PMID: 38281484 DOI: 10.1123/japa.2022-0371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 10/31/2023] [Accepted: 11/14/2023] [Indexed: 01/30/2024]
Abstract
Dementia-friendly communities (DFCs) are a policy-endorsed approach to community engagement in England that promotes social inclusion to enable people affected by dementia to live well. Research suggests that physical activity is beneficial in encouraging social connection and improving health. A mixed method sequential study design in England involving a national survey (n = 31) and semistructured interviews (n = 65) in three DFCs was carried out. The aim was to understand how DFCs enable people affected by dementia to participate in physical activities. An evaluation framework for DFCs was used to organize and interpret the data, and analysis was informed by the inclusive (social) citizen lens. Findings showed that DFCs offered a range of adapted dementia-inclusive and dementia-specific activities; however, people were not routinely offered information at time of diagnosis. Local authorities (councils) were key to enable access to information and infrastructure change to support sustainable inclusion within their local community.
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Affiliation(s)
- Rebecca Hadley
- Centre for Applied Clinical, Health and Care Research (CACHE), University of Hertfordshire, Hatfield, United Kingdom
| | - Elspeth Mathie
- Centre for Research in Public Health and Community Care (CRIPACC), University of Hertfordshire, Hatfield, United Kingdom
- NIHR Applied Research Collaboration (ARC) East of England (EoE), Cambridge, United Kingdom
| | - Elizabeth Pike
- Institute of Sport, University of Hertfordshire, Hatfield, United Kingdom
| | - Claire Goodman
- Centre for Research in Public Health and Community Care (CRIPACC), University of Hertfordshire, Hatfield, United Kingdom
- NIHR Applied Research Collaboration (ARC) East of England (EoE), Cambridge, United Kingdom
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Grogan C, Stafford L, Miller E, Burton J. Dementia Friendly Communities: Micro-processes and practices observed locally in Queensland Australia. J Aging Stud 2024; 69:101235. [PMID: 38834249 DOI: 10.1016/j.jaging.2024.101235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 05/13/2024] [Accepted: 05/19/2024] [Indexed: 06/06/2024]
Abstract
Having the choice to stay living in one's home and community for as long as possible is a desire of people living with dementia. Yet, for many, this is not a reality due to a lack of appropriate support, unsuitable housing and built environments, social exclusion, and stigma. The global movement called Dementia Friendly Communities aims to address such barriers and bring about positive change. At the local place-based level, Dementia Friendly Community initiatives are typically planned and implemented by committees, yet little is known about how they operate to enact Dementia Friendly Community principles. Using micro-ethnography and a case study approach, two Australian - Queensland Dementia Friendly Community committees and their activities were studied to better understand implementation at the local level. This involved 16 semi-structured interviews, participant observation and field notes identifying goals, approaches, and tensions. While both committees showed the capacity to raise awareness of issues impacting people living with dementia, there were substantial differences in the implementation of the key Dementia Friendly Community principle of inclusion of people living with dementia and carers. Key differences were the way people living with dementia were positioned and the part they were expected to play in committees, whether they were empowered and valued or tokenistically included yet not listened to. Three aspects of practice are central to more meaningful inclusion: engagement, power-sharing, and leadership. Local action groups directed and led by people living with dementia and their carers, with the support of key local people and organizations, help to progress Dementia Friendly Communities locally.
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Affiliation(s)
- Caroline Grogan
- Wesley Research Institute, Health Services Research, Auchenflower, Queensland, Australia; School of Nursing, Midwifery and Social Work, The University of Queensland, St Lucia, Queensland, Australia.
| | - Lisa Stafford
- School of Geography, Planning and Spatial Sciences, Sandy Bay Campus, University of Tasmania, Australia, Churchill Avenue, Hobart, Tasmania, Australia.
| | - Evonne Miller
- QUT Design Lab, Faculty of Creative Industries, Education & Social Justice, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Queensland, Australia.
| | - Judith Burton
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Queensland, Australia.
