Variation in Implementing Dementia-Friendly Community Initiatives: Advancing Theory for Social Change
1.1. Empirical Background
1.2. Focus of the Current Study
2. Materials and Methods
2.1. Study Setting
2.3. Data Collection
2.4. Data Analysis
3.1. Contexts Influencing Different Approaches to Implementation of DFC Initiatives
“We created a town-wide calendar for dementia-friendly programming. I was talking with the [assisted living] that also had a caregiver support group during the day. I scheduled ours at night so that if there’s someone who couldn’t come during the day, they could come at night.”
“[Name of Local Hospital] was working on an age-friendly health systems initiative. We were able get in some their meetings so that we can try to better integrate dementia-friendly into age-friendly. I think originally they were seen as separate initiatives, but I think it really is beneficial when they are integrated and working together.”
“I just decided what populations in town I wanted to target first. I needed to be out in the community. For my dementia-friendly campaign, I spend my time with the Lions Club, Rotary Club, confirmation classes, Boy Scouts, Girls Scouts. I go to churches and do presentations after the services.”
“We had a gentleman living with dementia attend our exercise group [at the senior center]…he had been kicked out of other centers before because he was saying inappropriate things to other people…So, each time a new person came into the group, I [educated them about dementia] and [encouraged them] to have compassion for him and his wife.”
3.2. Case Illustrations
3.2.1. Case #1: Toward a More Dementia-Friendly Town
“[The process of signing the DFM pledge] put me in front of the select board for them to sign…It formalized this work group a little bit, and it also put something in front of the town administrator to say, ’Town employees need to be trained, and they need to know this, and the town should go be on the forefront of it, and then the rest of the town can follow.”
“There is a line item in the [COA] budget for $20,000 [to use towards dementia-related programs and services]…I think memory cafés are just a phenomenal way for a caregiver to have an hour and a half to be with other caregivers and in a very comfortable space so that they can share their anxieties, their thoughts, their resources, their everything.”
3.2.2. Case #2: Toward a More Dementia-Friendly Senior Center
“We have eight employees at our senior center…We know the majority of people who have any level of dementia [at the senior center], whether it’s an official diagnosis or not.”
“Instead of planning and executing [the DFC initiative work], it was all-hands-on-deck [for crisis response to the COVID-19 pandemic]. We did meals and food delivery the entire time. We just opened our center this week…So we’re just getting back out of crisis mode.”
3.2.3. Case #3: ‘Living’ at the Senior Center for Now
“Our hope was to not have it be a Council on Aging initiative, but to have it be something that was a town activity. We were actually thinking that the library might be a better place for it to live moving forward, but they were having staffing decreases and then COVID happened, and we have more staff, so it’s staying, it’s living here for now.”
“We were in a transition phase starting in the fall before COVID because the person who took on the chairmanship could not continue…Eventually the visiting nurse and myself decided we would split [the leadership role] until we could identify another volunteer leader of the group, but then COVID happened.”
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
- Alzheimer’s Disease International. Dementia Friendly Communities: Global Developments. 2016. Available online: https://www.alzint.org/u/dfc-developments.pdf (accessed on 16 September 2021).
- UK Department of Health. Prime Minister’s Challenge on Dementia 2020. 2020. Available online: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/414344/pm-dementia2020.pdf (accessed on 3 February 2023).
- UK Department of Health. Prime Minister’s Challenge on Dementia 2012. 2012. Available online: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/215101/dh_133176.pdf (accessed on 3 February 2023).
- Alzheimer’s Society. How to Become a Recognised Dementia-Friendly Community. Available online: https://www.alzheimers.org.uk/get-involved/dementia-friendly-communities/how-to-become-dementia-friendly-community (accessed on 26 April 2022).
- Buckner, S.; Darlington, N.; Woodward, M.; Buswell, M.; Mathie, E.; Arthur, A.; Lafortune, L.; Killett, A.; Mayrhofer, A.; Thurman, J.; et al. Dementia-friendly communities in England: A scoping study. Int. J. Geriatr. Psychiatry 2019, 34, 1235–1243. [Google Scholar] [CrossRef] [PubMed]
- ACT on Alzheimer’s. About ACT on Alzheimer’s. Available online: https://www.actonalz.org/about (accessed on 17 September 2021).
