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Article
Publication date: 24 November 2021

Simon Chester Evans, Sarah Waller and Jennifer Bray

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…

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Abstract

Purpose

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.

Design/methodology/approach

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.

Findings

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.

Originality/value

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.

Details

Working with Older People, vol. 26 no. 2
Type: Research Article
ISSN: 1366-3666

Keywords

Article
Publication date: 18 November 2021

Simon Chester Evans, Teresa Atkinson, Mike Rogerson and Jennifer Bray

There is growing interest in and evidence for the benefits of connecting with nature for people living with dementia, sometimes known as “green care”, including reduced…

Abstract

Purpose

There is growing interest in and evidence for the benefits of connecting with nature for people living with dementia, sometimes known as “green care”, including reduced stress, improved sleeping and even enhanced cognition. However, many people living with dementia are denied such opportunities, often because of practitioner perceptions of risk and poor design of outdoor spaces. This paper reports on the evaluation of a project that worked with national providers to give people living with dementia opportunities and support to access the natural environment.

Design/methodology/approach

The evaluation adopted a mixed-methods approach, using a combination of bespoke and commonly used tools and in-depth case study work to identify the facilitators and challenges to delivering the project and explore the experiences of activity participants.

Findings

Qualitative measures indicated a significant improvement in mental well-being for participants with dementia and family carers following attendance at activity sessions. Research interviews indicated that participants enjoyed activities based on connecting with nature. Being outdoors was a major factor in the experience, along with taking part in activities that were meaningful and opportunities for social interaction.

Originality/value

This paper provides evidence for the benefits of connecting with nature for people living with dementia. This paper concludes that access to the outdoors is not a luxury, it is a basic human right and one which has become increasingly important in light of restrictions that have emerged as a result of the COVID19 pandemic.

Details

Working with Older People, vol. 26 no. 1
Type: Research Article
ISSN: 1366-3666

Keywords

Article
Publication date: 22 February 2021

Jennifer Bray, Dawn Brooker, Isabelle Latham and Darrin Baines

The purpose of this paper is to populate a theoretical cost model with real-world data, calculating staffing, resource and consumable costs of delivering Namaste Care…

Abstract

Purpose

The purpose of this paper is to populate a theoretical cost model with real-world data, calculating staffing, resource and consumable costs of delivering Namaste Care Intervention UK (NCI-UK) sessions versus “usual care” for care home residents with advanced dementia.

Design/methodology/approach

Data from five care homes delivering NCI-UK sessions populated the cost model to generate session- and resident-level costs. Comparator usual care costs were calculated based on expert opinion and observational data. Outcome data for residents assessed the impact of NCI-UK sessions and aligned with the resident-level costs of NCI-UK.

Findings

NCI-UK had a positive impact on residents’ physical, social and emotional well-being. An average NCI-UK group session cost £220.53, 22% more than usual care, and ran for 1.5–2 h per day for 4–9 residents. No additional staff were employed to deliver NCI-UK, but staff-resident ratios were higher during Namaste Care. Usual care costs were calculated for the same time period when no group activity was organised. The average cost per resident, per NCI-UK session was £38.01, £7.24 more than usual care. In reality, costs were offset by consumables and resources being available from stock within a home.

Originality/value

Activity costs are rarely calculated as the focus tends to be on impact and outcomes. This paper shows that, although not cost neutral as previously thought, NCI-UK is a low-cost way of improving the lives of people living with advanced dementia in care homes.

Details

Working with Older People, vol. 25 no. 2
Type: Research Article
ISSN: 1366-3666

Keywords

Article
Publication date: 14 September 2022

Shirley Evans, Jennifer Bray, Dawn Brooker and Nathan Stephens

Meeting Centres (MCs) are a complex community-based psychosocial intervention to support people affected by dementia. The purpose of this paper is to describe the process…

Abstract

Purpose

Meeting Centres (MCs) are a complex community-based psychosocial intervention to support people affected by dementia. The purpose of this paper is to describe the process of identifying the essential features of MCs from a UK perspective.

Design/methodology/approach

The essential features were examined within a concept analysis framework, which combines both static and evolutionary methods, enabling multiple stakeholder groups to be included in the process in an iterative manner.

Findings

Eleven essential features were developed, providing a conceptual model of the UK MCs. The underpinning rationale is sufficiently flexible to enable community-based development, while at the same time providing a robust platform upon which to build the evidence base.

Originality/Value

While some features may be common to other types of community-based support, the combination of characteristics and the underpinning ethos differentiates MCs and enables each one to meet the needs of its own community.

