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The meaning, construction and place of neighbourhood in the lives of people with dementia and their carers : a longitudinal mapping study

Background: Dementia is a public health priority due to the growth in the ageing population, resulting in an increase of people living with dementia both nationally and internationally. Whilst dementia has been framed as an economic and societal burden, this is not the whole story. People living with dementia have rights and an asset-based approach outlines the contribution that they bring to relationships in the everyday places and spaces where life is lived. To continue to enable people living with dementia to stay in their own home and community and to offer opportunities for social participation and contribution, the neighbourhood is one focus of ageing and dementia policy supporting enabling environments. Although the literature illustrates the significant impact, from multiple dimensions, of the neighbourhood on people living with dementia and their carers, there is a scarcity of evidence about how they define, construct, and interact with their neighbourhood. Aims: This longitudinal study employed narrative inquiry as a methodological frame and used a participatory approach, together with multiple data collection methods, to uncover the meaning, construction and place of neighbourhood in the lives of people with mild dementia and their carers to gain in-depth knowledge of the dynamic relationships between people and environment and of their daily lived experience of dementia. Findings: A total of five couples, where one partner had mild dementia, located in an East Midlands county of England, participated in the study and the age range for people living with dementia was from 66 to 86 years. Participation was longitudinal with the researcher conducting a total of 65 home visits and collecting over 57 hours of interview data alongside other data sources, such as participatory neighbourhood maps. Each case was outlined using the same headings allowing for cross-case analysis and emphasis was placed on the creation and pictorial representation of the neighbourhood maps with data collection led by the persons living with dementia and/or their carers. A cross-case analysis was then applied to the data set where a meta-theme of biographical connectivity to the neighbourhood emerged, supported by two themes of connecting to people and connecting to places. The meta-theme highlighted the significance of personal biographies in influencing neighbourhood connectivity, which further shaped personal biographies. Within this cumulative process, resources and relationships had an effect on biographical connections to the neighbourhood, particularly affecting how the persons living with dementia negotiated environmental opportunities and challenges. The resulting model illustrated the fluid, dynamic relationships between participants and their neighbourhood through the lens of personal biographies. Conclusions: The meta-theme of biographical connectivity to the neighbourhood presented the significance of personal and relational biographies in influencing the subjective view of the experiences of interactions with the neighbourhood. This is the first study where people living with dementia and their carers co-produced neighbourhood maps with the researcher to bring their understanding of spaces, places, and people to life. The study is also an early attempt to support a bottom-up approach to neighbourhood constructions and meanings where the intersection of the life of the person to their self-identified neighbourhood becomes the focal point for supportive interventions. The thesis concludes with a re-contextualisation of biographical connectivity to the neighbourhood and its supporting properties to the literature and outlines its implications for policy, practice, education, and research.

Identiferoai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:740397
Date January 2018
CreatorsLi, Xia
ContributorsKeady, John
PublisherUniversity of Manchester
Source SetsEthos UK
Detected LanguageEnglish
TypeElectronic Thesis or Dissertation
Sourcehttps://www.research.manchester.ac.uk/portal/en/theses/the-meaning-construction-and-place-of-neighbourhood-in-the-lives-of-people-with-dementia-and-their-carers-a-longitudinal-mapping-study(11798d5f-23bf-43d3-8178-c6fa67a85de3).html

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