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Hersh D, Williamson C, Brogan E, Stanley M. "It's day to day problems:" Experiences of people with aphasia who live alone. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 26:367-379. [PMID: 38912681 DOI: 10.1080/17549507.2024.2358830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/25/2024]
Abstract
PURPOSE Living alone is increasing and associated with health and social risks. Aphasia compounds these risks but there is little research on how living alone interacts with aphasia. This study is a preliminary exploration of this issue. METHOD Five people with aphasia who lived alone participated in two supported semi-structured interviews, with the second interview including sharing an artefact that held significance for living alone with aphasia. Interviews were recorded, transcribed verbatim, and analysed through reflexive thematic analysis. RESULT Four themes encompassed meaning-making about living alone with aphasia: relationships and reliance on others; risk, vulnerability, and uncertainty; loneliness and time alone; self-reliance and the need to keep busy. Participants had to continuously manage and renegotiate daily challenges around living alone with aphasia. CONCLUSION Living alone increases the risk of loneliness. For people with aphasia, the buffer against loneliness provided by social connection and meaningful activity may be more difficult to achieve because of communication challenges. While experiences vary, reliance on others, managing practical and administrative tasks, and negotiating risks are all important issues when alone. The intersection of living alone, loneliness, and living with aphasia needs more research, and more explicit clinical focus when discussing and planning intervention and support.
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Affiliation(s)
- Deborah Hersh
- Speech Pathology, School of Allied Health and EnAble Institute, Curtin University, Perth, Australia
- Speech Pathology, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
- School of Allied Health Science and Practice, Adelaide University, Adelaide, Australia
| | | | - Emily Brogan
- Speech Pathology, School of Allied Health and EnAble Institute, Curtin University, Perth, Australia
- Speech Pathology, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
- Speech Pathology, Fiona Stanley Fremantle Hospital Group, Perth, Australia
| | - Mandy Stanley
- Occupational Therapy, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
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Gan DRY, Mann J, Chaudhury H. Dementia care and prevention in community settings: a built environment framework for cognitive health promotion. Curr Opin Psychiatry 2024; 37:107-122. [PMID: 38226537 DOI: 10.1097/yco.0000000000000917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
Abstract
PURPOSE OF REVIEW Most people with dementia live in the community. As lifespan increases, one in three persons aged 85+ are expected to live with dementia. We conduct a systematic search to identify frameworks for dementia care and prevention in community settings. This is important to ensure quality of life for people living with cognitive decline (PLCD). RECENT FINDINGS 61 frameworks are synthesized into the dementia care and prevention in community (DCPC) framework. It highlights three levels of provision: built environment and policy supports, access and innovation, and inclusion across stages of decline. Domains of intervention include: basic needs; built environment health and accessibility; service access and use; community health infrastructure; community engagement; mental health and wellbeing; technology; end-of-life care; cultural considerations; policy, education, and resources. Personhood is not adequately represented in current built environment frameworks. This is supplemented with 14 articles on lived experiences at home and social practices that contribute to PLCD's social identity and psychological safety. SUMMARY Policy makers, health and built environment professionals must work together to promote "personhood in community" with PLCD. Clinicians and community staff may focus on inclusion, social identity and a sense of at-homeness as attainable outcomes despite diagnosis.
