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.

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