Louise Lafortune is a Senior Research Associate in the Public Health and Ageing Research Unit at the University of Cambridge, UK. Her expertise includes evidence reviews, priority setting partnership activities, and research that focuses on the development and evaluation of preventive interventions for frail older adults and people affected by dementia. She is co-investigator on the UK National Evaluation of Dementia Friendly Communities Study (DEMCOM) and leads a project on Frailty and Care Trajectories which harnesses routinely collected data across care settings. She has recently co-led a pilot study to test an age-friendly cities evaluation tool and led the study commissioned by the Centre for Ageing Better to assess the needs and develop evaluation and monitoring resources for members of the UK Network of Age-Friendly Cities.
Developing a tool to evaluate Dementia Friendly Communities
In recent years the number of Dementia Friendly Communities (DFCs) in England has increased rapidly. This has been accompanied by a call for robust monitoring and evaluation. To do this, an evidence-based tool that can be readily used by communities is needed to provide an analysis of how DFCs reach and impact people affected by dementia, and of underlying structures and processes.
This paper reports on the National Evaluation of Dementia Friendly Communities in England (DEMCOM). The study aims to identify (1) the characteristics and foci of DFCs in England, (2) the factors and preconditions for DFC initiatives that produce positive outcomes for people affected by dementia, and (3) generalizable lessons about the resource requirements for, and economic benefits of, DFCs.
Drawing on findings from the initial phase of DEMCOM, which involved mapping and describing the key features of DFCs, this paper focuses on the adaptation to DFCs of an evaluation tool that was originally developed for Age-Friendly Cities. The tool consists of ten areas where evidence is required to assess DFCs. It is applied in a DFC through collaboration between the researchers and a stakeholder steering group that includes people affected by dementia. This provides the mechanism by which data is collected and appraised before it is used to assess the DFC. This process has been carried in two pilot sites, where the findings have given rise to recommendations for future work on dementia friendliness.
Findings so far have demonstrated that the pilot DFCs perform strongly in areas such as service provision and collaboration. Areas for improvements have also been identified, for example around the use of evidence when prioritising dementia-specific interventions, resource allocation, and ways of engaging with people affected by dementia. Early findings have led to initial adjustments to the evaluation tool to fine-tune it to dementia friendliness. For example, it now incorporates a more detailed focus on the involvement of people affected by dementia in DFC initiatives.
When applied in a particular context, the DFC evaluation tool will help develop an evidence informed account of what needs to be in place for a community to become dementia friendly and how to measure their impact on people living with dementia. Importantly, evidence pertaining to the merits of different approaches will accrue over time and inform how to plan for continuing improvement and impact at the policy, organisational and individual level of provision.