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Affiliation(s)
- Daniel R Y Gan
- Department of Gerontology, Simon Fraser University
- EQUIGENESIS UrbanLab, Vancouver
| | - Jim Mann
- Person living with dementia, University of British Columbia
| | - Habib Chaudhury
- Department of Gerontology, Simon Fraser University
- Centre for Advancing Health Outcomes, Providence Health Care, Canada
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3
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Seetharaman K, Chaudhury H, Hung L, Phinney A, Freeman S, Groulx M, Hemingway D, Lanthier-Labonté S, Randa C, Rossnagel E. Protocol for A Mixed-Methods Study: Dementia-Inclusive Streets and Community Access, Participation, and Engagement (DemSCAPE). INTERNATIONAL JOURNAL OF QUALITATIVE METHODS 2023; 22:160940692311573. [DOI: 10.1177/16094069231157350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/19/2023]
Abstract
Neighbourhoods are known to help maintain functional abilities and enable out-of-home activities and social participation for people living with dementia. Dementia friendly and inclusive communities (DFC) frameworks recognize the importance of developing supportive and empowering environments for people living with dementia and their families. Beyond the core objective of raising awareness and eliminating stigma associated with dementia, most DFC frameworks also focus on improving accessibility and navigability in the neighbourhood environment. Limited research on this topic points to the importance of evidence-based design of the neighbourhood built environment to promote mobility and wayfinding, legibility, familiarity, and safety for people living with dementia. Increased relevance of DFCs for policy and practice calls for expanding this body of knowledge. The proposed study, titled “Dementia-inclusive Spaces for Community Access, Participation, and Engagement (DemSCAPE),” focuses on identifying neighbourhood destinations considered important by people living with dementia, as well as neighbourhood built environmental features relevant for their outdoor mobility, engagement, and social participation. This study protocol paper offers key information on 1) the need for mixed methods research on this topic and its theoretical and methodological underpinnings, 2) study sampling and recruitment strategy, 3) data collection methods, which include a series of structured and semi-structured sit-down interviews and a walk-along interview, 4) procedure for data analysis, 5) ethical and methodological considerations, and 6) measures taken to enhance study rigour.
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Affiliation(s)
| | - Habib Chaudhury
- Department of Gerontology, Simon Fraser University, Vancouver, BC, Canada
| | - Lillian Hung
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Alison Phinney
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Shannon Freeman
- School of Nursing, University of Northern British Columbia, Prince George, BC, Canada
| | - Mark Groulx
- School of Planning and Sustainability,University of Northern British Columbia, Prince George, BC, Canada
| | - Dawn Hemingway
- School of Social Work, University of Northern British Columbia, Prince George, BC, Canada
| | | | - Cari Randa
- Department of Gerontology, Simon Fraser University, Vancouver, BC, Canada
| | - Emma Rossnagel
- School of Nursing, University of Northern British Columbia, Prince George, BC, Canada
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Bower M, Kent J, Patulny R, Green O, McGrath L, Teesson L, Jamalishahni T, Sandison H, Rugel E. The impact of the built environment on loneliness: A systematic review and narrative synthesis. Health Place 2023; 79:102962. [PMID: 36623467 DOI: 10.1016/j.healthplace.2022.102962] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 12/15/2022] [Accepted: 12/19/2022] [Indexed: 01/09/2023]
Abstract
Loneliness is a pressing public health issue. Although quintessentially individual, it is shaped by wider environmental, cultural, socio-economic, and political circumstances. Using a systematic review methodology, this paper draws on interdisciplinary research to conceptualise the relationship between the built environment and loneliness. We present a narrative synthesis of 57 relevant studies to characterise the body of evidence and highlight specific built-environment elements. Our findings demonstrate the need for further conceptual and empirical explorations of the multifaceted ways in which built environments can prevent loneliness, supporting calls for investment into this public-health approach.
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Affiliation(s)
- Marlee Bower
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | - Jennifer Kent
- The University of Sydney School of Architecture, Design, and Planning, The University of Sydney, Australia.
