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Family caregivers of people with dementia can find the impairments in their relative's ability to communicate an enormous challenge. Peer facilitated educational interventions are a potentially efficient and effective way to address these complex communication issues. This paper examines the processes required to support the development of peer educators and the impact this has had on facilitators and course attendees. Semi-structured interviews with six participants who facilitated Empowered Conversations (EC) a communication skills educational program for caregivers of people with dementia and 28 participants who attended the program. A qualitative thematic analysis approach identified emergent themes within the data. Three broad findings are reported: first the support that is needed for peer facilitators; second, the impact of the course reported by facilitators and course attendees; and third, suggestions for improvements. The content of the EC program is strong and the reflective cycle encouraged via support mechanisms prior to, during and following the delivery of sessions is effective for supporting facilitators. When upscaling the program it was important to enhance the support structures for new peer facilitators. Introducing a support session focusing on examples of logistical issues experienced and how these could be addressed would be a useful addition to the support mechanisms already devised. Attendees reported positively on participation in the course, particularly valuing the input from facilitators with experience of caregiving. Suggested improvements related to better information about the course and a settling in period, with some specific individual suggestions for content relating to their personal experiences.

Objectives: Our aims were to examine whether an experiential course for care partners of people living with dementia, Empowered Conversations (EC), was acceptable to participants and to explore participants' perceptions of the impact of the course upon their communicative interactions. EC is based on an integrative model derived from psychological and linguistic theory and empirical evidence. EC is based on mentalisation theory, perceptual control theory and linguistic theory (The Communicative Impact Model). Methods: Qualitative data were collected via 28 semistructured interviews. Framework analysis was used to analyse data. Results: Three superordinate themes, 'improved communication', 'improved well-being' and 'support through others' were identified. Twenty-seven out of the 28 participants described feeling that they were able to better connect with the person living with dementia that they were supporting through attending EC. Conclusions: The findings indicated that EC was acceptable and beneficial to care partners. Care partners developed a range of strategies and understandings that enabled them to communicate better with the person they were supporting, enhanced well- being and relationships, as well as developing social networks. This is the first qualitative study to examine a psychosocial intervention for care partners of people living with dementia using a non- CBT framework and indicates that perceived control could influence how care partners respond to stress and difficulties. [ABSTRACT FROM AUTHOR]

This rapid review aims to identify the types of technologies used by people with dementia and their supporters during the COVID-19 pandemic, and the issues which influenced technology adoption within their usual care routines. PubMed, PsychInfo, Scopus, and Cochrane COVID reviews were searched to identify peer-review studies published since 2020. A total of 18 studies were included and synthesised thematically. Of these, most were conducted in the community (n = 15) with people with dementia only (n = 11) and involved qualitative methods (n = 11). The majority (n = 12) focused on digital off-the-shelf and low-cost solutions, such as free video conferencing platforms, to access care, socialise or take part in interventions. Whilst often well-accepted and associated with positive outcomes (such as improved social connectedness), lack of digital literacy or support to use technologies, limited access to appropriate technology, individuals' physical, cognitive, or sensory difficulties, were highlighted and likely to threaten the adoption of these solutions. The quality of the evidence was mixed, neither very robust nor easily generalisable which may be attributed to the challenges of conducting research during the pandemic or the need to rapidly adapt to a new reality. While COVID-19 has fast-tracked the adoption of technology, its use is likely to continue beyond the pandemic. We need to ensure this technology can leverage dementia support and care and that people with dementia are enabled and empowered to use it. [ABSTRACT FROM AUTHOR]

