Neighbourhoods and dementia in the health and social care context: a realist review of the literature and implications for UK policy development

Abstract

SummaryThe National Dementia Strategy in England has performed an essential role in transforming health and social care services and improving the commissioning architecture. However, to date, little attention has been paid to understanding the ways in which the outdoor and built environment impacts and intersects with the lives of people with dementia and their carers. One way of better understanding the outdoor and built environment is through a focus on the ‘neighbourhood’ as this is an area of public policy where attempts are being made across disciplines to unpack its meanings, significance and identity. This paper adopts a realist review method to detail the key findings and messages from the body of work that links the experience of living with dementia to the neighbourhood. Our findings from this review are assimilated and defined/presented under three headings, namely: outdoor spaces, built environment, and everyday technologies. These headings and our definitions are not discrete properties and there is some overlap in content. We found no research that sets out to enquire about how people with dementia might define their neighbourhood or that explores everyday neighbourhood practices for those living with the condition. Emerging concepts such as citizenship and, in the UK, the Coalition Government advancement of the ‘Big Society’, promote a vision of civic responsibilities and networked, dementia-capable communities, but evaluation of such initiatives are virtually absent from the literature. The review did uncover some interesting and innovative research methods that extend neighbourhood working, such as the ‘walking interview’. In order to develop a neighbourhood model for dementia, future research should examine the relationship and interaction between the neighbourhood as a social space and as a physical space alongside the active role of people with dementia as ‘place-makers’.

Living Life and Doing Things Together: Collaborative Research With Couples Where One Partner Has a Diagnosis of Dementia

“…Wiles et al 2012;Gillsjö et al 2011;Soilemezi et al 2017;Ward et al 2017;Keady et al 2012;Keady et al 2014;Nygård, 2004 Comfort/safety inside home Comfort/safety outside home Being able to stay in familiar environments. Importance of facilitating daily activities and chores to promote independence and activity inside the home and in the neighborhood.…”

“…Importance of facilitating daily activities and chores to promote independence and activity inside the home and in the neighborhood. Tanner et al 2008;Torrington, 2009;Werthon & Monk, 2008;Soilemezi et al 2017;Mitchell & Burton, 2010;Keady et al 2012;Ward et al 2017;Keady et al 2014 Physical wellbeing Physical activity as a source of doing things together as a couple and to promote healthy aging, cognitive function and physical wellbeing.…”

A Home-Based Couple Management Guide for Couples Affected by Dementia (DemPower): A Protocol (Preprint)

“…All the eight work programmes are underpinned by the neighbourhoods' model [11], positioning people and communities at the centre of the overall study. Informed by this approach the current work programme is centred on the lives of couples where one partner has a diagnosis of dementia and they live together at home.…”

Place memory and dementia: Findings from participatory film-making in long-term social care

“…At present there are many initiatives nationally and internationally to create 'dementia friendly communities', typically in urban centres and public spaces (Keady et al 2012). In reality, however, our participants had very little access to the external world, or even to the immediate environs of the care facility where they lived.…”