Recent advancements in dementia care have moved away from a custodial type of care where people have been considered well cared for if they were clean, dry, fed, quiet and not at any risk. This type of care often failed to recognize the person with dementia as an adult human being with a right to lead a dignified and meaningful life. In this new culture of care, which promotes a person-centered approach (Kitwood and Bredin, 1992), infantilization can be seen as inappropriate.

Purpose: This paper considers reasons for the successful maintenance of community based, falls-prevention programs. While the physical achievement of such programs has been demonstrated through randomized trials, other features influential in ongoing membership have received less attention. This study examined the sustainability of a specific model of a community-based program in a New Zealand city: SAYGO, the strength and balance classes for older adults lead by older volunteer leaders recruited from local communities. Method: A qualitative, descriptive approach was used and first-hand knowledge of the experiences of those involved in the groups gathered. Data collection methods included individual interviews of two group organizers and seven focus groups: six with the members of the exercise groups (57 participants) and one with the peer leaders from these same groups (6 participants). Results: Three major themes emerged from the interviews. Two were related to the outcomes of the groups (ie. physical and social benefits). The third was concerned with the support needs of the groups to ensure their on-going maintenance. The aspect that most invigorated the participants was the social value of the group. Conclusions: A major feature that contributed to the sustainability of the peer led exercise groups was the positive social connectedness created by the modeling of a caring culture by the peer-leaders. This caring culture involves support and inclusion of every member and acting as a resource and confidant for individual issues. Because group leaders are similar in age and physical problems, it is expected that they will empathize with participants, and because of their community and agency links, it is expected that they will be able to act as a resource for information on issues related to the participants, therefore, stand between the formal and informal domains and are perceived to have knowledge and connections in both. This, we suggest, is a major, previously unconsidered feature in the sustainability of these groups.

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The café provided a myriad of opportunities for participation in relationships and the creation and maintenance of social networks. This participation reinforced a sense of self and of being ordinary.

Background: The publics’ perceptions of aged care residential facilities (ACRF’s) are generally derogatory in nature; with terms such as the ‘end of the road’ or ‘the last resort’ being used to describe them. The institutional design and nature of the traditional ‘nursing home’ has contributed to such a perception. However, more contemporary models of residential aged care facilities are encompassing design features which aim to enhance the physical and social environment and therefore the lives of the older people residing within them. Purpose: This research reports on the inclusion of a café in the foyer of an aged care residential which is open to the public. Members of the public who use the café were interviewed. Methods: This research project utilised qualitative inquiry of a descriptive nature. Data was gathered through semi-structured interviews; seven participants were interviewed. Data analysis to establish themes utilised coding. Findings: The perceptions of members of the public who use the café is presented according to three major themes; place and purpose, people and relationships and community exposure and perceptions. The café is perceived, by the participants of this research project, as a place to go in the local community which was appreciated for its familiarity, pleasant surroundings and the quality of its service. Interactions between staff and residents were observed as caring and participants reflected that the staff were personally invested in their work. Visiting this café has challenged the notion that ACRF’s are closed off institutional places and the environment was described as open and inviting. The interaction between the community and the ACRF was discussed the benefits for the residents and for themselves were identified. Participants described a developing affiliation and connection between the facility and themselves and this prompted reflection about their own future residential needs. Conclusion: This café has opened a door between the ACRF and the local community. Members of the public who visit the café are able to observe, interact and make connections within the residential care environment. Perceptions about the nature of aged care facilities have been challenged and reflection about future residential care needs has occurred.