| | - Roger Patulny
- Faculty of the Arts, Social Sciences, and Humanities, University of Wollongong, Australia
| | - Olivia Green
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | - Laura McGrath
- Faculty of Arts and Social Sciences, The Open University, Milton Keynes, England; UK
| | - Lily Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | | | - Hannah Sandison
- The University of Sydney School of Architecture, Design, and Planning, The University of Sydney, Australia
| | - Emily Rugel
- Westmead Applied Research Centre, The University of Sydney, Australia
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5
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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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Symonds-Brown H, Ceci C, Judge H. 'Sand in the works?' Infrastructural affordances and life with dementia in the community. SOCIOLOGY OF HEALTH & ILLNESS 2022; 44:1517-1532. [PMID: 36054021 DOI: 10.1111/1467-9566.13532] [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: 04/22/2022] [Accepted: 07/06/2022] [Indexed: 06/15/2023]
Abstract
The social health of people living with dementia is a more recent addition to the dementia research agenda; to date conceptions of the problem and solutions have relied on underdeveloped theorisations of sociality and social inclusion. In this article, using a material-semiotic approach to care practices and infrastructure, we use an ethnographic case study of one family of a person living with dementia using a day programme and home care supports over a period of 9 months, to examine how infrastructural arrangements provide particular affordances for social relatedness for people living with dementia in the community. The aim of the analysis is to consider how the infrastructural affordances created by the organisation of care may create spatially bounded lives and limit the subject positions available for people living with dementia and their families. It is these narrowed positions of dwelling that we argue may be the necessary starting place for thinking about the social health of people living with dementia and the solutions that might be helpful for them.
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Affiliation(s)
| | - Christine Ceci
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Harkeert Judge
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
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Russell C, Kohe GZ, Evans S, Brooker D. Rethinking Spaces of Leisure: How People Living with Dementia Use the Opportunities Leisure Centres Provide to Promote their Identity and Place in the World. INTERNATIONAL JOURNAL OF THE SOCIOLOGY OF LEISURE 2022. [PMCID: PMC9610313 DOI: 10.1007/s41978-022-00121-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
We report on research that found joining activities within community leisure and fitness centres (Centres) enabled people living with dementia to create meaning about everyday life and foster identity. Focusing on three Centres in England, the study was informed by the experiences and accounts of four people living with dementia, their life-partner (if applicable) and the sports professional most closely associated with the person as each participated within a range of leisure opportunities. The methodology was underpinned by phenomenological philosophy and utilised participative methods. Theoretically, the paper draws upon considerations of serious leisure that provide ways in which the participants’ experiences could be understood and wider implications considered. Conceptual themes we derived from the data analysis were place, citizenship, and belonging (where the Centre acting as a physical space was important); identity and interaction (where the focus was upon space making and embodiment); safe spaces and care (i.e., how wellbeing was sustained and how participation and meaningful engagement occurred within the space); and, the value of Centres as opportunity structures (where all of these themes coalesced). Amid current public health debates over resourcing and care, this research provides timely insights and continued needed debates on the relationship between adequate social, economic and political support/resourcing, and the ability of Centres to facilitate and sustain meaningful and safe spaces. Beyond, we suggest our findings offer learning that might extend to wider contexts; for example, through including Centres within social care and health initiatives, where emphasis will be upon participation as a citizen rather than as a patient.
