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The purpose of this paper is to set out the history and origins of dementia-friendly communities (DFCs) and age-friendly communities (AFCs) in the UK, the differing frameworks and how they compare, and set out some key messages about how they might learn from each other.

This paper is a summary piece written by leaders in the two fields.

It aims to reduce potential confusion around AFCs and DFCs, and provides some practical ways that the two initiatives might work together and find common ground. By learning from each other, both age-friendly and DFCs can grow their reach and their impact as complementary, and not competing, programmes.

The original development of some of the ideas in this paper comes from a paper Natalie Turner co-wrote with Lydia Morken at AARP (www.aarp.org/content/dam/aarp/livable-communities/documents-2016/Better-Together-Research-Report.pdf). For this paper, the authors reviewed the approach within the UK context and have furthered and added to the original insights.

This paper aims to outline the findings from a research and development project to determine how York might become a more dementia‐friendly city and, in drawing out the features, to discuss the benefits for other places.

The project team worked with existing groups and individuals, including people with dementia and family carers, established a cross sector operational group formed of statutory and non‐statutory sectors, and developed a wider network to share news and ideas.

York as a city is already responding in many positive ways to the needs of people with dementia and their carers, but there is much more that can be done, there and elsewhere. The project proposes a model – People, Places, Networks and Resources – for analysing the suitability and helpfulness of existing arrangements or features of a place or an organisation in order to realise a more dementia‐friendly community.

The research was commissioned by and restricted to the City of York but there are lessons that can be taken and applied elsewhere. The project was also primarily concerned with the experience of people with dementia, generally post diagnosis, exploring their normal everyday lives as well as the contact they had and interventions from the statutory agencies. Reaching people with dementia who had not yet been diagnosed, or those on the margins of society, especially those living alone, proved hard to achieve.

The numbers of people with dementia are expected to double over the next 30 years, with a shrinking of the working population and a tripling of costs to the NHS and social care. The proposed model can be applied anywhere to support the creation of dementia‐friendly communities that understand how to help.

The concept of “dementia‐friendliness” is not the exclusive domain of the health and social care world. On the contrary, the research reveals that it is the daily attrition of everyday life where help is most needed. People with dementia and family carers find routine activities most difficult – shopping, managing finances, using transport, keeping active – causing them to withdraw. There are moral, economic and business reasons why we should support people to live well with their dementia, as well as reasons of health and well‐being.

This project makes a substantial contribution to the literature on what constitutes a dementia‐friendly community and how to achieve it. It highlights the need for a wider information and awareness raising campaign for the general public and for anyone working directly with the public.

Persons living with dementia (PLWD) constitute a global epidemic of more than 50 million people around the world, and tens of millions more serve as their caregivers. Public libraries must learn to assist, support, and sustain those with dementia in their communities. The good news is that some of the most powerful non-pharmacological interventions for PLWD – healthy lifestyle choices, lifelong learning for mental stimulation, and the stimulation and support of social networks – all are embedded in public libraries’ core mission. Thus, library services for the underserved population of PLWD and their caregivers can make a huge collective impact toward sustainable communities, social justice, and strong institutions.

Libraries can provide this help through dementia-friendly customer service and through programming that both supports individuals and develops and strengthens social relationships. Libraries can further promote good health and well-being, both through information resources and with targeted older adult programming. We can simultaneously contribute to social justice, mitigating the stigma and the deleterious effects of dementia which can be worse within minority communities. The positive impact of library dementia services can even be magnified through collective impact when different institutions within a community work together toward dementia-friendly standards.

This reflective chapter details the operation of library services for PLWD and their caregivers, providing concrete examples of dementia-friendly customer service, collection development, information and reference services, and a wide variety of older adult programming. Together, these library dementia services can create a powerful and positive impact through lifelong learning, mental stimulation, and social connections.

The purpose of this paper is to describe the key elements of a major work programme on dementia, and to reflect on the practical learning derived.

The paper describes the whole range of programme activity, including research projects, think-pieces, action research, demonstrations, evaluations and production of resources such as films, infographics, case studies, practice guides and positive image galleries.

