Negotiating Experiences of Belonging Alongside Age-Related Life Transitions.

Belonging is a pervasive human need that is vital to our well-being as we age. Ageist attitudes, stereotyping, and life transitions tend to jeopardise older adults' experiences of belonging. Although community involvement can lead to the development of social relationships that support belonging in older adulthood, little is known about how belonging is perceived and experienced by older adults. The purpose of this article is to share findings from research conducted with members of a community centre for people 50 years of age and older who shared their perceptions and experiences of belonging. Findings highlight the ways that age-related life transitions affect experiences of belonging. Findings also reveal that features of a belonging experience include feeling worthwhile, being welcomed and accepted, having opportunities for connection, and seeking to belong. We draw from these findings to suggest ways to enhance belonging for older adults.

Strategies for Maintaining Friendship in Dementia.

Although friendship is vital in later life, particularly amongst people who are living with dementia, little is known about how friendships are sustained following a diagnosis. Some research suggests that, because of dementia-related stigma, friendships dissolve following diagnosis; however, other researchers have shown that friendships can persist in dementia. The purpose of this article is to explore strategies that people with dementia and their friends (i.e., those who have been friends for at least 2 years) utilize to sustain their friendships. Following a constructivist approach, we interviewed people living with dementia, friends, and family members to better understand how friendships are maintained after a diagnosis of dementia. Data were analyzed using thematic analysis. An overarching theme, adapting to change, was generated. Participants adapted in several ways, including: (1) prioritizing friendship, (2) shifting ways of thinking about our friend/ship, and (3) addressing changes through practical strategies. These strategies helped maintain mutually beneficial, reciprocal friendships that were able to withstand changes that accompany a diagnosis of dementia.

The interplay between leisure, friendship, and dementia.

The ways in which friends behave can greatly influence the experience of living with dementia. For example, previous research has highlighted the negative implications that dwindling friendships have on one's leisure engagement after a diagnosis of dementia. In this study, we share findings from a study that highlights the interplay between leisure, friendship, and dementia to demonstrate the complementary relationship that can exist. Specifically, we describe ways friendship can be a bridge to maintaining leisure engagement and how leisure can, in turn, support the maintenance of friendships for individuals with dementia. Data were gathered through individual, dyad, and group interviews conducted with individuals with dementia and their friends and family. Our findings have implications for friends of individuals with dementia who may be searching for ways to support the continuation of mutually enjoyable leisure experiences. Findings also have implications for the ways leisure providers can more fully attend to the relational needs of individuals with dementia in order to help support their continued friendships.

Relationship-Centered Dementia Care: Insights from a Community-Based Culture Change Coalition.

This article reports on the work of a community-based culture change coalition affiliated with the Partnerships in Dementia Care Alliance, a research network committed to strengthening dementia care through supporting relationship-centered care approaches. Research to date emphasizes negative aspects of dementia care relationships. Drawing on data the culture change coalition collected as part of their culture change work using participatory action research guided by appreciative inquiry, this article examines what relationship qualities contributed to positive dementia care experiences and how positive relationships were created. Five types of care partners participated in the study through questionnaires, focus groups, and a mini appreciative inquiry summit. Data were analyzed collaboratively with culture change coalition members. Early in the analysis process, the aspiration statement "Relationships are at the heart of dementia care in [name of] County," was developed and informed further thematic analysis. Findings revealed several relationship characteristics including friendship, commonality of experience, developing trust and feeling appreciated, reciprocity, and taking time/making time for relationships. As this article illuminates, relationship-centered programs and policies have the potential to foster positive dementia care experiences among diverse care partners in community settings.

Theoretical foundations guiding culture change: The work of the Partnerships in Dementia Care Alliance.

Longstanding concerns about quality care provision, specifically in the area of long-term care, have prompted calls for changing the culture of care to reflect more client-driven and relationship-centred models. Despite an increase in culture change initiatives in both Canada and the United States, there is insufficient information about the theories and approaches that guide culture change. The purpose of this paper is to describe a culture change initiative currently underway in Canada, the Partnerships in Dementia Care Alliance, and the theoretical foundations informing our work. More specifically, we describe how the theoretical and philosophical underpinnings of the Alzheimer Disease and Related Dementias framework, the authentic partnership approach, participatory action research and Appreciative Inquiry have been integrated to guide a culture change process that encourages working collaboratively, thinking and doing differently and re-imagining new possibilities for changing the culture of dementia care.

"It was like reading a detective novel": Using PAR to work together for culture change.

Participatory action research (PAR), with its focus on engagement and collaboration, is uniquely suited to enhancing culture change initiatives in dementia care. Yet, there is limited literature of its application to culture change approaches in care settings, and even less in dementia specific care contexts. To address these gaps in the literature, the purpose of this paper is to examine the complexities of a PAR project aimed at changing the culture of dementia care in two diverse dementia care settings, including a long term care (LTC) and community care setting. Drawing from data gathered throughout the PAR process, we unpack the challenges experienced by participants working together to guide culture change within their respective care settings. These challenges include: overextending selves through culture change participation; fluctuating group membership; feeling uncertainty, confusion and apprehension about the process; frustratingly slow process; and seeking diverse group representation in decision making. We also highlight the potential for appreciative inquiry (AI) to be integrated with PAR to guide a process whereby participants involved in culture change initiatives can develop strategies to mitigate challenges they experience. We view the challenges and strategies shared here as being constructive to would-be culture change agents and hope this paper will move others to consider the use of PAR when engaging in culture change initiatives.