- DFA. What Is DFA? Dementia Friendly America. Available online: https://www.dfamerica.org/what-is-dfa (accessed on 26 April 2022).
- USAging. Our Mission and Work. Available online: https://www.usaging.org/ourmission (accessed on 24 January 2023).
- DFA. DFA Communities Listing, Dementia Friendly America. Available online: https://www.dfamerica.org/dfa-communities (accessed on 2 February 2023).
- CDC. Healthy Brain Initiative. 30 July 2020. Available online: https://www.cdc.gov/aging/healthybrain/index.htm (accessed on 24 January 2023).
- ACL. Alzheimer’s Disease Programs Initiative (ADPI) Funding Opportunity. Available online: https://acl.gov/news-and-events/announcements/alzheimers-disease-programs-initiative-adpi-funding-opportunity (accessed on 24 January 2023).
- AARP. Age-Friendly and Dementia Friendly Communities. AARP. Available online: https://www.aarp.org/livable-communities/network-age-friendly-communities/info-2016/dementia-friendly-communities.html (accessed on 8 February 2023).
- Mass.gov. Massachusetts Age- and Dementia Friendly Integration Toolkit. Available online: https://www.mass.gov/handbook/massachusetts-age-and-dementia-friendly-integration-toolkit (accessed on 8 February 2023).
- Alzheimer’s Disease International. Alzheimer’s Disease International (ADI). Available online: https://www.alzint.org/ (accessed on 2 February 2023).
- Alzheimer’s Disease International. Principles of a Dementia Friendly Community. 2021. Available online: https://www.alz.co.uk/dementia-friendly-communities/principles (accessed on 13 September 2020).
- Hebert, C.A.; Scales, K. Dementia friendly initiatives: A state of the science review. Dement. Lond. Engl. 2019, 18, 1858–1895. [Google Scholar] [CrossRef] [PubMed]
- Novak, L.S.; Horne, E.; Brackett, J.R.; Meyer, K.; Ajtai, R.M. Dementia-friendly communities: A review of current literature and reflections on implementation. Curr. Geriatr. Rep. 2020, 9, 176–182. [Google Scholar] [CrossRef]
- Sun, F.; Opur, F.A.; Kim, H.-N.; Prieto, L.R.; Conyers, C. Dementia-friendly initiatives within the context of COVID-19 pandemic: Challenges and strategies perceived by service professional stakeholders from the USA and China. Dementia 2022, 21, 1714–1733. [Google Scholar] [CrossRef]
- Shannon, K.; Bail, K.; Neville, S. Dementia-friendly community initiatives: An integrative review. J. Clin. Nurs. 2019, 28, 2035–2045. [Google Scholar] [CrossRef]
- Rahman, S.; Swaffer, K. Assets-based approaches and dementia-friendly communities. Dement. Lond. Engl. 2018, 17, 131–137. [Google Scholar] [CrossRef]
- Lin, S.-Y. “Dementia-friendly communities” and being dementia friendly in healthcare settings. Curr. Opin. Psychiatry 2017, 30, 145–150. [Google Scholar] [CrossRef]
- Mathie, E.; Antony, A.; Killett, A.; Darlington, N.; Buckner, S.; Lafortune, L.; Mayrhofer, A.; Dickinson, A.; Woodward, M.; Goodman, C. Dementia-friendly communities: The involvement of people living with dementia. Dementia 2022, 21, 1250–1269. [Google Scholar] [CrossRef]
- Coyle, C. Age & Dementia Friendly Cape Ann: A Regional Needs Assessment. January 2018. Available online: https://scholarworks.umb.edu/demographyofaging/33 (accessed on 1 February 2023).
- Coyle, C. Wenham Connects: An age and dementia friendly needs assessment. Cent. Soc. Demogr. Res. Aging Publ. 2018. Available online: https://scholarworks.umb.edu/demographyofaging/32 (accessed on 1 February 2023).
- Crampton, J.; Eley, R. Dementia-friendly communities: What the project “Creating a Dementia-friendly York” can tell us. Work. Older People 2013, 17, 49–57. [Google Scholar] [CrossRef]
- Phillipson. Dementia Friendly Kiama. 2016. Available online: http://dementiaillawarra.com/dementia-friendly-kiama/ (accessed on 13 September 2020).