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Affiliation(s)
- Christopher Russell
- Association for Dementia Studies, University of Worcester, Henwick Grove, Worcester, WR2 6AJ UK
| | - Geoffery Z. Kohe
- School of Sport & Exercise Sciences, University of Kent, Chatham, UK
| | - Shirley Evans
- Association for Dementia Studies, University of Worcester, Henwick Grove, Worcester, WR2 6AJ UK
| | - Dawn Brooker
- Association for Dementia Studies, University of Worcester, Henwick Grove, Worcester, WR2 6AJ UK
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Dixon J, Hicks B, Gridley K, Perach R, Baxter K, Birks Y, Colclough C, Storey B, Russell A, Karim A, Tipping E, Banerjee S. 'Pushing back': People newly diagnosed with dementia and their experiences of the Covid-19 pandemic restrictions in England. Int J Geriatr Psychiatry 2022; 37:10.1002/gps.5803. [PMID: 36052759 PMCID: PMC9539182 DOI: 10.1002/gps.5803] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 08/12/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND AND OBJECTIVES Research into people with dementia's experiences of the Covid-19 pandemic has tended to focus on vulnerabilities and negative outcomes, with the risk of reproducing a discourse in which people with dementia are positioned as passive. Informed by concepts positioning people with dementia as 'active social agents', we aimed to identify the pandemic-related challenges faced by people recently diagnosed with dementia and examine the ways in which they actively coped with, and adapted to, these challenges. RESEARCH DESIGN AND METHODS In-depth interviews with 21 people recently diagnosed with dementia, recruited through an existing national cohort. Data was analysed thematically using Framework. FINDINGS Key challenges included reduced social contact, loneliness and loss of social routines; difficulties accessing and trusting health services; dementia-unfriendly practices; and disparate experiences of being able to 'get out' into the physical neighbourhood. People with dementia responded to challenges by maintaining and extending their social networks and making the most of 'nodding acquaintances'; learning new skills, for communication and hobbies; supporting others, engaging in reciprocal exchange and valuing connection with peers; seeking help and advocacy and challenging and resisting dementia-unfriendly practices; maintaining and adapting habitual spatial practices and being determined to 'get out'; and employing similar emotional coping strategies for the pandemic and dementia. CONCLUSIONS Support for people with dementia, especially during public health crises when carers and services are under pressure, should involve utilising existing capacities, appropriately supporting the acquisition of new knowledge and skills, 'safety-netting' through the availability of a named professional, advocacy and support and use of 'check-in calls' and creating supportive social and environmental circumstances for people with dementia to sustain their own well-being.
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Affiliation(s)
- Josie Dixon
- Care Policy and Evaluation CentreLondon School of Economics and Political ScienceLondonUK
| | - Ben Hicks
- Brighton and Sussex Medical SchoolUniversity of SussexBrightonUK
| | - Kate Gridley
- Social Policy Research UnitUniversity of YorkYorkUK
| | - Rotem Perach
- School of PsychologyUniversity of SussexBrightonUK
| | - Kate Baxter
- Social Policy Research UnitUniversity of YorkYorkUK
| | - Yvonne Birks
- Social Policy Research UnitUniversity of YorkYorkUK
| | | | | | - Alice Russell
- Brighton and Sussex Medical SchoolUniversity of SussexBrightonUK
| | - Anomita Karim
- Brighton and Sussex Medical SchoolUniversity of SussexBrightonUK
| | - Eva Tipping
- Brighton and Sussex Medical SchoolUniversity of SussexBrightonUK
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Huizenga J, Scheffelaar A, Fruijtier A, Wilken JP, Bleijenberg N, Van Regenmortel T. Everyday Experiences of People Living with Mild Cognitive Impairment or Dementia: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10828. [PMID: 36078544 PMCID: PMC9518176 DOI: 10.3390/ijerph191710828] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/23/2022] [Accepted: 08/26/2022] [Indexed: 06/15/2023]
Abstract
Increasing attention has been paid to the 'voice' of people living with mild cognitive impairment (MCI) or dementia, but there is a lack of clarity about how everyday life is perceived from this insider's perspective. This study aimed to explore the everyday life experiences, challenges and facilitators of individuals with MCI and dementia living at home. A scoping review of qualitative studies, guided by the Joanna Briggs Institute Reviewers Manual, was conducted. Eight databases were searched, resulting in 6345 records, of which 58 papers published between 2011 and 2021 were included. Analysis was carried out by descriptive content analysis. Findings were categorized into seven spheres of everyday life: experiences related to the condition, self, relationships, activities, environment, health and social care and public opinions. The results show many disruptions and losses in everyday life and how people try to accommodate these changes. In all areas of everyday life, people show a deep desire to have reciprocal relationships, stay engaged through participation in activities and have a sense of belonging in the community. However, more research is needed on the factors that promote and impede the sense of reciprocity and belonging.
