Extending active life for older people with cognitive impairment through innovation in the visitor economy of the natural environment (ENLIVEN)

Lead Research Organisation: University of Exeter
Department Name: Institute of Health Research

Abstract

Getting out and about in nature is good for us. It helps us stay healthy and active, stimulates our brains, keeps us in contact with other people, and brings pleasure and joy to our lives. During the COVID-19 pandemic, spending time in the garden or watching nature from the doorstep has helped people cope and feel connected.

Older people living with cognitive impairment, and people with young-onset dementia, say that nature helps them in lots of ways. They feel more engaged, more enthusiastic, more hopeful, more resilient and better able to deal with challenges. Their family members agree that getting out and about in nature is helpful. This could be as simple as spending time in a nearby park or garden, or it could be a visit or organised outing to a special place or beauty spot that rekindles past memories.

They also say there are things that get in the way and stop them enjoying nature as much as they would like. These include lack of facilities such as seats where you can have a rest, features like awkward steps that make it hard to get around, fear of getting lost due to lack of signs, staff seeming unhelpful, or a sense that older people are unwelcome. We need to remove these barriers and change attitudes.

The places where people go to enjoy nature are usually managed by businesses, local councils, social enterprises and charities. We will call them 'providers'. Many providers want to make it easier for older people living with cognitive impairments and their families to access the places they manage, but do not know how.

There is little guidance available for providers, because the amount of research so far has been small. Providers need to know how to respond to a growing market. If people are more satisfied with their visit to a particular place, they will tell others and more people will come. This will generate new business. The provider can then add better facilities. It is important that more research is done to help make these changes. A good number of providers and other organisations are keen to work with us on this project.

Our research project will ask: What can be done to make outdoor places easier for older people living with cognitive impairment (including people with young-onset dementia) and their family members of all ages to visit?

We will do this in 4 stages.

We will involve older people (for the purposes of this project, this means older people living with cognitive impairment, including people with young-onset dementia) and their families in all of the stages. We will involve provider organisations in all of the stages as well.

Stage 1
We will invite a wide range of people, providers and other organisations to send us information. We will talk to older people about their experiences of getting out and about in nature and what would make this easier. We will talk to providers to find out what works well and what could be improved. We will learn from the research that has already been done.

Stage 2
We will work with older people and their families, and with managers and staff from provider organisations, to find ways to help people enjoy getting out and about in nature more. We will come up with a variety of ideas, to allow for different preferences and abilities.

Stage 3
We will test these ideas out. We will work with different kinds of providers in different areas to find ways of making the places they run more accessible and welcoming. We will help them make changes. We will find out how well these changes work by talking with the older people who visit and with managers and staff.

Stage 4
When we have finished we will pull together everything we have learned and share it with as many people as possible. We will work with older people and providers to develop resources such as guidelines and toolkits, and networks for sharing information. This will allow more people to use the results of our research.

Organisations

Publications

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Title Qualitative interview schedules 
Description Qualitative interview schedules designed to elicit a unique data set to support the extension of active life of older people living with cognitive impairment and their families through innovation in the visitor economy of the natural environment. 
Type Of Material Improvements to research infrastructure 
Year Produced 2021 
Provided To Others? No  
Impact ENLIVEN's qualitative interview schedules have provided a window onto the intersection between cognitive impairment and innovation in the visitor economy. This is an area where there is currently a knowledge gap. 
 
Description ENILIVEN business meetings 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Industry/Business
Results and Impact Discussions with a diverse range of businesses and organisations to raise awareness of innovation for dementia friendly experiences and spaces in the visitor economy of the natural environment.
Year(s) Of Engagement Activity 2021,2022
 
Description ENLIVEN Community of Practice meetings 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Industry/Business
Results and Impact ENLIVEN's community of practice meetings have provided a space for mutual learning amongst businesses and organisations. They have also facilitated the formation of new business connections.
Year(s) Of Engagement Activity 2021,2022
 
Description ENLIVEN engagement with Lewy Body Society 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Patients, carers and/or patient groups
Results and Impact This was an event consisting of a short presentation to attendees about the ENLIVEN project, describing opportunities to get involved. The short presentation was followed by a wider discussion about experiences of getting out into the nature, focusing on what helps and what gets in the way.
Year(s) Of Engagement Activity 2021
URL https://www.youtube.com/watch?v=-WekTW8OnxM
 
Description ENLIVEN launch of website 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Industry/Business
Results and Impact Launch of website to raise awareness of ENLIVEN, help others to learn more about the project and highlight opportunities to get involved.
Year(s) Of Engagement Activity 2021,2022
URL https://enlivenproject.co.uk/
 
Description ENLIVEN newsletter 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Industry/Business
Results and Impact ENLIVEN's newsletter is co-produced with the research team and ENLIVEN's partner organisations and businesses. It raises awareness of dementia related issues and provision, 'spotlighting' the work of our partner businesses and organisations who are at various stages of their journey in becoming dementia-friendly.
Year(s) Of Engagement Activity 2021,2022
URL https://enlivenproject.co.uk/newsletters/
 
Description Launch and first meeting of ENLIVEN's PPI Advisory Group 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Patients, carers and/or patient groups
Results and Impact ENLIVEN's Advisory Group launched and held its first meeting, providing persons living with dementia as well as carers/supporters an opportunity for their voices to be heard and shape strategic decision making about the future trajectory of ENLIVEN.
Year(s) Of Engagement Activity 2021
URL https://enlivenproject.co.uk/enliven-advisory-group/
 
Description PPI participation in ENLIVEN management meetings 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Study participants or study members
Results and Impact Participation of one person living with dementia and one carer in ENLIVEN management meetings, providing a space for PPI voices to become embedded at the heart of the ENLIVEN research project.
Year(s) Of Engagement Activity 2021,2022
 
Description RHS Bridgewater invited visit 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Patients, carers and/or patient groups
Results and Impact On 4th October 2021, ENLIVEN Co-Investigator Dr Carol Opdebeeck was invited to RHS Bridgewater to meet the Fabulous Forgetful Friends group. This helped to raise awareness of the project and ENLIVEN's work to make outdoor nature spaces in the visitor economy more accessible for all.
Year(s) Of Engagement Activity 2021