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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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Li YT, Bai JX, He JM, Yang SW, Huang HL. The Mediating Role of Attitudes Towards Dementia on the Relationship Between Dementia Knowledge and Behaviors Towards Persons with Dementia: A Cross-Sectional Study. J Multidiscip Healthc 2023; 16:4213-4225. [PMID: 38156291 PMCID: PMC10752817 DOI: 10.2147/jmdh.s443189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 12/19/2023] [Indexed: 12/30/2023] Open
Abstract
Purpose To examine the mediating effect of attitudes towards dementia on the relationship between dementia knowledge and behaviors towards persons with dementia. Participants and Methods A cross-sectional survey was conducted with 313 adults (age ≤ 20 years). Participants were recruited using non-probability convenience sampling from medical clinics, community centers, and supermarkets located in the Wanhua District of Taipei City. Data were collected with the following self-report questionnaires: a demographic survey, validated instruments for dementia knowledge and attitudes towards dementia (assessed using the Alzheimer's Disease Knowledge Scale and the Approaches to Dementia Questionnaire, respectively), and a researcher-developed survey on unfriendly behaviors towards persons with dementia. Results Pearson's correlation and multiple linear regression analysis indicated that higher scores for dementia knowledge and more positive attitudes about dementia were significantly associated with lower levels of unfriendly behaviors towards persons living with dementia. Mediation analysis using a robust bootstrap test with 5000 samples indicated that attitudes toward dementia had a partial mediating effect on the relationship between dementia knowledge and unfriendly behaviors. Conclusion Our findings suggest that increasing public awareness and knowledge about dementia could help the general population develop better attitudes towards dementia, which could subsequently help improve behaviors towards persons living with dementia.
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Affiliation(s)
- Yang-Tzu Li
- Department of Long-Term Care, College of Health Technology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Jing-Xuan Bai
- Department of Information Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Jia-Ming He
- Department of Information Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Shao-Wei Yang
- Department of Health Administration, College of Health Technology and Management, Tzu Chi University of Science and Technology, Hualien City, Taiwan
| | - Hsiu-Li Huang
- Department of Long-Term Care, College of Health Technology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
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Shatnawi E, Steiner-Lim GZ, Karamacoska D. Cultural inclusivity and diversity in dementia friendly communities: An integrative review. DEMENTIA 2023; 22:2024-2046. [PMID: 37871120 PMCID: PMC10644696 DOI: 10.1177/14713012231206292] [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: 10/25/2023]
Abstract
People with dementia from culturally and linguistically diverse backgrounds often face poor health and social outcomes such as stigma, depression, and reduced help seeking behaviours. Dementia friendly communities have been shown to reduce stigma, and the gap in health and social outcomes for people impacted by dementia. Despite the large presence of established dementia friendly communities, their functioning in multicultural communities remains underexplored. The aim of this review was to identify the barriers and facilitators of cultural inclusivity to inform the development of a multicultural dementia friendly community. We systematically searched for academic and grey literature regarding existing and prospective age or dementia-friendly communities that engaged with culturally and linguistically diverse communities. Using the matrix method, data on the barriers and facilitators to engagement were extracted. Papers were analysed for common themes and findings were integrated in a narrative format. A total of 3,164 papers were identified, 11 of which met inclusion criteria. There were 6 dementia friendly communities in North America, 3 in Europe, 1 in Australia and 1 in Asia. Analyses revealed that barriers to cultural inclusivity were centered around the accessibility of services, sociocultural factors, and the environment, including issues such as low awareness of dementia and stigma, language barriers, isolation, and the inaccessibility of transport and buildings. Leveraging existing cultural leaders and social structures to target culturally and linguistically diverse populations and develop tailored dementia friendly initiatives were key facilitators. To foster cultural inclusivity in dementia friendly communities, a culturally specific lens that addresses these barriers and utilises facilitators must be applied from the design stage through to implementation and evaluation.