Details

Working with Older People, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1366-3666

Keywords

Article
Publication date: 2 March 2022

Jennifer Bray, Simon Chester Evans and Teresa Atkinson

When new interventions are piloted, the implementation process often takes a back seat but can be key to ensuring that an intervention is successful. This paper aims to…

Abstract

Purpose

When new interventions are piloted, the implementation process often takes a back seat but can be key to ensuring that an intervention is successful. This paper aims to highlight the enablers and challenges encountered when implementing a nature-based intervention for people living with dementia.

Design/methodology/approach

The evaluation adopted a mixed methods approach including case studies, telephone interviews with delegates and interviews with participants. Thematic analysis was used to identify overarching themes relating to the enablers and challenges of implementing the intervention.

Findings

Challenges related to understanding how the intervention fitted with existing work and practicalities of what an organisation can offer to support the implementation process. A stable underlying support structure for delegates is required, along with suitable advertising, transport and facilities to support participants. While there is no “one size fits all” approach to implementing an intervention, these findings will help organisations to consider where to focus their support.

Originality/value

The implementation of interventions is often poorly understood but is important when supporting the wider roll out of an intervention. While this paper reports on a nature-based intervention, the learning will be relevant and applicable more broadly for organisations aiming to implement a new intervention and complements previous work relating to the challenges of implementing arts activities.

Details

Working with Older People, vol. 26 no. 3
Type: Research Article
ISSN: 1366-3666

Keywords

Article
Publication date: 24 June 2021

Simon Chester Evans, Jennifer Bray and Claire Garabedian

The purpose of this paper is to report on an independent evaluation of a three-year “Creative Ageing” programme, focussing on the impacts for participants and factors…

Abstract

Purpose

The purpose of this paper is to report on an independent evaluation of a three-year “Creative Ageing” programme, focussing on the impacts for participants and factors promoting successful delivery of sessions.

Design/methodology/approach

Artists provided feedback through reflective journals and questionnaires, while the views of care staff and participants were also captured in a standard format at the end of each arts session. Thematic analysis of the qualitative data identified common themes.

Findings

Twenty-three arts projects were delivered across a range of settings and through diverse art forms including dance, drama, music, visual arts and poetry. They reached nearly 2,200 participants who recorded over 8,100 session attendances in total. Participation in high quality creative experiences improved well-being for older people, as well as increasing social interaction and reducing isolation. Several factors facilitated successful implementation and delivery of the activities, particularly the need to hold planning meetings with staff to provide guidance around participant numbers and suitability, minimising disruption of the sessions and the supportive role of staff during the sessions. Opportunities for reflection enabled artists to address potential challenges and adapt their practice to meet the needs and preferences of participants and to the complexities of diverse settings.

Originality/value

Previous research has largely focussed on the impact of activities in a single setting. This study supports the role of creative arts in increasing social interaction as an attempt to tackle isolation and loneliness, both for older people living in the community and for those living in a communal setting such as care homes and supported living schemes.

Details

Working with Older People, vol. 26 no. 1
Type: Research Article
ISSN: 1366-3666

Keywords

Article
Publication date: 17 May 2021

Shirley Evans, Jennifer Bray and Dawn Brooker

Because of COVID-19 restrictions, Meeting Centres (MCs) for people affected by dementia in the UK ceased to meet physically but continued to provide remote support. The…

Abstract

Purpose

Because of COVID-19 restrictions, Meeting Centres (MCs) for people affected by dementia in the UK ceased to meet physically but continued to provide remote support. The aim was to understand the extent to which MCs were able to operate when physical meetings were not possible and how they achieved particularly in relation to the adaptation and coping model and practical, emotional and social adjustment.

Design/methodology/approach

Semi-structured interviews and focus groups were conducted with people affected by dementia, staff, volunteers, managers and trustees from MCs. Data were collected on the type and quantity of contact MCs had with people affected by dementia during lockdown. Data were coded and mapped against adaptation and coping strategies, i.e. practical understanding and empowerment, optimising emotional well-being and opportunities for social engagement.

Findings

A range of remote approaches, both technological (e.g. using online platforms) and non-technological (e.g. newsletters and post) were implemented alongside limited face-to-face contact. Regular MC activities were adapted using the different approaches. It was possible to map all the adaptation and coping model support strategies to the activities delivered in this way. MCs were able to adapt rapidly to continue to support people to adjust to change.

Social implications

Moving forward, combining approaches (usual MC and remote) means person-centred support could be optimized, addressing social isolation and reaching those who cannot attend MCs.

Originality/value

This paper offers new insight into the extent to which community-based support for people with dementia can continue when face-to-face contact is not possible because of COVID-19.

