Duggan, Blackman, Martyr and van Schaik 2
AbstractThis paper reports the voices of twenty-two people with early to moderate dementia and their carers about the use of the outdoor environment. Analysis of semi-structured interviews demonstrates that people with early dementia value the outdoor environment for reasons such as exercise, fresh air, emotional well-being, the opportunity for informal encounters with neighbours and friends and the appreciation of the countryside. Conversely, not being able to go out was associated with depressive feelings. Carers reported that the impact of dementia was to decrease the frequency of outdoor activity and to limit the areas visited to those that were the most familiar. Maintaining outdoor activity is likely to be an effective preventative measure in extending the period of good quality living and might decrease the period when intensive services are required. It should therefore be considered in planning for both residential care and community living in the future.
. (2001) 'Neighbourhood renewal and health :evidence from a local case study.', Health and place., 7 (2). pp. 93-103. Further information on publisher's website:http://dx.doi.org/10.1016/S1353-8292(01)00003-X Publisher's copyright statement:Additional information:
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AbstractThis article presents findings from a before-and-after study of the effects of neighbourhood renewal on residents' health. Survey data were analysed using multivariate logistic regression. Before the renewal programme, damp and draughts had significant independent effects on respiratory health problems. Draughts and perceived community safety were associated with mental health problems. Children's mental health was associated with parental mental health.Following the renewal work, improvements occurred in both adults' and children's mental health, and smoking declined sharply. Respiratory health did not improve and there was no change in use of health services. Neighbourhood renewal in deprived areas can have an important role in improving community health.
Few studies have investigated how outdoor environments might disable people with dementia. The issue is rarely considered in planning and design guidelines and not at all in regulations, despite dementia being within the scope of disability discrimination legislation in the United Kingdom and other countries. This article reports a study that involved older people with mild to moderate dementias taking two walks, one in a real town centre and one in a virtual reality (VR) simulation. Adaptations were made to the VR simulation to test possible design improvements. Overall, the town centre posed relatively few problems for the 38 older people with dementia who participated, although more difficulty was evident with greater impairment. Some features of particular places were liked more than others, particularly the segregation of spaces from motor traffic. There were measurable benefits from using clear textual signs to support wayfinding and to identify objects and places in the environment. Diminished outdoor activity is likely to be experienced as a decrease in quality of life and may accelerate the progression of dementia. We conclude that older people with mild to moderate dementia should be encouraged to be active outdoors and that this can be facilitated by small environmental modifications. Some limitations of the VR technology used for the study are also reported.
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