Realising dementia-friendly communities
Authors:   , Portegijs Suzanne 
Published: January 2025

International society faces major challenges in the coming decades. The number of persons affected by dementia is increasing rapidly, while the working population is slowly decreasing. Dementia is (in its more advanced stages) associated with a high degree of dependency in the performance of daily activities. Therefore, many persons with a moderate or severe form of dementia stay in a long-term care facility.

The increase in the number of persons affected by dementia and the decrease in the number of nursing staff requires a different approach from society. Dementia is related to stigma, which has a negative effect on both persons with dementia and their caregivers. Improving knowledge and understanding of dementia can help reduce this stigma. Dementia-friendly communities have the potential to provide a meaningful contribution in this regard.

Long-term care facilities are also part of dementia-friendly communities. Currently, knowledge is limited how nursing homes relate to dementia-friendly communities and their potential contribution However, nursing homes are often still designed in such a way that residents cannot leave them independently, which limits residents with dementia to venture outside and meet other persons.

This thesis attempts to answer the question whether nursing homes can contribute to dementia-friendly communities and the changes that are required. This thesis also identifies important stakeholders and underlying mechanisms within nursing homes that are important in changing the organisation of care. To gain insight into these stakeholders and mechanisms, research was conducted into the physical activity and agitated behaviour of residents, environmental factors of nursing homes, perspectives and behaviour of nursing staff regarding safety and autonomy and social networks between nursing staff, residents with dementia and family members in the community .

Conclusion
Nursing homes have the potential to contribute meaningfully to dementia-friendly communities. Yet, the transition from traditional nursing home care towards dementia-friendly communities is highly complex and influenced by various mechanisms. Mutual interaction between persons with dementia and community members is a vital element of dementia-friendly communities. This interaction requires a shared easily-accessible meeting space and sufficient physical activity for residents. However, realising both is not sufficient to stimulate autonomy and quality of life of residents. The interaction between nursing staff and residents is crucial to fully utilise the potential of the physical environment, both on the level of individual care as well as on the group-level in which nursing staff and residents also interact. Furthermore, the already existing social networks between nursing homes and the community – that are formed by ties between residents, nursing staff and members of the community - are inadequately used and provide opportunities for changing the organisation of care and the position of nursing homes within communities. A successful transition from a traditional nursing home towards a dementia-friendly community requires extensive and lengthy change processes on the level of individual care processes, the nursing home and society. In order to achieve successful transition, more research is essential to gain sufficient insight into the elements that are needed to realise these changes and its successful implementation within both practice and policy.