The ‘Neighbourhoods: our people, our places study’ (2014 – 2019) was undertaken as part of a wider programme of research exploring dementia in a neighbourhood context (Keady 2014). The research was intended to inform commitments set out in the Prime Minister’s Challenge on Dementia (DoH 2012) which included plans to develop a nationwide network of dementia friendly communities. The project built on a pilot study involving 14 carers of people with dementia, conducted in the north-west of England during 2011 (Ward et al 2012). This allowed us to test the feasibility and refine the design in collaboration with stakeholders using workshops that included people with dementia, carers, practitioners, service commissioners and local policymakers. Design and methodology: The main aim was to investigate how neighbourhoods and local communities can support people living with dementia to remain socially and physically active. Working within a social constructionist paradigm, we used qualitative methods framed by a longitudinal and comparative design. The project extended over three fieldsites: Greater Manchester in northern England; the Central Belt of Scotland; and the county of Östergötland in the south of Sweden. Each fieldsite incorporated a research phase followed by planning and development for a neighbourhood-based intervention.Dementia is often presented as a global issue with substantial economic consequences for all countries and societies providing diagnostic and/or supportive services. Whilst we believe this is necessary and important information, in our 5-year study we want to celebrate the achievements, growth and contribution that people with dementia and their carers make to society. To do this, we are putting the local neighbourhood and networks in which people with dementia and their carers live and belong at the centre of our work. We have designed a study on neighbourhood living that has 4 inter-linked work packages (WPs), an international partner , the Center for Dementia Research [CEDER] at Linköping University, Sweden, and strong user involvement through the EDUCATE and Open Doors groups [Greater Manchester, England]; The ACE Club [Rhyl, North Wales]; and the Scottish Dementia Working Group [Glasgow, Scotland]. In the UK our academic partners are situated in Manchester, Salford, Stirling, Liverpool and London and we have third sector involvement through the Deaf Heritage Project at the British Deaf Association, as well as a range of project partners which includes the North West People in Research Forum, the Citizen Scientist initiative and a Community Integrated Company that supports people with dementia through accessible technology [Finerday]. As this is a complex set of networks based around a neighbourhoods theme, each WP will use different research methods and partners to meet their primary aims and objectives. WP1 is a secondary analysis of the English Longitudinal Study of Aging database which will compile Neighbourhood Profiles that will be available for the whole country; these Profiles will include information on cognitive risk factors and clusters of population; WP2 will develop a set of core outcomes measures in dementia that will involve people with dementia and their carers in deciding what measures and priorities are important for them; WP3 will explore what makes a dementia friendly neighbourhood and will take place in Stirling, Salford and Linköping; WP4 has 3 interventions representing various stages of the Medical Research Council's complex interventions framework. Intervention 1 will be a full RCT of an educational intervention for general hospitals that several members of the project team have developed and piloted over the last 2 years. In this study, we want to find out if the educational intervention results in people with dementia leaving hospital for their neighbourhood home sooner, but with high levels of satisfaction. Interventions 2 and 3 are pilot trials. Intervention 2 will be conducted in Sweden and Manchester, UK and will use technology to help couples, where one person has a dementia, to better self-manage the condition and, more importantly, their relationship. In intervention 3, we are looking at the diversity of a neighbourhood and will develop the first digitalised life story intervention in the world for Deaf people (BSL users) who live with dementia. This will be the first intervention for this group in the world. In this programme of work we will develop a user research programme as some people with dementia have told us that they would like to work alongside the research team as co-researchers. We will therefore appoint a PPI co-ordinator for the duration of the study with a responsibility for identifying co-researcher training needs, running a regular co-research programme, mentoring co-researchers, ensuring user goal preferences are met and facilitating user dissemination. Through the implementation of a neighbourhood approach each WP will promote closer relations and working between professionals, lay people and people living with dementia. This study will also contribute to the currently limited evidence base for dementia friendly communities and provide knowledge and insights to support a robust theoretical framework of neighbourhood work that will have international scope and relevance.
Across all three fieldsites, walking interviews were used to engage in ‘in-situ’ discussions where participants were asked to take the researcher on a preferred or commonly-used route through their neighbourhood. As discussed by Kullberg and Odzakovic (2018) walking involves bodily movement and synchrony, creating a connection and space for spontaneous conversation about the social and material aspects of the neighbourhood (see also Phillips and Evans 2016). A walking method is well-suited to the participation of people with dementia as the focus for our discussions was often readily to hand, providing immediate and material prompts to support narratives of neighbourhood life. The UK fieldsites also employed home tours, which drew upon Pink’s (2009) ‘walking with video method’, and which were either filmed or audio-recorded. Here, the participants took us on a tour, moving through different domestic spaces, pointing out and even handling objects of significance. In both the neighbourhood walks and home tours, the person with dementia led the process, some even adopting the role of tour guide, sharing anecdotes and histories of the places we passed through. Walking together enabled us to study a moving research subject ‘through an embodied and sensory engagement with the practices and places’ of the people we were interviewing (Pink 2012, p.33). We also used social network mapping while visiting participants at home. These were open-ended interviews with ‘mapping’ used as an elicitation device to explore social connectedness and the everyday give and take of help and support. This method introduced participants to a relational and affective practice of visualising support, providing opportunities for reflection, while co-producing an ‘affective artefact’ to inform the analysis process (Campbell et al 2019). The mapping interviews were sometimes led by care partners because of the emphasis on recall but were often carried out jointly and where possible led by the person with dementia. Taken collectively, the mix of interviews allowed us to explore the social, material, and affective dimensions of neighbourhood living for people with dementia. Returning to many of our participants after a break of 8 – 12 months we were also able to deepen our understanding of the temporal dimension by repeating the walking and mapping interviews for a second time.