Dementia, a complex and challenging non-communicable disease, is rapidly emerging as a global health concern. With the number of individuals affected by dementia projected to increase from 57.4 million in 2019 to a staggering 152.8 million by 2050, addressing this issue has become a global imperative. While dementia poses a significant burden worldwide, India, in particular, faces unique challenges due to its diverse socio-cultural landscape and limited healthcare resources.
The concept of Dementia-Friendly Communities (DFC) has gained significant traction in recent years, offering hope and support to individuals living with dementia and their caregivers. This article explores the implementation of dementia-friendly communities in India, focusing on brain health and key areas and strategies to create a more inclusive and supportive environment for those affected by dementia.
Dementia-friendly community: Elaboration of key areas
A dementia-friendly community is defined as a place where individuals with dementia are empowered to have high aspirations, feel confident, and believe they can contribute and participate in meaningful activities. The concept recognises and addresses the challenges faced by individuals with dementia and their caregivers, striving to enable them to lead fulfilling lives. Creating a DFC goes beyond the physical environment; it involves a holistic approach that considers health, coping issues, and social factors, while respecting cultural norms and diversity.
In India, which boasts a rich tapestry of cultural and societal norms, designing dementia-friendly communities should be a nuanced process, considering the country’s vast socio-cultural diversity. People’s experiences of their environment vary due to a combination of social, cultural, cognitive, and physical factors. It is essential to integrate these elements into the design of DFC to ensure their effectiveness.
Creating dementia-friendly Communities
Dementia-friendly neighbourhoods should be welcoming, safe, accessible, and enjoyable for individuals with dementia, as well as others visiting or living in these communities. Housing plays a crucial role, with both specific and general housing options that facilitate home-based health and social care services, supporting individuals with dementia in leading independent lives. In addition to housing, several key principles need to be addressed when designing dementia-friendly communities:
Familiarity: Environments that are easily recognizable and provide a sense of familiarity.
Legibility: Make it easy for people to identify where they are and where they need to go.
Comfort: Soothing and calming spaces that promote a sense of ease and well-being.
Accessibility: Barrier-free design that ensures accessibility for all individuals, regardless of their physical abilities.
Distinctiveness: Varied and distinct areas that provide visual cues for orientation and memory loss.
Safety: Secure and safe environments that minimise the risk of harm and accidents.
Tailoring DFC to the Indian context
In India, where multi-generational living arrangements have traditionally provided support to individuals with dementia, the rise of nuclear families presents new challenges. DFCs should consider this shift and prioritize home-based care solutions. Additionally, specialised dementia-specific facilities and dementia-friendly hospital wards are crucial to ensure comprehensive healthcare for individuals with dementia.
Harnessing the power assistive technology
Assistive technology (AT) plays a significant role in supporting individuals with dementia. AT includes devices designed to assist, adapt, or rehabilitate individuals who need it, and it can greatly enhance the quality of life for people with dementia. In a DFC, specific AT solutions should be tailored to the unique needs of those with dementia, promoting independence and well-being.
Creating therapeutic landscapes
The concept of therapeutic landscapes suggests that certain physical, social, and symbolic aspects of spaces can have healing properties. This holistic approach to designing spaces emphasises the need to move away from keeping individuals with dementia indoors and instead allows them greater freedom and administrative recognition within the community. Recent research has highlighted the benefits of non-pharmacological treatments for dementia, such as outdoor activities like gardening and cognitive training.
Addressing transportation challenges
Transport and travel are major challenges for individuals with dementia. DFCs should focus on improving transportation options for those affected by dementia, considering issues such as self-driving, the risks associated with age and dementia, and the need for sensitised cab services. Walking as part of healthy ageing and visiting shops can also present challenges for individuals with dementia. Proper labelling of shops and locations in a DFC is essential.
Fostering awareness and acceptance
One of the fundamental aspects of a DFC is raising awareness about dementia and fostering acceptance within the community. Intergenerational bonding and various forms of health education, such as pamphlets, banners, mass media campaigns, and lectures, can all play a vital role in promoting understanding and empathy for individuals living with dementia.
Alignment with healthcare programs
Dementia needs to be integrated into India’s healthcare programs, such as the National Mental Health Program and the National Program for the Healthcare of the Elderly. Ayushman Bharat, a flagship healthcare program in India, can help disseminate the concept of DFC through its network of health and wellness centres.
Integration into medical curriculum
To create a sustainable impact, the concept of DFC should be integrated into medical education. Both undergraduate and postgraduate medical curricula should include comprehensive training on DFC, emphasising its multi-dimensional aspects and importance in providing holistic care to individuals with dementia.
Conclusion
The creation of dementia-friendly communities in India represents a progressive shift from a mere focus on the physical environment to a dynamic and interactive space for individuals living with dementia. Early diagnosis, behaviour change communication, and involvement of various stakeholders are key to the successful implementation of DFC. Integrating the concept into India’s public health programs and medical education curriculum is crucial for the sustainable development of dementia-friendly communities. As India faces the challenges posed by its evolving healthcare landscape, DFCs offer a ray of hope for those affected by dementia, promoting empowerment, inclusion, and a better quality of life. If you found this article useful, you might also like: Optimising brain health for lifelong well-being. You can also benefit from finding out your cognitive age and how it compares to your actual age.
Credits: Abhik Sinha, Sukamal Bisoi, and Sanjay Zodpey
We thank the authors for their valuable research on the topic of rural-urban differences in successful aging among older Indian adults. Their work contributes to our understanding of the factors that influence the aging process and highlights the importance of addressing these issues to ensure the well-being of older individuals in India. This article is a layman’s summary of their research, aiming to make their findings accessible to a wider audience.
