Much of the focus on “living well with dementia” has concentrated on the importance of an indoor home environment. However, research shows that interaction within the local neighbourhood, community, and outdoor environment is vital for all age groups. This includes people with dementia, providing meaning and ongoing feelings of belonging and staying connected.
Creating a society where neighbourhoods are supportive, and public places are “dementia-friendly” is seen as key to improving the quality of life of those living in the community with dementia. For example, where people with dementia are encouraged to continue active engagement within the public domain.
You may wonder, what exactly does that mean? Why are neighbourhoods important, and what is a dementia-friendly community? How can we support our loved ones to continue to live well in the local community?
In this article, we aim to answer these questions.
The Importance of Our Local Neighbourhood
Research demonstrates that continued interaction within the local neighbourhood can help provide meaning and connection to culture and community. It can help us live in the moment. It helps re-invigorate our spirit and positively affects feelings of well-being, sense of belonging, and overall happiness.
According to research, neighbourhoods are important in two ways:
- Connection to People: because of our relationships with others living and working there.
- Connection to Place: to provide practical support, goods, and services that can also help develop relationships and daily interactions.
These connections can develop across a lifetime of living in one location.
Stay Connected: Difficulties for People with Dementia
Despite ample evidence highlighting the advantages, many people with dementia continue to see it as a frightening prospect.
Routine activities can become difficult as the condition progresses- shopping, accessing public places, using transport. Often this can cause people with dementia to withdraw, retreating into what has been described historically as a “shrinking world”. Therefore, outdoor environments should be increasingly designed to help people with dementia continue to use their local neighbourhoods. This will ensure that they do not isolate themselves in their homes.
How can we nurture social connections?
Our local neighbourhood is not just a physical place but also an environment that can offer social and cultural support. The neighbourhood is not just about the characteristics of the spaces in which people live. It is also about how they feel about, identify with and act in and around their homes. Interactions with neighbours and other “strangers” can play a key part in the social health of people with dementia.
Supporting our loved ones to remain connected within the community can help provide support in several different ways for various purposes.
Stay Connected to People
Routine trips to the local coffee shop or restaurant can become a familiar event. Regular and frequent interaction with “strangers” can build the value of mutual recognition and acknowledgment within informal interactions. Something as simple as a smile through a window or an acknowledgment when passing by can enable a sense of connection and, consequently, of belonging.
Regular interaction with the same people in the same places builds familiarity and a sense of belonging. Research shows that this can build confidence for people living with dementia. This type of connection can range from interactions with storekeepers and service providers (such as chemists, café and bar staff, and hairdressers) to people walking their dogs or jogging, which may be seen or passed by regularly.
Everyone, from office workers, healthcare employees, bank clerks, shop owners, bus drivers, and waitresses, all have a role in ensuring people with dementia feel welcomed, engaged, active, and valued within our local communities.
Stay Connected to People
Research tells us that traditionally, the design of the outdoor environment is based on the “young male adult”, with any change tending to focus on physical accessibility with little attention given to cognitive challenges. However, the outdoors for people with dementia should be attractive, welcoming, safe, easy to access, navigate, and enjoyable.
According to DSDC (Dementia Services Development centre) at the University of Stirling, a centre of excellence in research and dementia care practice, important factors to bear in mind when creating dementia-friendly environments include:
- Colour and contrast (making buildings, signs, and doorways stand out).
- Soft lighting reduces glare or shadows.
- Clear signage.
- Good visual access.
- Lack of unhelpful stimulation, such as excessive noise.
- Well-defined pathways that are clear of clutter.
Studies into how to develop communities that create dementia-friendly environments describe several aspects that make communities dementia-friendly:
- Familiarity: Buildings that are well established and, in the main, the functions of the places and buildings are obvious.
- Legibility: Clear junctions, access to pedestrian crossings, and clear directional signage can help facilitate decision-making
- Distinctiveness: Historical or architectural buildings to help create landmark way-finding cues. Distinct marking of key public services such as the post office, library, or bank could act as independent cues for people.
- Accessibility: Facilities should have easily recognisable purposes and accessible entrances. Easy access to public toilets and plenty of disabled parking spaces can help.
- Comfort: Public telephone boxes, covered bus shelters with seating, and comfortable benches with arms to provide respite would benefit everyone, not least those with dementia.
- Safety: Even footpaths and well-maintained surfaces that are non-slippy and free from clutter are essential.
Technology
Technology plays an increasing role in providing a positive influence in the day-to-day lives of people with dementia, not only by improving safety but through stimulation.
Assisted Technology (AT) is an area that can help within the community to increase the independence and safety of those with dementia while reducing anxiety and providing peace of mind for carers.
As Smart technologies become a ubiquitous feature of everyday life, more and more attention is being paid to developing dementia-friendly products and neighbourhoods and, consequently, transforming the lives of people with dementia.
People with dementia already take advantage of Smart functionality in their home environment.
Home automation systems can monitor and/or control lighting, climate, entertainment systems, appliances, water leaks, refrigerators, smoke and CO leaks, and security by installing sensors throughout the home.
Motion sensors can track movement in different rooms and areas of the house so that caregivers can tell when the person has woken up, visited the bathroom, or entered the kitchen. Appliances use monitors, memory aids, and emergency contact systems, and Smart plugs are added applications that can improve the independence, safety, and quality of life of people with dementia in their own homes.
Cities with Smart infrastructures already in situ offer technology benefits to citizens beyond the Smart Home and out into the external domain. Some of these benefits are particularly relevant to people with dementia and an ageing population. They include easy-to-use mobiles, GPS tracking devices, smart shoes, etc. When considering this type of device, it’s important to remember that it’s not about keeping track of where a person is or spying on them. It’s about coming up with solutions that are agreed upon with someone with dementia. It’s about helping them remain as independent as possible and ensuring safety. Find out more tips on how Assistive Technology can help people with dementia negotiate the environment here
Summing Up
The Oxford dictionary describes a community as a group of people “sharing the same social values and responsibilities”. If we are to consider the implications for someone with dementia truly, then we must concede that to promote a sense of well-being and belonging as valued members of our community, we must enter their world. We much place ourselves in their shoes and walk at their place in a community adapted to their needs.
Thank you for reading.
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Please also check out our other articles on self-care for family carers and therapeutic interventions for people with dementia.