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Affiliation(s)
- Eman Shatnawi
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Genevieve Z Steiner-Lim
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
- Translational Health Research Institute (THRI), Western Sydney University, Penrith, NSW, Australia
| | - Diana Karamacoska
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
- Translational Health Research Institute (THRI), Western Sydney University, Penrith, NSW, Australia
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Krier D, de Boer B, Hiligsmann M, Wittwer J, Amieva H. Evaluation of Dementia-Friendly Initiatives, Small-Scale Homelike Residential Care, and Dementia Village Models: A Scoping Review. J Am Med Dir Assoc 2023; 24:1020-1027.e1. [PMID: 37121264 DOI: 10.1016/j.jamda.2023.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/16/2023] [Accepted: 03/16/2023] [Indexed: 05/02/2023]
Abstract
OBJECTIVES Numerous initiatives are emerging to improve the care management of persons suffering from Alzheimer's disease or related disorders (ADRD). The aim of this review is to identify research evaluations of initiatives in long-term care facilities and those making society more inclusive. DESIGN Scoping review with systematic search of PubMed. SETTING AND PARTICIPANTS Reviewed articles focused on the impact of (1) dementia-friendly initiatives (DFIs), (2) small-scale homelike (SSHL) facilities, and (3) dementia/Alzheimer villages. The intervention targets people (or their carers) with dementia or cognitive impairment. METHODS A scoping review was performed on PubMed, including papers published up to November 2022. Further hand-searching from reference lists and the gray literature was carried out. RESULTS A total of 477 articles were identified initially, and finally 12 more specifically related to the impact of DFI (n = 4) and SSHL facilities (n = 8) were selected. They included preliminary effectiveness analyses on DFI-related training and awareness intervention and comparative studies on an SSHL model. Scarce but promising results were found on the physical functioning, social participation, and quality of life for older adults living in SSHL facilities compared to those living in conventional nursing homes. No quantitative evaluation on dementia villages was published. CONCLUSIONS AND IMPLICATIONS The article highlights the lack of studies providing data on the efficacy of such innovative facilities on clinical, economic, and social outcomes. Such data are essential to better characterize these models and assess their potential efficiency and reproducibility.
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Affiliation(s)
- Damien Krier
- Bordeaux Population Health, U1219, University of Bordeaux, Bordeaux, Nouvelle-Aquitaine, France.
| | - Bram de Boer
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, Limburg, the Netherlands
| | - Mickaël Hiligsmann
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, Limburg, the Netherlands
| | - Jérôme Wittwer
- Bordeaux Population Health, U1219, University of Bordeaux, Bordeaux, Nouvelle-Aquitaine, France
| | - Hélène Amieva
- Bordeaux Population Health, U1219, University of Bordeaux, Bordeaux, Nouvelle-Aquitaine, France
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Scher CJ, Somerville C, Greenfield EA, Coyle C. Organizational Characteristics of Senior Centers and Engagement in Dementia-Friendly Communities. Innov Aging 2023; 7:igad050. [PMID: 37520857 PMCID: PMC10374275 DOI: 10.1093/geroni/igad050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Indexed: 08/01/2023] Open
Abstract
Background and Objectives Dementia-friendly communities (DFCs) are systematic and collaborative efforts to make local communities more supportive and inclusive of persons living with dementia and their care partners. This study explores how the organizational characteristics of senior centers influence their engagement in DFCs. Research Design and Methods We used a partially mixed, concurrent, equal status design, drawing on qualitative interviews with staff from 13 senior centers leading DFC initiatives as part of a statewide dementia-friendly network in Massachusetts, as well as quantitative data from 342 senior centers collected as part of a statewide survey. Results The qualitative results demonstrated ways in which human, social, tangible, and programmatic capital facilitate senior centers' DFC engagement. In particular, the results illuminated the importance of social capital with organizations and groups outside of the senior center, spanning the municipal, regional, and state levels. Findings from multivariate analyses further indicated robust and strong associations between higher levels of social capital, as well as more dementia-focused programming and greater variety of funding sources, with greater likelihood of engagement in DFC work. Discussion and Implications Results indicate the importance of policy and practice to foster both organizational capacity and multilevel systems conditions to enable and motivate senior centers' involvement in DFC initiatives.