- Lin, S.-Y.; Becker, M.; Belza, B. From dementia fearful to dementia friendly: Be a champion in your community. J. Gerontol. Nurs. 2014, 40, 3–5. [Google Scholar] [CrossRef]
- Hung, L.; Hudson, A.; Gregorio, M.; Jackson, L.; Mann, J.; Horne, N.; Berndt, A.; Wallsworth, C.; Wong, L.; Phinney, A. Creating dementia-friendly communities for social inclusion: A scoping review. Gerontol. Geriatr. Med. 2021, 7, 23337214211013596. [Google Scholar] [CrossRef] [PubMed]
- Gan, D.R.Y.; Chaudhury, H.; Mann, J.; Wister, A.V. Dementia-friendly neighbourhood and the built environment: A scoping review. Gerontol. 2021, 62, e340–e356. [Google Scholar] [CrossRef] [PubMed]
- DEMCOM Study. The DEMCOM Study: A National Evaluation of Dementia Friendly Communities, ARC East of England. Available online: https://arc-eoe.nihr.ac.uk/research-implementation/research-themes/ageing-and-multi-morbidity/demcom-study-national-evaluation (accessed on 9 November 2022).
- Buckner, S.; Lafortune, L.; Darlington, N.; Dickinson, A.; Killett, A.; Mathie, E.; Mayrhofer, A.; Woodward, M.; Goodman, C. A suite of evaluation resources for Dementia Friendly Communities: Development and guidance for use. Dementia 2022, 21, 2381–2401. [Google Scholar] [CrossRef]
- MCOA. About Us. MCOA Online. Available online: https://mcoaonline.com/about-us/ (accessed on 1 June 2022).
- Woodward, M.; Arthur, A.; Darlington, N.; Buckner, S.; Killett, A.; Thurman, J.; Buswell, M.; Lafortune, L.; Mathie, E.; Mayrhofer, A.; et al. The place for dementia-friendly communities in England and its relationship with epidemiological need. Int. J. Geriatr. Psychiatry 2019, 34, 67–71. [Google Scholar] [CrossRef]
- DFM. Leadership Team: Dementia Friendly Massachusetts. 8 February 2019. Available online: https://dfmassachusetts.org/about-us/leadership-team/ (accessed on 9 February 2023).
- MCOA. History of MCOA. MCOA Online. Available online: https://mcoaonline.com/about-us/# (accessed on 9 February 2023).
- DFM. Step Four: Be Recognized for Your Commitment. 27 February 2019. Available online: https://dfmassachusetts.org/dfm-communities/step-four/ (accessed on 9 February 2023).
- Patton, M.Q. Qualitative Research & Evaluation Methods: Integrating Theory and Practice; SAGE Publications: New York, NY, USA, 2014. [Google Scholar]
- Chaskin, R.J. Building community capacity: A definitional framework and case studies from a comprehensive community initiative. Urban Aff. Rev. 2001, 36, 291–323. [Google Scholar] [CrossRef]
- DFA. New Evaluation Guide for DFA Communities. Dementia Friendly America. Available online: https://www.dfamerica.org/spotlight/2021/5/26/new-evaluation-guide-for-dfa-communities (accessed on 15 November 2021).
- Greenfield, E.A.; Black, K.; Oh, P.; Pestine-Stevens, A. Theories of community collaboration to advance age-friendly community change. Gerontol. 2022, 62, 36–45. [Google Scholar] [CrossRef]
- Pestine-Stevens, A.; Greenfield, E.A. Giving, receiving, and doing together: Interorganizational interactions in age-friendly community initiatives. J. Aging Soc. Policy 2022, 34, 218–236. [Google Scholar] [CrossRef] [PubMed]
- Williams, M.; Moser, T. The Art of Coding and Thematic Exploration in Qualitative Research. Int. Manag. Rev. 2019, 15, 45–55. Available online: https://www.semanticscholar.org/paper/The-Art-of-Coding-and-Thematic-Exploration-in-Williams-Moser/c0a0c26ac41cb8beb337834e6c1e2f35b91d071d (accessed on 25 January 2023).