Aim: This review aimed to map studies related to healthcare professionals' perceptions and attitudes towards the rehabilitation for persons living with dementia and extract what they perceive are the barriers and solutions. Background: Rehabilitation can improve the quality of life and integration of persons living with dementia into society. However, there are several barriers to accessing rehabilitation services. Healthcare professionals are a source of information to understand the challenges and provide solutions to improve these services. Design: Arksey and O′ Malley (International Journal of Social Research Methodology, 8, 2005 and 19) five‐step framework for scoping reviews and the PRISMA‐ScR checklist was used. The PAGER (Patterns, Advances, Gaps, Evidence for practice and Research recommendations) framework was used to identify research and practice recommendations. Method: Seven databases including Medline Complete, Academic Search Ultimate, Ageline, CINAHL, PsycInfo, Pubmed and Google Scholar were searched. The healthcare professionals' perceived challenges and solutions were categorised using Braun & Clarke (Qualitative Research in Psychology, 3, 2006 and 77) thematic analysis. Results: Fifteen articles were selected for review. The challenges and solutions were organised according to their association with three stakeholders; the persons living with dementia/informal caregivers, healthcare professionals and the organisation providing the service. Nine of the studies focused on persons living with dementia following a fall or a hip fracture. Most of the studies focused on the perceptions of allied healthcare professionals, with nurses working in rehabilitation settings being underrepresented. Conclusion: Healthcare professionals have to consider the complexity of rehabilitating persons living with dementia irrespective of the rehabilitation speciality. Moreover, more studies are needed that focus on the views of rehabilitation nurses. Relevance to Clinical Practice: This review provides further evidence of the healthcare professionals' misconceptions about the rehabilitation potential of persons living with dementia. There is a need to educate healthcare professionals about the societal, attitudinal and environmental barriers faced by persons living with dementia and their caregivers. Patient Contribution No Patient or Public Contribution—scoping review. [ABSTRACT FROM AUTHOR]

Those diagnosed with dementia and those who provide care and support often feel socially isolated with limited opportunities for social engagement, increasing the potential for loneliness and further isolation that is detrimental to social health. This study examined how a co‐designed dementia café impacted on the self‐reported social health of community dwelling people with dementia and their care partners in the North‐West of England. Semi‐structured interviews were conducted at two time periods (summer of 2019 and spring of 2020), with five people living with dementia and eight care partners. The key finding was that participating in the cafés led to a sense of belonging and purpose that was beneficial to well‐being and social health for all participants. Community‐based initiatives that provide opportunities for peer support for the person with the diagnosis and the care partner are essential so that people living with dementia may rebuild their confidence as well as retaining opportunities to socialise. [ABSTRACT FROM AUTHOR]

Evidence exists relating to music‐based initiatives and positive health outcomes for people living with dementia who can access them. Yet, knowledge about the impact of 'music‐making' on the well‐being of community‐dwelling people with dementia is limited. Much of the existing evidence about the benefits of music is focused on care home settings where initiatives can be readily applied as part of a weekly schedule of activities. Therefore, this initiative aimed to provide opportunities to participate in music‐making, to increase social interaction and ultimately well‐being in a community environment. Ten music‐making session were scheduled for community‐dwelling people living with dementia and care‐partners, once a month between September 2019 and March 2020. Three sessions did not take place due to Covid19. Eighteen participants consented to take part including seven people living with dementia, five care‐partners and six former care‐partners. Baseline semi‐structured interviews explored the lived experience of music and expectations of the upcoming music‐making cafes. Self‐report questionnaires captured 'in the moment' experiences of each music‐making cafe. Follow‐up semi‐structured interviews explored the impact of music‐making on participants' self‐reported well‐being. Interviews were transcribed verbatim and analysed thematically. The findings demonstrate that participating in the music‐making café benefitted the self‐reported well‐being of participants in three ways: first, a sense of camaraderie that enabled the facilitation of connections with others; second, creating opportunities to 'level the playing field' by always assuming a person's strengths and abilities; and third, group participation in music‐making meets a need for meaningful musical experiences. We conclude that participating in music‐making is a powerful medium to promote well‐being for community‐dwelling people living with dementia and care‐partners. [ABSTRACT FROM AUTHOR]