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Affiliation(s)
- Clara J Scher
- School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
| | - Ceara Somerville
- Center for Social & Demographic Research on Aging, Gerontology Institute, University of Massachusetts Boston, Boston, Massachusetts, USA
| | - Emily A Greenfield
- School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
| | - Caitlin Coyle
- Center for Social & Demographic Research on Aging, Gerontology Institute, University of Massachusetts Boston, Boston, Massachusetts, USA
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Fletcher JR, Deng M, Dobson D. The art of friendliness: Organiser perspectives on curating dementia friendly cultural events. DEMENTIA 2023; 22:743-759. [PMID: 36803203 PMCID: PMC10088333 DOI: 10.1177/14713012231158429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Over recent decades, the arts have become a popular response to dementia. Amidst wider concerns with accessibility, widening participation and audience diversity, coupled with greater attention to creativity across dementia studies, many arts organisations are now offering dementia friendly initiatives. While dementia friendliness has been well-established for almost a decade, the meaning of friendliness remains vague. This paper reports results from a study of how stakeholders navigate this nebulousness when developing their own dementia friendly cultural events. To assess this, we interviewed stakeholders working for arts organisations in the northwest of England. We found that participants built up local informal networks of knowledge exchange, sharing experiences between stakeholders. The dementia friendliness that characterises this network centres on the crafting of vibes that enable people with dementia to 'unhide' themselves. Through this accommodating approach, dementia friendliness converges with stakeholder interests, becoming something of an art form in its own right, typified by active embodied experience, flexible and creative self-expression, and being in-the-moment.
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Affiliation(s)
| | - Maohui Deng
- Department of Drama and Film, 5292University of Manchester, UK
| | - David Dobson
- Department of Sociology, 5292University of Manchester, UK
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Ward R, Rummery K, Odzakovic E, Manji K, Kullberg A, Keady J, Clark A, Campbell S. Taking time: The temporal politics of dementia, care and support in the neighbourhood. SOCIOLOGY OF HEALTH & ILLNESS 2022; 44:1427-1444. [PMID: 36062552 PMCID: PMC9825962 DOI: 10.1111/1467-9566.13524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 06/27/2022] [Indexed: 06/15/2023]
Abstract
Dementia is a global health challenge and currently the focus of a coordinated international response articulated through the notion of 'dementia-friendly communities and initiatives' (DFCIs). Yet, while increasing research attention has been paid to the social and spatial dimensions to life with dementia in a neighbourhood setting, the temporalities of dementia have been largely overlooked. This article sets out different aspects of the lived experience of time for people with dementia and unpaid carers, before exploring the temporal politics of formal dementia care and support. The authors show that time is a site for material struggle and a marker of unequal relations of power. People with dementia and unpaid carers are disempowered through access to formal care, and this is illustrated in their loss of (temporal) autonomy and limited options for changing the conditions of the care received. The authors advocate for a time-space configured understanding of the relationship with neighbourhood and foreground a tempo-material understanding of dementia. Set against the backdrop of austerity policy in the UK, the findings reveal that ongoing budgetary restrictions have diminished the capacity for social care to mediate in questions of social justice and inequality, at times even compounding inequity.