- Boeije, H. A Purposeful Approach to the Constant Comparative Method in the Analysis of Qualitative Interviews. Qual. Quant. 2002, 36, 391–409. [Google Scholar] [CrossRef]
- Greenfield, E.A.; Oberlink, M.; Scharlach, A.E.; Neal, M.B.; Stafford, P.B. Age-friendly community initiatives: Conceptual issues and key questions. Gerontol. 2015, 55, 191–198. [Google Scholar] [CrossRef]
- Bandura, A. Social Cognitive Theory: An Agentic Perspective. Annu. Rev. Psychol. 2001, 52, 1–26. [Google Scholar] [CrossRef] [PubMed]
- Scharlach, A.E.; Lehning, A.J. Creating Aging-Friendly Communities; Oxford University Press: New York, NY, USA, 2016. [Google Scholar]
- Menec, V.H. Conceptualizing social connectivity in the context of age-friendly communities. J. Hous. Elder. 2017, 31, 99–116. [Google Scholar] [CrossRef]
- Moore, G.F.; Evans, R.E.; Hawkins, J.; Littlecott, H.; Melendez-Torres, G.J.; Bonell, C.; Murphy, S. From complex social interventions to interventions in complex social systems: Future directions and unresolved questions for intervention development and evaluation. Eval. Lond. Engl. 1995 2019, 25, 23–45. [Google Scholar] [CrossRef] [PubMed]
- Garon, S.; Paris, M.; Beaulieu, M.; Veil, A.; Laliberté, A. Collaborative partnership in age-friendly cities: Two case studies from Quebec, Canada. J. Aging Soc. Policy 2014, 26, 73–87. [Google Scholar] [CrossRef]
- Somerville, C.; Scher, C.; Coyle, C.; Greenfield, E.; Akincigil, A. Senior center involvement with dementia-friendly communities: Community and organizational factors. Innov. Aging 2022, 6, 24–25. [Google Scholar] [CrossRef]
- Buckner, S.; Mattocks, C.; Rimmer, M.; Lafortune, L. An evaluation tool for Age-Friendly and Dementia Friendly Communities. Work. Older People Brighton Engl. 2018, 22, 48–58. [Google Scholar] [CrossRef]
- Epps, F.; Heidbreder, V.; Alexander, K.; Tomlinson, A.; Freeman, V.; Williams, N. A dementia-friendly church: How can the African American church support families affected by dementia? Dement. Lond. Engl. 2021, 20, 556–569. [Google Scholar] [CrossRef]
- Davitt, J.K.; Lehning, A.J.; Scharlach, A.; Greenfield, E.A. Sociopolitical and Cultural Contexts of Community-Based Models in Aging: The Village Initiative. Public Policy Aging Rep. 2015, 25, 15–19. [Google Scholar] [CrossRef]
- Bergeron, C.D.; Robinson, M.T.; Willis, F.B.; Albertie, M.L.; Wainwright, J.D.; Fudge, M.R.; Parfitt, F.C.; Lucas, J.A. Creating a Dementia Friendly Community in an African American Neighborhood: Perspectives of People Living with Dementia, Care Partners, Stakeholders, and Community Residents. J. Appl. Gerontol. Off. J. South. Gerontol. Soc. 2022, 42, 7334648221130055. [Google Scholar] [CrossRef]
- Weiss, C.H. Evaluation: Methods for Studying Programs and Policies; Pearson Prentice Hall: Upper Saddle River, NJ, USA, 1998. [Google Scholar]
|Total population size||45,532||3745||185,428|
|% Population 65+||16%||9%||21%|
|% Population Non-Hispanic White||80%||55%||98%|
|% Population Bachelor’s Degree or Higher||49%||19%||84%|
|Median Household Income||$98,699||$39,432||$145,679|
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Scher, C.J.; Greenfield, E.A. Variation in Implementing Dementia-Friendly Community Initiatives: Advancing Theory for Social Change. Geriatrics 2023, 8, 45. https://doi.org/10.3390/geriatrics8020045
Scher CJ, Greenfield EA. Variation in Implementing Dementia-Friendly Community Initiatives: Advancing Theory for Social Change. Geriatrics. 2023; 8(2):45. https://doi.org/10.3390/geriatrics8020045Chicago/Turabian Style
Scher, Clara J., and Emily A. Greenfield. 2023. "Variation in Implementing Dementia-Friendly Community Initiatives: Advancing Theory for Social Change" Geriatrics 8, no. 2: 45. https://doi.org/10.3390/geriatrics8020045