The active, meaningful engagement of people with dementia and their families is fundamental. Communities must engage with, and achieve equity for, all people with dementia, whatever their circumstances. Practical barriers to inclusion must be addressed if normal lives are to be continued. The human rights of people with dementia and carers must be recognised and promoted. Local grassroots community activity is the bedrock of dementia friendly communities – but this activity must be supported by strong strategic planning, commissioning and leadership. There is no template – each community must develop its own approach.

The paper highlights many examples of good practice which can inform the work of commissioners and practitioners, as well as wider communities. These focus particularly on good practice in engagement and involvement; and the co-production of dementia friendly communities with people with dementia.

The programme highlights the importance of social barriers to the inclusion of people with dementia in their communities, and gives examples of communities which have tried to overcome these through attitudinal and environmental change.

Joseph Rowntree Foundation’s programme is highly innovative and well-regarded.

The purpose of this paper is to report how an evaluation tool originally developed for Age-Friendly Cities was pilot-tested in the context of the Dementia Friendly Community (DFC) initiative of the city of Sheffield/UK. It presents finding and outputs on which other communities with dementia friendly agendas can draw.

The original evaluation tool was adapted to a focus on dementia friendliness. Data collection involved scoping conversations, documentary analysis, interviews and group discussions. Following evidence appraisal, Sheffield’s approach to dementia friendliness was assessed. A local steering group was central to the study.

The evidence indicates areas of strength in Sheffield’s approach to dementia friendliness: involvement of older people; service provision; collaboration; monitoring and evaluation. Scope for improvement was identified around resource allocation, and use of existing guidance on dementia friendliness. Recommendations for policy and practice include enhancing pooling of resources, more detailed recording of resources allocated to dementia-related activity, and collection of evidence on how people affected by dementia have shaped the city’s DFC initiative. Key research outputs are an adaptable logic model and an emerging evaluation framework for DFCs.

The study was a short pilot with limited resources. Its findings and outputs must be considered preliminary.

The findings and outputs provide a basis for further research. The study has suggested key components of an evaluation framework for DFCs. It is informing ongoing work to develop such a framework.

The dementia-friendly housing charter was developed by the sector in response to the Prime Minister’s challenge on dementia and a need for this resource within the housing sector. The purpose of this paper is to highlight the positive impact the housing sector can have on people living with dementia and identify resources available which the sector can use to support this.

The charter identifies relevant resources and examples of good practice to encourage their integration into all aspects of people, places and processes, the three “pillars” which the charter is built around. To develop the charter, people with dementia were engaged to identify the challenges they face and potential solutions that could be provided. The feedback of people with dementia highlighted the importance of design in housing to ensure it meets an individual’s needs as their dementia progresses. This could include adaptations such as sensor lights, plug sockets at arm level, wet rooms and open plan living. The importance of good quality training for staff was also highlighted.

There are a number of areas that were not included in the housing charter. Some were consciously not included, such as care homes, while others such as issues apparent when considering the wider agenda of equality are now being explored and will be incorporated.

In the first three months, over 600 copies of the charter were downloaded by a range of organisations including housing with care providers, local authorities and housing associations. An evaluation of the effectiveness of the charter will take place during Autumn 2017 to understand more about the success and limitations of the charter after which amends will be made if required.

This paper aims to identify costs related to dementia care provision and explore how purpose-built environment investments can help control these costs and improve quality of life and clinical outcomes.

This research adopts a multi-method approach where the findings of a literature review drove the analysis of data obtained from the 115 pilot projects funded by the Department of Health England’s National Dementia Capital Investment Programme.

Under the UK Government’s new productivity challenge, it is fundamental to identify actions that provide value for money to prioritise policy and practice. This paper identifies healthcare spaces (e.g. bathroom) where the impact of the built environment on healthcare costs are most evident and building elements (e.g. lighting) to which these costs can be directly associated. The paper advocates the development of evidence and decision support tools capable of: linking built environment interventions to the healthcare costs; and helping the healthcare and social care sectors to develop effective and efficient capital investment strategies.

