The Influence of Place on Everyday Life: Observations of Persons with Dementia in Regular Day Care and at the Green Care Farm

Abstract

Day care services for persons with dementia are becoming an important aspect of community services. Place, therefore, becomes vital concerning how such establishments are organized regarding both the physical and social environment and the programs that are offered. The aim of this study was to describe the influence of place on everyday life in two different organized daycare services for persons with dementia. Based on observations and informal conversations with persons with dementia and staff members at a green care farm and a regular day care, we used an inductive manifest content analysis. The analysis reveals a main category: enabling and collaboration in daily life. The results are discussed in light of Goffman's analysis of the structures of social encounters from the perspective of the dramatic performance. The main findings in this study involve how place contributes to enabling activities and collaboration between participants and staff, as it influences participants' ability to achieve an active or passive role in everyday life at the day care services.

<p>Care Farming for People with Dementia; What Can Healthcare Leaders Learn from This Innovative Care Concept?</p>

“…Care farms have a wide range of health-promoting environmental characteristics, including the presence of outdoor spaces (eg, farmyard, vegetable garden, paddocks), farm and companion animals, plants, daily life stimuli, and a familiar and home-like environment. 14,[31][32][33][34] The different healthpromoting characteristics are naturally present in the farm environment and are therefore extensively used in the wide range of activities care farms offer to people with dementia. [34][35] These activities, which are regarded as stimulating and meaningful, include walking outside, indoor horticulture activities, meal preparation, feeding and viewing the animals, picking eggs, gardening, sweeping the yard, crafts, woodworking, and playing games.…”

“…[34][35] These activities, which are regarded as stimulating and meaningful, include walking outside, indoor horticulture activities, meal preparation, feeding and viewing the animals, picking eggs, gardening, sweeping the yard, crafts, woodworking, and playing games. 14,33,34,[36][37][38] Activity engagement and required physical effort to partake in activities at care farms are usually higher than in activities in regular dementia care environments. 13,35,36,39 People with physical disabilities are able to participate in care farm activities as well.…”

“…This is in contrast to regular dementia care environments, where it has been observed that the institution may hinder engagement, for example, staff doing certain domestic activities (eg, meal preparation) themselves, without the involvement of people with dementia. 29,31,33,38,40,41 Moreover, organizational aspects such as working routines in regular dementia care environments appear rigid and are often perceived as unalterable, which also complicates engaging people with dementia and using the physical environment in an optimal way. 42 Potential downsides of an inviting and open environment, such as a care farm environment, are potential hazards.…”

“…Several participants of care farms do not have any previous experience with country life or farms, and have occupational backgrounds in other sectors such as technology, education, or health care. 14,33,46 Some family carers of clients of care farms indicated that if services at care farms had not been available, they would have postponed the use of adult day services or would have not used them at all as these would insufficiently meet the needs and capacities of their loved ones. 38,46 What Can Healthcare Leaders Learn from Dementia Care Provision at Care Farms?…”

“…Successful implementation of care farming principles also requires competent staff members; that is, staff being flexible and creative and having a progressive mindset that is open to change. 30,33,40,49 Third, it is recommended that healthcare leaders seek innovative collaborations, particularly those who are unable to create innovative dementia care environments by themselves or in their own settings. In the Netherlands for instance, we see increasing numbers of dementia care institutions collaborating with social entrepreneurs.…”