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Affiliation(s)
- Jacoba Huizenga
- Institute of Social Work, HU University of Applied Sciences Utrecht, 3507 LC Utrecht, The Netherlands
- Research Center Social Innovation, HU University of Applied Sciences Utrecht, 3507 LC Utrecht, The Netherlands
- Department of Tranzo, School of Social and Behavioral Sciences, Tilburg University, 5000 LE Tilburg, The Netherlands
| | - Aukelien Scheffelaar
- Department of Tranzo, School of Social and Behavioral Sciences, Tilburg University, 5000 LE Tilburg, The Netherlands
| | - Agnetha Fruijtier
- Research Center Social Innovation, HU University of Applied Sciences Utrecht, 3507 LC Utrecht, The Netherlands
| | - Jean Pierre Wilken
- Research Center Social Innovation, HU University of Applied Sciences Utrecht, 3507 LC Utrecht, The Netherlands
| | - Nienke Bleijenberg
- Research Center Healthy & Sustainable Living, HU University of Applied Sciences Utrecht, 3507 LC Utrecht, The Netherlands
- Department Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, 3584 CG Utrecht, The Netherlands
| | - Tine Van Regenmortel
- Department of Tranzo, School of Social and Behavioral Sciences, Tilburg University, 5000 LE Tilburg, The Netherlands
- HIVA—Research Institute for Work and Society, Faculty of Social Sciences, University of Leuven, B-3000 Leuven, Belgium
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Margot-Cattin I, Berchtold A, Gaber S, Kuhne N, Nygård L, Malinowsky C. Associations between community participation and types of places visited among persons living with and without dementia: risks perception and socio-demographic aspects. BMC Geriatr 2022; 22:309. [PMID: 35397532 PMCID: PMC8994370 DOI: 10.1186/s12877-022-03015-5] [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: 02/02/2022] [Accepted: 03/30/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Introduction
Increasingly, literature has focused on community participation in places visited by persons living with and without dementia. Earlier research indicates that multiple factors, including socio-demographic aspects and risk perception may influence community participation.
Aim and methods
This cross-sectional, explorative study aims to inquire into how places visited, socio-demographic aspects and risks perception are associated with self-rated community participation for persons living with and without dementia (n = 70) in Switzerland. Data was collected through face-to-face interviews with questionnaires (ACT-OUT, MoCA, sociodemographic). First, we investigated whether the number of places visited was correlated with self-rated participation; then we added socio-demographic and risks perception factors with a bivariate analysis; and searched for a model using multinomial logistic regressions.
Results
For the group of participants living with dementia, risks of falling (p = .014) and of getting lost (p = .037) were significantly associated with self-rated participation. For the group of participants living without dementia, visiting places outside the home was significantly associated with self-rated participation, especially visiting places in domain D/places for recreational and physical activities (p = .005).
Discussion and conclusions
The results of exploring multiple factors and searching for a model highlights the complexity of community participation as a construct. Risks and visiting places for recreational and physical activities seem to play a role in self-rated participation. Mobile interviews might be better suited to gain in-depth understanding on community participation for persons living with dementia.
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Abstract
Abstract
‘Dementia-friendly communities’ herald a shift toward the neighbourhood as a locus for the care and support of people with dementia, sparking growing interest in the geographies of dementia care and raising questions over the shifting spatial and social experience of the condition. Existing research claims that many people with dementia experience a ‘shrinking world’ whereby the boundaries to their social and physical worlds gradually constrict over time, leading to a loss of control and independence. This paper reports a five-year, international study that investigated the neighbourhood experience of people with dementia and those who care for and support them. We interrogate the notion of a shrinking world and in so doing highlight an absence of attention paid to the agency and actions of people with dementia themselves. The paper draws together a socio-relational and embodied-material approach to question the adequacy of the shrinking world concept as an explanatory framework and to challenge reliance within policy and practice upon notions of place as fixed or stable. We argue instead for the importance of foregrounding ‘lived place’ and attending to social practices and the networks in which such practices evolve. Our findings have implications for policy and practice, emphasising the need to bolster the agency of people living with dementia as a route to fostering accessible and inclusive neighbourhoods.
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