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Affiliation(s)
- Richard Ward
- Faculty of Social SciencesUniversity of StirlingStirlingScotland
| | - Kirstein Rummery
- Faculty of Social SciencesUniversity of StirlingStirlingScotland
| | | | - Kainde Manji
- Independent Researcher (previously Faculty of Social Sciences University of Stirling)StirlingScotland
| | - Agneta Kullberg
- Faculty of Medicine and Health SciencesLinköping UniversityLinkopingSweden
| | - John Keady
- Division of NursingMidwifery and Social WorkUniversity of ManchesterManchesterUK
| | - Andrew Clark
- School of Health and SocietyUniversity of SalfordSalfordUK
| | - Sarah Campbell
- Department of Social Care and Social WorkManchester Metropolitan UniversityManchesterUK
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12
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Buckner S, Lafortune L, Darlington N, Dickinson A, Killett A, Mathie E, Mayrhofer A, Woodward M, Goodman C. A suite of evaluation resources for Dementia Friendly Communities: Development and guidance for use. DEMENTIA 2022; 21:2381-2401. [PMID: 36067141 PMCID: PMC9583293 DOI: 10.1177/14713012221106634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Objectives In the context of a growing number of dementia friendly communities (DFCs)
globally, a need remains for robust evaluation, and for tools to capture
relevant evidence. This paper reports the development of a suite of
evaluation resources for DFCs through a national study in England. Methods Fieldwork took place in six diverse case study sites across England. A mixed
methods design was adopted that entailed documentary analysis, focus groups,
interviews, observations, and a survey. Participants were people affected by
dementia and practice-based stakeholders. A national stakeholder workshop
was held to obtain input beyond the research sites. A workshop at the end of
the study served to check the resonance of the findings and emerging outputs
with stakeholders from the case study DFCs. Results The study had three key outputs for the evaluation of DFCs: First, an
evaluation framework that highlights thematic areas to be considered in
evaluating DFCs. Second, a Theory of Change that presents inputs into a DFC
and short, medium and longer term outcomes. Third, a matrix for assessing a
DFC’s degree of maturity, which enables a sense of the kinds of outcomes a
DFC might realistically aspire to. These three outputs form a suite of
interlinking and complementary evaluation resources for DFCs. Conclusions The study has contributed evidence-based resources for monitoring and
evaluation that complement existing frameworks. They can be applied to
arrive at a detailed assessment of how well a DFC works for people affected
by dementia, and at insights into the underlying factors that can guide
future policy and practice.
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Affiliation(s)
- Stefanie Buckner
- Cambridge, Public Health, 2152University of Cambridge, Cambridge, UK
| | - Louise Lafortune
- Cambridge, Public Health, 2152University of Cambridge, Cambridge, UK
| | - Nicole Darlington
- Centre for Research in Public Health and Community, 3769University of Hertfordshire, Hatfield, UK
| | - Angela Dickinson
- Centre for Research in Public Health and Community, 3769University of Hertfordshire, Hatfield, UK
| | - Anne Killett
- Faculty of Medicine and Health Sciences, 6106University of East Anglia, Norwich, UK
| | - Elspeth Mathie
- Centre for Research in Public Health and Community, 3769University of Hertfordshire, Hatfield, UK
| | - Andrea Mayrhofer
- Population Health Sciences Institute, 5994Newcastle University, Newcastle upon Tyne, UK
| | - Michael Woodward
- Faculty of Medicine and Health Sciences, 6106University of East Anglia, Norwich, UK
| | - Claire Goodman
- Centre for Research in Public Health and Community, 3769University of Hertfordshire, Hatfield, UK
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Parkinson L, Sullivan KA, Graham K. On becoming a dementia-friendly community: An empirical study of the individual factors that predict openness towards dementia-friendly communities. DEMENTIA 2022; 21:1971-1986. [PMID: 35642568 DOI: 10.1177/14713012221106328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND OBJECTIVES Evidence suggests that limited public awareness and dementia-related stigma can create barriers to community inclusiveness. This study explored the relation between public knowledge of dementia, attitudes towards people with dementia, experience with dementia and openness towards dementia-friendly communities. RESEARCH DESIGN AND METHODS Two-hundred and twenty-nine members of the public completed a cross-sectional online survey with three established measures [Alzheimer's Disease Knowledge Test, Attitudes Towards People with Dementia scale and Understanding of Health Problems survey] and one exploratory scale [Openness Towards Dementia-Friendly Communities]. An existing 'mild' dementia vignette was used to evaluate dementia recognition. Factors contributing to correct dementia recognition (knowledge, exposure to dementia, education and gender), worry about developing dementia (knowledge, exposure and respondent age), and openness towards dementia-friendly communities (knowledge, exposure and attitudes) were examined through group comparisons and a multiple linear regression. RESULTS Consistent with the literature, the respondents had poor knowledge, reasonably good dementia recognition, and mostly positive attitudes towards people with dementia. None of the proposed factors were significantly associated with correct dementia recognition, and only gender was significantly associated with dementia worry. Knowledge and attitudes towards people with dementia (not exposure) were significant independent predictors of openness towards dementia-friendly communities. DISCUSSION AND IMPLICATIONS The expansion of dementia-friendly communities will require further investment in awareness-raising initiatives to improve dementia knowledge and attitudes in the community. This study shows the importance of these factors in the broader community's openness towards dementia-friendly communities.
