"When I hear my language, I travel back in time and I feel at home": Intersections of culture with social inclusion and exclusion of persons with dementia and their caregivers.

Individuals with dementia and their carers often experience a rupture of relationships that co-occurs with declining functional and cognitive abilities, leading to their increased social exclusion in both intimate relationships and community settings. While initiatives have been developed to support meaningful interaction and participation in society, they have broadly ignored the significance of how cultural factors influence experiences of inclusion/exclusion of these individuals. An ethnographic study was conducted by an interdisciplinary research team between April 2018 and January 2019 to explore the intersections of culture and social inclusion/exclusion in a culturally diverse group of persons with dementia, caregivers and staff members of a non-profit organization located in a multicultural neighborhood of a bilingual Canadian city. The participants' culture was inextricably linked to their experiences in three overarching themes of social inclusion/exclusion: transformation of the person with dementia and the caregiver; participation in social networks and meaningful relations; and styles of care provision in health and social services. Cultural mandates that prescribe practices of intergenerational care shape the way certain caregivers perceive their role and mitigated experiences of exclusion. Culturally specific notions and views associated with dementia prevalent in certain communities increased experiences of inclusion or exclusion. Engagement with the cultural elements of individuals with dementia was shown to be an effective and underexplored tool for fostering inclusion. The results of this study highlight the value of the ethnographic methods for incorporating the perspective of persons with dementia in research.

Mouvement de passage: Creating connections through movement among persons with dementia.

One of the challenging consequences of dementia is the change in relationships that can co-occur with the progression of this condition. Despite this well-documented change, few arts-based interventions target the relational dimension of dementia. This study aims to explore the effects of one arts-based relational intervention: a movement program designed to foster connections within a group of persons with dementia. We used ethnographic methods-including participant observations and informal interviews-to understand the relational effects of this program conducted by two dancers and a musician. The movement sessions were video recorded, and participant movement trajectories were analyzed for different ways in which they created connections. We identified two types of connections-nonreciprocal and reciprocal-and four subtypes of connections-connection to exercise/music, connection to participant, interpersonal connection, and group connection-that participants engaged in during the movement program. Despite most participants not remembering the previous movement sessions, they experienced increasing numbers of connections over the course of the program, particularly reciprocal interpersonal connections. Participants explored new forms of moving and creatively transformed the movement structures proposed by the dancers. The results demonstrate the effectiveness of this program in augmenting connections and fostering exploration and creativity in individuals with dementia, providing a template for further developments of interventions targeting the relational dimensions of dementia. This study also highlights the potential of combining ethnographic methods and video analysis to include the perspectives of persons with dementia in research.