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 policy and…
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.
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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 stress…
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.
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Sarah Waller, Simon Chester Evans, Jennifer Bray and Teresa Atkinson
There is increasing interest in the UK in developing environments that support people who are neurodiverse. This paper aims to report on a project to develop a cognitively…
Abstract
Purpose
There is increasing interest in the UK in developing environments that support people who are neurodiverse. This paper aims to report on a project to develop a cognitively supportive environmental assessment tool to improve the design of health centres, where the majority of National Health Service consultations take place, for all users, including people living with dementia and those who are neurodiverse.
Design/methodology/approach
A three-stage process was used: a literature review; the development of a matrix of key design features for people living with dementia, autism and other neurodiverse conditions; and the development of an environmental assessment tool and guide for users, which included easy-to-read versions to maximise service user involvement.
Findings
The overarching concepts of dementia-friendly design can be adapted to create designs for everyone, including those who are neurodiverse.
Research limitations/implications
There is a paucity of research in environmental design for primary care from the patient’s perspective, and, more generally, further research on design for adults with learning disabilities and autism is needed.
Practical implications
The tools are free to download. With adaptation, they have potential applicability across health and care settings.
Originality/value
This project has confirmed that the principles of dementia-friendly design are applicable, with modifications, to a wider group of neurodiverse people. Critically, each person’s response to sensory stimuli is individual rather than determined by their condition.
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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 promoting…
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.
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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 highlight…
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.
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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 these…
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.
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Simon Chester Evans and Jennifer Bray
Approximately 100,000 people in the UK aged 75 and over have concurrent dementia and sight loss, but current understanding of their experiences, needs and preferences is limited…
Abstract
Purpose
Approximately 100,000 people in the UK aged 75 and over have concurrent dementia and sight loss, but current understanding of their experiences, needs and preferences is limited. The purpose of this paper is to report on a research project that explored the provision of social care and support for older people with both conditions.
Design/methodology/approach
The project was a collaboration between the universities of York, Worcester, Bournemouth and Cambridge, supported by the Thomas Pocklington Trust and the Housing and Dementia Research Consortium. Data for this paper were drawn from focus groups held in 2013 involving 47 professionals across the dementia, sight loss and housing sectors.
Findings
Thematic analysis identified five main barriers to providing high-quality, cost-effective social care and support: time constraints; financial limitations; insufficient professional knowledge; a lack of joint working; and inconsistency of services. The requirements of dementia and sight loss often conflict, which can limit the usefulness of equipment, aids and adaptations. Support and information needs to address individual needs and preferences.
Research limitations/implications
Unless professionals consider dementia and sight loss together, they are unlikely to think about the impact of both conditions and the potential of their own services to provide effective support for individuals and their informal carers. Failing to consider both conditions together can also limit the availability and accessibility of social care and support services. This paper is based on input from a small sample of self-selecting professionals across three geographical regions of England. More research is needed in this area.
Practical implications
There are growing numbers of people living with concurrent dementia and sight loss, many of whom wish to remain living in their own homes. There is limited awareness of the experiences and needs of this group and limited provision of appropriate services aids/adaptations. A range of measures should be implemented in order to support independence and well-being for people living with both conditions and their family carers. These include increased awareness, improved assessment, more training and greater joint working.
Social implications
People living with dementia or sight loss are at high risk of social isolation, increasingly so for those with both conditions. Services that take an inclusive approach to both conditions can provide crucial opportunities for social interaction. Extra care housing has the potential to provide a supportive, community-based environment that can help residents to maintain social contact.
Originality/value
This paper adds much-needed evidence to the limited existing literature, and reflects the views of diverse professionals across housing, health and social care.
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Aarhus Kommunes Biblioteker (Teknisk Bibliotek), Ingerslevs Plads 7, Aarhus, Denmark. Representative: V. NEDERGAARD PEDERSEN (Librarian).
It has often been said that a great part of the strength of Aslib lies in the fact that it brings together those whose experience has been gained in many widely differing fields…
Abstract
It has often been said that a great part of the strength of Aslib lies in the fact that it brings together those whose experience has been gained in many widely differing fields but who have a common interest in the means by which information may be collected and disseminated to the greatest advantage. Lists of its members have, therefore, a more than ordinary value since they present, in miniature, a cross‐section of institutions and individuals who share this special interest.
Chester Whitney Wright (1879–1966) received his A.B. in 1901, A.M. in 1902 and Ph.D. in 1906, all from Harvard University. After teaching at Cornell University during 1906–1907…
Abstract
Chester Whitney Wright (1879–1966) received his A.B. in 1901, A.M. in 1902 and Ph.D. in 1906, all from Harvard University. After teaching at Cornell University during 1906–1907, he taught at the University of Chicago from 1907 to 1944. Wright was the author of Economic History of the United States (1941, 1949); editor of Economic Problems of War and Its Aftermath (1942), to which he contributed a chapter on economic lessons from previous wars, and other chapters were authored by John U. Nef (war and the early industrial revolution) and by Frank H. Knight (the war and the crisis of individualism); and co-editor of Materials for the Study of Elementary Economics (1913). Wright’s Wool-Growing and the Tariff received the David Ames Wells Prize for 1907–1908, and was volume 5 in the Harvard Economic Studies. I am indebted to Holly Flynn for assistance in preparing Wright’s biography and in tracking down incomplete references; to Marianne Johnson in preparing many tables and charts; and to F. Taylor Ostrander, as usual, for help in transcribing and proofreading.