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Affiliation(s)
- Lauren Parkinson
- School of Psychology and Counselling, Faculty of Health, 1969Queensland University of Technology, Brisbane, Australia
| | - Karen A Sullivan
- School of Psychology and Counselling, Faculty of Health, 1969Queensland University of Technology, Brisbane, Australia
- Australian Centre for Health Law Research, Queensland University of Technology, Brisbane, Australia
| | - Karen Graham
- School of Psychology and Counselling, Faculty of Health, 1969Queensland University of Technology, Brisbane, Australia
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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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Mathie E, Antony A, Killett A, Darlington N, Buckner S, Lafortune L, Mayrhofer A, Dickinson A, Woodward M, Goodman C. Dementia-friendly communities: The involvement of people living with dementia. DEMENTIA 2022; 21:1250-1269. [PMID: 35088605 PMCID: PMC9109212 DOI: 10.1177/14713012211073200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Dementia Friendly Communities (DFCs) offer an approach to community engagement to improve the lives of people living with dementia and their family supporters. The involvement of those living with dementia is key to creating successful DFCs. This paper examines how people affected by dementia were involved in developing and designing DFCs in England, and the impact of their involvement. METHODS This study used a mixed method case study design in six DFCs in England. Data collection involved documentary analysis, a survey, and interviews and focus groups with service providers and people living with dementia and their supporters. FINDINGS All six DFCs aspired to involve people living with dementia and their family supporters, but often relied on a small number of people living with dementia. The range of involvement activities in DFCs included Steering Group meetings, wider public consultations, and enabling feedback through data collection methods such as surveys and 'ad hoc' conversations. Organisations within the DFCs with experience of public consultation offered structured opportunities for involvement. There was no evidence of people living with dementia initiating or co-leading the organisation, its direction and/or the activities of the DFCs. CONCLUSION The involvement of people living with dementia in DFCs went beyond rhetoric, with some evidence of context sensitive and meaningful participation. Approaches towards involvement should focus on involvement in strategic planning, and on harnessing expertise in delivering different involvement activities to optimise participation of a greater breadth of people living with dementia. Engagement with local organisations who work with, and for, people living with dementia, and dedicating the resources needed for involvement work, are crucial for creating DFCs. The success of DFCs are determined by how the needs of people living with dementia are identified, discussed and reviewed by those within the community who are most affected.
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Affiliation(s)
- Elspeth Mathie
- 3769University of Hertfordshire, Centre for Research in Public Health and Community Care, College Lane, Hatfield, Hertfordshire, UK
| | - Arthur Antony
- 6106University of East Anglia, Faculty of Medicine and Health Sciences Norwich, Norfolk, UK
| | - Anne Killett
- 6106University of East Anglia, Faculty of Medicine and Health Sciences Norwich, Norfolk, UK
| | - Nicole Darlington
- 8018University of Hertfordshire, Centre for Research in Public Health and Community Care, College Lane, Hatfield, UK
| | - Stefanie Buckner
- 2152University of Cambridge, Cambridge Public Health, Forvie Site, Robinson Way, Cambridge, UK
| | - Louise Lafortune
- 2152University of Cambridge, Cambridge Public Health, Forvie Site, Robinson Way, Cambridge, UK
| | - Andrea Mayrhofer
- Newcastle University, Population Health Sciences Institute, Newcastle Upon Tyne, UK
| | - Angela Dickinson
- University of Hertfordshire, Centre for Research in Public Health and Community Care, Hatfield, Hertfordshire, UK
| | - Michael Woodward
- University of East Anglia, Faculty of Medicine and Health Sciences Norwich, Norfolk, UK
| | - Claire Goodman
- University of Hertfordshire, Centre for Research in Public Health and Community Care, College Lane, UK
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