Constructing Normalcy in Dementia Care: Carers' Perceptions of Their Roles and the Supports They Need.

BACKGROUND AND OBJECTIVES: People with dementia are critically dependent on their carers when accessing and utilizing health care. To inform health care development and delivery, we aimed to explore carers' perceptions of their role in caring for a family member with dementia and to identify carers' skills and attributes and factors impacting on care. RESEARCH DESIGN AND METHODS: We used semistructured interviews to collect data from 25 carers supporting older adults with dementia. Data were thematically analyzed and the paradigm model was used to guide theory development. RESULTS: "Constructing normalcy" was central to all carers did, impacted by stage of life and relationship status and driven by a holistic focus on their care-recipient's quality of life. Goals guiding care were: keeping the peace; facilitating participation, happiness and independence; and ensuring safety. Enablers included: social contact; knowledge; and quality social services. Barriers included health and legal issues; symptoms of dementia; and reduced knowledge. These goals kept the peace and reduced stress for the cared-for person, but often at the cost of unrelenting responsibility and loss of carers' original roles. Discussion and Implications: As carers are so critical to the access and uptake of health care of those with dementia, health professionals and services need to support carers in their quest to construct normalcy. Our findings provide guidance to assist in ensuring appropriate support and understanding of carers work in order to optimize dementia health care delivery.

The impacts of ageing on connection to nature: the varied responses of older adults.

Access to nature is important for wellbeing at all ages with significant benefits for older adults. This paper explores the impacts of older adults' age-related health conditions on nature connection, their responses to the changes and identifies the types of nature connections and greenspaces available to and prioritised by older adults. It is based on the experiences of 72 New Zealand older adults aged 65-99, living in family homes, down-sized homes and rest homes. Data were gathered through interviews, photographs and assessments of the natural features of their home environment. Nearly all participants experienced age-related changes in their ways of connecting with nature as living accommodation and especially health and mobility changed. Reduced mobility was the primary factor limiting nature experiences especially for frailer adults. In contrast, for 'younger' older adults, retirement can provide more time and opportunities to engage with nature. Nature connection opportunities are valued by nearly all adults irrespective of age and health. Accessible nature opportunities in the nearby and home environment should be available to all adults irrespective of health and accommodation type. Dedicated resources need to be provided to ensure these opportunities are present for the frailest whose opportunities to have direct contact with nature are frequently absent.