How do community based dementia friendly initiatives work for people with dementia and their caregivers, and why? A rapid realist review

Abstract

Objectives To describe and explain the outcomes of community dementia friendly initiatives (DFIs) for people with dementia and their caregivers to inform the development and tailoring of DFIs. Methods Literature searches on DFIs were performed through two systematic online database searches of PubMed, Embase, ASSIA, CINAHL and Google scholar. Papers were only included if they evaluated outcomes using empirical data from people with dementia or caregivers. Data collection and analysis were guided by the categorization in the DEM‐FACT taxonomy and RAMESES guidelines for realist reviews. Results Of 7154 records identified, 22 papers were included with qualitative, mixed method and quantitative study designs. The synthesis led to a description of programme theories addressing caring, stimulating and activating communities. Outcomes for people with dementia and caregivers included having contact with others, enjoyment and decrease of stress and, lastly, support. This synthesis also indicated how people with dementia participated in a specific role in DFIs, such as patient, team member or active citizen. Conclusions DFIs generate different outcomes for people with dementia and caregivers, depending on the kind of initiative and the specific role for people with dementia. These findings could be a catalyst for initiation and further development of DFIs in a dementia friendly community (DFC). This draws attention to the multiple aspects of DFCs and supports reflection on their essential principles.

Towards age‐friendly municipalities: What are municipalities doing to support their ageing population with mental health problems?

“…Researchers and policy makers have given the concept of dementia‐friendly communities quite a bit of attention in recent years (Hebert & Scales, 2019; Henwood & Downs, 2014; Heward et al, 2017; Hung et al, 2021; Mitchell et al, 2003; Mitchell et al, 2004; Shannon et al, 2019; Thijssen et al, 2021; Alzheimer's Society, 2013). The municipalities involved in the SFC project were quite familiar with this concept, and some were already working on becoming a dementia‐friendly community.…”

Supporting Resilience of Older Adults with Cognitive Decline Requires a Multi-Level System Approach

“…In a Dementia Friendly Community, the physical and social environment is responsive to the needs of a person with dementia. This means that people are aware of, and try to understand people with dementia and their caregivers, so that both feel included and involved, and are supported to have control over their day-to-day lives [63][64][65]. An example is collaboration of art and care professionals in local cultural initiatives with frail older persons, such as participation in choirs for persons with dementia.…”

It is time to be heard and understood: Readmission probably is not the outcome that matters among people with dementia considering percutaneous coronary intervention

“…Not surprisingly, people with dementia undergoing surgery have a higher risk for adverse outcomes 3 . Holistic care is especially relevant in the population with dementia and entails serious consideration of the individual's overall well‐being and life trajectory 4 …”

“…3 Holistic care is especially relevant in the population with dementia and entails serious consideration of the individual's overall well-being and life trajectory. 4 In this issue of the Journal of the American Geriatrics Society, Park and colleagues use the National Readmissions Database 2017-2018 and propensity score-matching to report on 30-day all-cause hospital readmission among adults with and without ADRD following index admission with PCI for ST-elevation myocardial infarction (STEMI), non-ST-elevation myocardial infarction (NSTEMI), unstable angina (UA), or stable ischemic heart disease (SIHD). 5 Outpatient PCI is understandably, excluded from their analysis.…”