Ensuring that environments are designed to cater for those with decreasing orientation, perceptual and mobility skills, is an example of how environments are being changed to become more age and dementia friendly. However, environmental design should directly involve potential users of the environment to ensure that their views are accounted for. Four open-ended questions, focusing on orientation strategies, reasons for disorientation, and design preferences, were given to 32 older adults after they had completed a route learning task through an unfamiliar environment. A Content Analysis found a strong focus on participants' ability to memorize routes based on verbally encoding the route and on their ability to remember landmarks, with the reports linking closely to cognitive theories of navigation. Design suggestions included the importance of a homely and welcoming environment, memorable features, and access to the outdoors. The findings can be used inform age and dementia friendly design principles. [ABSTRACT FROM AUTHOR]

Objectives: To examine the feasibility, acceptability and impact of an experiential course for family care partners of people living with dementia, Empowered Conversations (EC). This study aimed to assess the impact of participation in an EC course on care partner stress levels, communication and mentalization (a form of relational-based empathy). Method: This study uses an uncontrolled pre–post-follow-up design. Follow-up was at 4-months after the initial EC session where baseline data were collected. One hundred and fifty-nine care partners were recruited. EC is a training course that has been designed to improve care partner communication, well-being and relationships. It is based on an integrative framework that targets the specific psychological, relationship and communication needs of carers. This framework informs targeted strategies and interactive exercises that facilitate carers to consider the goals and emotions of those they are caring for, alongside their own goals and emotions, and to use this to maximize good communication. Results: Stress was significantly reduced across the three time points. Communication significantly improved across time. There were no significant changes in reflective functioning (mentalization). Discussion: This study provides preliminary evidence that a communication-skills training course for care partners of people living with dementia is an acceptable and feasible intervention and has an impact both post-intervention and at follow-up. These findings require validation in a rigorous, randomized study. [ABSTRACT FROM AUTHOR]

Background: Research suggests there is a lack of post-diagnostic support to enable people living with dementia to fulfil social and active lives throughout their dementia journey. Gardening has been found to have many benefits for people living with dementia. Although such research is important, most research frames people with dementia as passive recipients of stimulation. Research into the impact of a community-based gardening group, where people living with dementia are active in the development of an outdoor space, is underdeveloped. Knowledge about the impact of participating in such groups is also sparse. The Good Life Club (GLC) was co-developed and evaluated to respond to these gaps. Objectives: The primary aim of this article is to present the findings regarding the impact of attending the GLC on the self-reported well-being for people living with dementia and care partners. Methods: Qualitative data were collected via 22 semi-structured interviews. Fourteen interviews were conducted before the GLC and eight after the GLC. Thematic analysis was used to analyse data. Dementia Care Mapping data were collected to supplement the interview data. Findings: Four key themes were identified. The first was that participants considered having active participation in social life to be a key aspect of living a good life. The second was that the way that the GLC was set up and delivered gave the participants ownership of the GLC and within this they felt able to contribute. The third was the importance of social connectedness and peer support to the well-being of both people living with dementia and care partners. Fourth, positive mood and well-being was directly experienced through gardening. Conclusions: The combination of long-term investment of time and energy to the GLC, ongoing friendships and in-session autonomy act as key ingredients in creating a group that is relaxed, full of humour and highly valued. [ABSTRACT FROM AUTHOR]

Multiple transitions across care settings can be disruptive for older adults with dementia and their care partners, and can lead to fragmented care with adverse outcomes. This scoping review was conducted to identify and classify care trajectories across multiple settings for people with dementia, and to understand the prevalence of multiple transitions and associated factors at the individual and organizational levels. Searches of three databases, limited to peer-reviewed studies published between 2007 and 2017, provided 33 articles for inclusion. We identified 26 distinct care trajectories. Common trajectories involved hospital readmission or discharge from hospital to long-term care. Factors associated with transitions were identified mainly at the level of demographic and medical characteristics. Findings suggest a need for investing in stronger community-based systems of care that may reduce transitions. Further research is recommended to address knowledge gaps about complex and longitudinal care trajectories and trajectories experienced by sub-populations of people living with dementia.