Further work needs to develop more systematic ways of rationalising proactive and timely built environment interventions capable of mitigating dementia (and older people) care cost escalation.

This research takes an innovative view on capital investment for care environments and suggests that appropriate built environment interventions can have a profound impact on costs associated with dementia care provision.

Recent years have seen a growing interest in and awareness of the importance of environmental design to the well-being of people living with dementia, in terms of both policy and practice. This trend has been accompanied by a plethora of advice, guidance and tools that aim to encourage and promote the development of inclusive environments. Not all of these are evidence-based, and even those that claim to be so are limited by a paucity of good quality, comprehensive research studies. This paper aims to consider the current state of knowledge in the field of dementia-friendly design and describes a project that refreshed and updated the suite of Environmental Assessment Tools originally developed by The Kings Fund and now managed by the Association for Dementia Studies.

The mixed methods project reported on in this paper comprised a review of the literature, a survey of people who have used the five design assessment tools and an iterative process of updating the tools to make them as evidence-based and user-friendly as possible.

The suite of five assessment tools was refreshed and updated to reflect the latest evidence and the views of professionals and others who use the tools. The authors conclude that while a focus on dementia-friendly design is to be welcomed, there remains a need for relevant high-quality evidence to inform such work. In particular, there is a lack of research within people’s own homes and studies that include the perspectives of people living with dementia.

Few assessment tools and guidelines for dementia-friendly environments are truly evidence-based. This paper reports on a project that combined a comprehensive literature review with the views of practitioners to update a widely used suite of tools that aim to make a range of settings more suitable for people living with dementia.

The purpose of this paper is to describe a community-based peer support project in the London borough of Brent, led by people living with dementia for people living with dementia.

The Brent Dementia Peer Support Project is a collaboration between a social movement Community Action on Dementia Brent, Brent CCG, Brent Council, third-sector organisations and faith communities.

Stakeholder workshops, ethnographic research highlighted the need to support people living with dementia, especially by people who understand that experience. The findings also demonstrated the abilities and skills retained by people living with dementia, their wish to help others to contribute and to remain connected with their communities.

This is an account of one pilot project in a London borough, but is broadly applicable elsewhere. Further research is needed into the values and practicalities of peer support by and for people living with dementia.

People with dementia and their carers lack accessible information and empathetic support to cope with the condition and live independently. This can be offered through dementia peer support services.

There are growing numbers of people living with dementia who are motivated to share their knowledge, skills and experiences to improve the lives of other people with dementia.

This paper describes how people with dementia can be enabled to design, inform and deliver support to other people with the condition.

The purpose of this paper, practice-based mixed methods small-scale study, is to explore the design features of a “dementia friendly” acute ward environment and, staff views on the implications of daily activity engagement for patients with dementia.

Eight staff members of the multidisciplinary team who work full time on an acute “dementia friendly” ward completed semi-structured questionnaires. Thematic analysis explored responses to the open-ended questions, and a further environmental assessment tool rated features of the “dementia friendly” ward design, on promoting aspects of well-being in patients with dementia.

Six overarching themes were found. These included: contrasting ward colours; clear ward signage; positive staff interaction; memorabilia, and activity rooms and items, had a positive influence on patient interaction, well-being and engagement in daily activities. The audit scores were rated highly for various aspects of the ward design. These included: the ward design promoting patient interaction, well-being, mobility, orientation, continence, eating and drinking and calm and security.

This practice-based small-scale study highlights the importance that a “dementia friendly” ward environment may have on patient engagement and well-being, from a daily activity perspective. Further research into the key aspects of design that enable meaningful daily activity engagement is required.

This study supports staff perceived views of the positive influence that “dementia friendly” design may have for patients with dementia. Both the physical design modifications of the ward and staff interaction were highlighted as positively influencing patient well-being, and daily activity engagement. Staff members also felt that they needed to balance the clinical ward priorities, with the contextual requirements of patients with dementia, to establish an effective “dementia friendly” ward.

The value of this research is the combined consideration of an environmental assessment tool and qualitative interviews with members of the multidisciplinary team.