Details

Working with Older People, vol. 25 no. 4
Type: Research Article
ISSN: 1366-3666

Keywords

Article
Publication date: 18 June 2019

Simon Chester Evans, Julie Barrett, Neil Mapes, June Hennell, Teresa Atkinson, Jennifer Bray, Claire Garabedian and Chris Russell

The benefits of “green dementia care”, whereby people living with dementia are supported to connect with nature, are increasingly being recognised. Evidence suggests that…

Abstract

Purpose

The benefits of “green dementia care”, whereby people living with dementia are supported to connect with nature, are increasingly being recognised. Evidence suggests that these benefits span physical, emotional and social spheres and can make a significant contribution towards quality of life. However, care settings often present specific challenges to promoting such connections due to a range of factors including risk-averse cultures and environmental limitations. The purpose of this paper is to report on a project that aims to explore the opportunities, benefits, barriers and enablers to interaction with nature for people living with dementia in residential care and extra care housing schemes in the UK.

Design/methodology/approach

Data were gathered from 144 responses to an online survey by managers/staff of extra care housing schemes and care homes in the UK. In depth-case studies were carried out at three care homes and three extra care housing schemes, involving interviews with residents, staff and family carers.

Findings

A wide variety of nature-based activities were reported, both outdoor and indoor. Positive benefits reported included improved mood, higher levels of social interaction and increased motivation for residents, and greater job satisfaction for staff. The design and layout of indoor and outdoor spaces is key, in addition to staff who feel enabled to promote connections with nature.

Research limitations/implications

This paper is based on a relatively small research project in which the participants were self-selecting and therefore not necessarily representative.

Practical implications

The paper makes some key recommendations for good practice in green dementia care in extra care housing and care homes.

Social implications

Outdoor activities can promote social interaction for people living with dementia in care settings. The authors’ findings are relevant to the recent policy focus on social prescribing.

Originality/value

The paper makes some key recommendations for good practice in green dementia care in extra care housing and care homes.

Details

Working with Older People, vol. 23 no. 3
Type: Research Article
ISSN: 1366-3666

Keywords

Article
Publication date: 11 September 2018

Christine Carter, Jennifer Bray, Kate Read, Karen Harrison-Dening, Rachel Thompson and Dawn Brooker

The purpose of this paper is to describe the process of developing a contemporary competency framework for admiral nurses in dementia care.

Abstract

Purpose

The purpose of this paper is to describe the process of developing a contemporary competency framework for admiral nurses in dementia care.

Design/methodology/approach

Information and evidence was gathered from research and policy literature regarding competencies to deliver advanced practice within dementia care. An online survey completed by 75 admiral nurses with follow-up interviews clarified current practice across the range of service contexts in which they work. A focus group (FG) of people living with dementia and family carers, and a reference group of practitioners helped to develop a competency framework which was refined through FGs with admiral nurses working in different areas.

Findings

The literature review, survey and interviews provided a framework grounded in up-to-date evidence and contemporary practice. There was broad agreement in the literature and the practitioners’ priorities regarding the core competencies of advanced practice, with constructive suggestions for making the framework useable in practice. This resulted in a robust framework articulating the competencies of admiral nurses which could be used for continuous professional development.

Originality/value

Engaging the admiral nurses ensured the competencies were contemporary, succinct and applicable within practice, and also cultivated a sense of ownership. Developing the competency framework with the admiral nurses not for them provides an approach which may have value for professionals undertaking a similar process in their specialist area. It is anticipated the competency framework will provide further evidence of the benefits of specialist nurse support for families affected by dementia.

Details

Working with Older People, vol. 22 no. 3
Type: Research Article
ISSN: 1366-3666

Keywords

Book part
Publication date: 6 September 2018

Denise Paquette Boots, Laura M. Gulledge, Timothy Bray and Jennifer Wareham

Purpose – Presents metrics and policy recommendations from the Dallas Domestic Violence Task Force (DDVTF) concerning the systemic response to domestic violence (DV…

Abstract

Purpose – Presents metrics and policy recommendations from the Dallas Domestic Violence Task Force (DDVTF) concerning the systemic response to domestic violence (DV) within this community.

Design/methodology/approach – In June 2017, 47 private citizens, nonprofit, criminal justice, social service and religious organizations, and governmental officials who participated on the task force were invited via email to participate in an electronic Qualtrics survey.

Findings – Both general annual metrics are offered as well as detailed monthly metrics and long-term trends for shelter and advocacy providers, police, the district and city attorney’s offices, and courts. In 2016–2017 alone, roughly 15,000 people were educated on DV, 246 victims were sheltered in emergency beds each night on average, roughly 8,000 victims were turned away due to lack of space, over 15,500 DV-related calls were handled by police, 11,000 county criminal cases were filed, and 7 intimate partner homicides occurred within the city of Dallas. Policy recommendations are offered.

Originality/value – The DDVTF annual report is one of the largest and most comprehensive reports of its kind in the United States, with over 3,000 variables collected across the partners. Now in its third reporting year, this chapter offers an overview of key findings and policy recommendations and highlights the work of this coordinated community response team.

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