2015: Is Europe becoming more dementia friendly?
Work developed by Alzheimer Europe in 2015  suggested that, in seven European countries, the concept of dementia-friendly communities is largely used and that examples of dementia-friendly communities have been implemented.
This report provides information on dementia-friendly communities in these seven European countries. The information provided in this report has been provided by:
- Alzheimer Austria
- La Ligue Alzheimer (Wallonia and Brussels)
- The Flemish Alzheimer’s Association (Flemish region)
- Alzheimer Gesellschaft e.V.
- Robert Bosch Stiftung GmbH
- The Alzheimer Society of Ireland
- Alzheimer Nederland
- Nasjonalforeningen for folkehelsen
- Alzheimer’s Society (England)
- Alzheimer Scotland (Scotland)
The term dementia-friendly community (DFC) has emerged in recent years, according to Mitchell (2012) it reflects “a growing movement to remind society that people with dementia have the same right as everyone else to be treated with dignity and respect, to lead independent, autonomous lives and to continue to be active citizens in society whose opinions are heard and acted upon” (2012:1). The work towards building dementia-friendly communities also builds on the “Age Friendly Cities” movement, that has been largely developed by the WHO and which aims at creating environments that are accessible and inclusive of the needs of people of all ages.
“An age-friendly world enables people of all ages to actively participate in community activities and treats everyone with respect, regardless of their age. It is a place that makes it easy for older people to stay connected to people that are important to them. And it helps people stay healthy and active even at the oldest ages and provides appropriate support to those who can no longer look after themselves” (WHO, 2007).
Among the most recent evidence supporting dementia-friendly communities is found in the report “Dementia Capable Communities: the views of people with dementia and their supporters”.In this piece of work, carried out by Innovations in Dementia in 2011, people with dementia were involved in the conceptualisation of DFC. The report highlighted five aspects of community life that people with dementia identified as important to them (the physical environment, local facilities, support services, social networks and local groups), and suggested four main actions needed to become dementia friendly, namely improve awareness of dementia, support local groups for people with dementia and carers, provide accessible information about local services and facilities, and think about how local mainstream services and facilities can be made more accessible for people with dementia.
Some other key reports that have been produced in recent years include “Knowing the Foundations of Dementia-Friendly Communities for the North East”(Prior, 2012) and“Creating a Dementia-Friendly York”(Joseph Rowntree Foundation, 2012). These reports underline that DFCs should aim at reducing stigma, increasing understanding and awareness about dementia, and supporting people with dementia to remain active, included and independent. In its report, the Joseph Rowntree Foundation proposed a model for realising a dementia-friendly community: “The Four Cornerstone Model”. This model emphasises that the voices of people with dementia should be at the heart of dementia-friendly communities, and sets out four main structural supports or “cornerstones” that underpin a dementia-friendly community, namely:
1) place (e.g. housing, transport and outdoors),
2) people (e.g. what do people in the community know, think and feel about dementia? Do they have a positive and supportive attitude towards people with dementia?),
3) resources (e.g. what are the city’s resources and how dementia friendly are they? This means thinking beyond health, social care and other public sector services to the shops, businesses, facilities and assets that the whole city offers) and
4) networks (e.g. this relates to the way people work together to support people with dementia. This may be professional to professional; across sectors; or between professionals and people with dementia and their families).
The report “Building dementia-friendly communities: A priority for everyone” (Alzheimer’s Society, 2013) is another example of the body of literature that has developed in recent years addressing this topic. Overall, the report aimed to provide guidance to geographical areas that are planning to become dementia friendly or that are already committed to becoming dementia friendly. The report showcased examples of projects that were making a difference for people with dementia in the UK. It identified 10 key areas in which communities working to become dementia friendly should focus, namely: involvement of people with dementia; challenge stigma and build understanding; accessible community activities, acknowledge potential; ensure an early diagnosis; practical support to enable engagement in community life; community-based solutions; consistent and reliable travel options; easy-to-navigate environments, respectful and responsive businesses and services.
Most recently, the British Standards Institution (UK’s National Standards Body) published the “Code of practice for the recognition of dementia-friendly communities in England” (2015). The guidance has been developed in conjunction with Alzheimer’s Society and the Department of Health. It provides recommendations for who should be involved in developing a dementia-friendly community, what areas of a community to consider and what changes to expect as a result. People with dementia and carers are an integral part of each stage of the process. In here, DFCs are defined as “geographic areas where people with dementia are understood, respected and supported, and confident they can contribute to community life. In a dementia-friendly community people are aware of and understand dementia, and people with dementia feel included and involved, and have choice and control over their day-to-day lives. A dementia-friendly community is made up of individuals, businesses, organisations, services, and faith communities that support the needs of people with dementia” (2015:10).
In 2015, Alzheimer Disease International (ADI) produced a booklet entitled “Dementia-Friendly Communities (DFCs): New domains and global examples”, this booklet provides some examples of good practices worldwide. In the booklet, two new emerging domains in DFCs were identified: support for carers and the empowerment and equipping of faith based communities to carry out the important work of nurturing the spiritual health of persons with dementia.
In a nutshell, this new concept that has emerged in the dementia landscape seems to reflect a shift from understanding dementia as a medical condition to a broader conceptualisation of the term. It can be regarded as a manifestation of the social model of understanding dementia in practice (Mental Health Foundation, 2015). In this, the way of understanding dementia goes beyond the responsibility of health and social care services and professionals, and incorporates the whole community, touching upon all areas of live. DFCs are not about getting people with dementia to “fit in”, but about the coming together of communities and adapting and developing the environments, where people with dementia live, to be more responsive and inclusive (Mental Health Foundation, 2015). It aims to challenge the stigma, inequalities and the isolation often associated with living with dementia, so that people with dementia are no longer considered special or unengaged, but as having an active role in their communities and being included in mainstream everyday life.
 In 2015, Alzheimer Europe produced a comparative report on dementia-friendly communities. The report was part of the 2015 Work Plan of Alzheimer Europe, which has received funding from the European Union in the framework of the Health Programme. In total, 31 European countries were involved in the report.
Alzheimer Europe would like to thank the following organisations for reviewing or updating the information about dementia friendly communities in their country:
- Alzheimer Austria, Austria
- La Ligue Alzheimer, Belgium (Wallonia and Brussels)
- The Flemish Alzheimer’s Association, Belgium (Flemish region)
- Alzheimer Gesellschaft e.V., Germany
- Robert Bosch Stiftung GmbH, Germany
- The Alzheimer Society of Ireland, Ireland
- Genio, Ireland
- Alzheimer Nederland, Netherlands
- Nasjonalforeningen for folkehelsen, Norway
- Alzheimer Scotland, UK (Scotland)
- Alzheimer’s Society, UK (England)
Last Updated: Monday 18 July 2016