Wellbeing in older age: Qualitative innovations

July 12 2019

Insights from the session she took part in at the International Medical Geography Symposium in Queenstown last week. (Photo by Aileen Collier)

Lori Nielson presented highlights from her Master’s research completed with Janine Wiles at the University of Auckland. Her topic centred on social exclusion and community in one of New Zealand’s urban retirement villages. She juxtaposed the marketing used by corporate owners of retirement villages with the experiences of people who lived in them. Corporations promote the villages as a lifestyle choice “offering a wealth of activities and social interaction in resort-like settings, along with security and increasing care on site as needed.”

Lori used an ethnographic approach to explore residents views. Her results indicated that “social connections were often fragile and existing social group membership was key to shared community experiences and a sense of belonging.” Newcomers, and those declining in health, often felt marginalised, excluded or stigmatised. Lori concluded that resident experiences can be at odds with “the commercial and populist framing of these places as inclusive communities promoting active lifestyles.”

Rachel Herron from Canada’s Brandon University reported on the benefits of dance for people with dementia and their carers. In contrast to research that measures the impact of dance programmes on such factors as behaviour, cognition and emotional states, Rachel’s research looked at the benefits of dance for relationality, self-expression and social inclusion.

Using observation, diaries, focus groups and interviews, Rachel and her team focused on a dance program developed in Canada that people with dementia and their carers participate in as a group. Using “the concept of encounter as an analytical lens,” they “identified moments, processes and places of transformation.” These included “changing ideas and expressions about the self; changing interactions with staff, volunteers and carers; changing engagement with the [dance] activities and changing relationships with home and community.” Based on their results, Rachel came to the conclusion that, in addition to its other benefits, dance is good for fostering multiple ways of relating to others.

Finally, my presentation, referenced my pilot study that co-created digital stories with people with dementia. The stories ask the question, ‘What makes you happy’ and in reviewing them, I (major thanks to Aileen Collier and Janine Wiles for their help on conceptualisation) realised they had something to contribute to human geography.

As our populations age and more people are living with dementia, we can see how the tensions play out between the stigma around dementia and the desire to create inclusive spaces that welcome them. Cameron Duff writes about enabling places in Health and Place, which are ones  in which social, affective and material resources have interconnected to promote health and wellbeing. In the two videos I showed, it’s evident that research participants Siniva and Maureen are able to access enabling places that do indeed help them to flourish.

Strikingly, research by Smith et al echoes what Duff found. After the Christchurch earthquakes in 2011, they interviewed people with dementia in order to discover what a dementia-friendly rebuilt Christchurch might look like. They encountered a recurring theme related to belonging or connection amongst those who had had their neighbourhoods destroyed. They felt the loss of community most keenly. They wanted their enabling places back.

What I concluded is that we ought to consider space and place when thinking about what people with dementia need to lives their best lives.  Rather than merely adopting a biomedical model that focuses on  diagnosis and disease, let’s develop the processes, resources and physical spaces that, with the  collaboration and co-creation of people with dementia, engender a more welcoming world.