INTERGENERATIONAL INCLUSION FOR PEOPLE LIVING WITH DEMENTIA GLOBALLY AND NATIONALLY: A TWO-PHASE STUDY
Importance: This research explores the topic of intergenerational inclusion for people living with dementia. Both in Scotland and internationally, intergenerational programmes have been implemented with the aim of fostering inclusive relationships between people of different age groups. A sub-set of intergenerational programmes, moreover, have focused on the inclusion and participation of people living with dementia in particular. Such programmes are perceived to be important due to the potential they have to combat trends of loneliness and social isolation that may affect people of all ages. Programmes are also perceived to have the potential to generate positive outcomes for both younger and older participants, such as increased knowledge and understanding of ageing and dementia among younger age groups and enhanced enjoyment and engagement among older participants. Research Gap & Questions: However, intergenerational practice has been recognised to unfold in the absence of an adequate conceptual framework (Vanderven, 2004). This research uses a comparative and evaluative methodology to analyse how the concept of intergenerational inclusion for people living with dementia has been understood and operationalised internationally and in Scotland. Using insights from this analysis of international and national practice, the research further explores how intergenerational practice and policy can be further developed. Methodology: The research uses a two-phase study design informed by realist evaluation (Pawson, 2013) and thematic analysis. The first phase of the study comprises a realist synthesis review method to explore the understanding and operationalisation of intergenerational inclusion for people living with dementia internationally. The second phase of the study comprises a qualitative, semi-structured interview method to explore the understanding and operationalisation of intergenerational inclusion for people living with dementia in Scotland. Interviewees involved in the study are Scottish stakeholders with expertise in the provision of dementia services and/or intergenerational practice. Results: Results have been thematically analysed according to the context-mechanism-outcome configuration of realist evaluation. Mechanisms identified at the international level include role provision; matching and preferences; and meaningful and structured activities. Mechanisms identified within the Scottish context include preparation and planning; purpose and roles; preferences, lived experience and personhood; and sharing and learning. Higher- level findings are presented regarding intergenerational inclusion for people living with dementia, policymaking, and partnership working in Scotland. Implications: The implications of this research include, firstly, presenting a definition of intergenerational dementia programmes along with reflections on current ambiguities and tension in regard to existing definitions. Secondly, synthesised findings regarding how intergenerational dementia programmes ‘work’ in terms of their contexts, mechanisms, and outcomes are presented, with explanatory factors including the provision of roles for participants, the use of individual preferences to inform programme design, the development of meaningful and structured activities, flexible planning, and processes of sharing and learning between different age groups. Finally, an exploration of how the understanding and operationalisation of intergenerational inclusion is linked to key theories and concepts is undertaken along with recommendations for future theoretical development, encompassing personhood, intergroup contact theory, relationship and activity theory, and generativity. Directions for further research are also presented.