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Exploring the ‘active mechanisms’ for engaging rural-dwelling older men with dementia in a community technological initiative

Published online by Cambridge University Press:  05 April 2019

Ben Hicks*
Affiliation:
Department of Psychology and Ageing & Dementia Research Centre, Bournemouth University, Bournemouth, UK
Anthea Innes
Affiliation:
Salford Institute for Dementia, Salford, UK
Samuel R. Nyman
Affiliation:
Department of Psychology and Ageing & Dementia Research Centre, Bournemouth University, Bournemouth, UK
*
*Corresponding author. Email: [email protected]

Abstract

Research has suggested ecopsychosocial initiatives can promote a sense of wellbeing and inclusion in people with dementia. However, few studies have elucidated the ‘active mechanisms’ whereby such initiatives can achieve these outcomes, so hindering their generalisability. This is particularly pertinent when seeking to support community-dwelling older men with dementia who are reluctant to engage with traditional health and social care initiatives. This paper reports on a study that drew from the principles of Participatory Action Research to explore the ‘active mechanisms’ of a technological initiative for older men (65+ years) with dementia in rural England. An individually tailored, male-only initiative, using off-the-shelf computer game technology (e.g. iPad, Nintendo Wii and Microsoft Kinect) was delivered over a nine-week period. Multiple qualitative methods were employed, including: focus groups, open interviews and extensive reflective field notes, to gather data from the perspective of 22 men, 15 care partners and five community volunteers. The data were analysed thematically and interpreted using a masculinity lens. Three mechanisms contributed to the initiative's success: the use of the technology, the male-only environment and the empowering approach adopted. The paper argues that initiatives aimed at community-dwelling older men with dementia would be advised to consider these gendered experiences and ensure participants can maximise their masculine capital when participating in them, by providing enabling activities, non-threatening environments and empowering approaches of delivery.

Type
Article
Copyright
Copyright © Cambridge University Press 2019

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References

Aguirre, E, Spector, A and Orrell, M (2014) Guidelines for adapting cognitive stimulation therapy to other cultures. Clinical Interventions in Aging 9, 10031007.CrossRefGoogle ScholarPubMed
Alzheimer's Disease International (2015) The Global Impact of Dementia: An Analysis of Prevalence, Incidence, Cost and Trends. London: Alzheimer's Disease International.Google Scholar
Astell, A (2013) Technology and fun for a happy old age. In Sixsmith, A and Gutman, G (eds), Technologies for Active Aging. New York, NY: Springer, pp. 169187.CrossRefGoogle Scholar
Australian Government (2010) National Male Health Policy. Building on the Strengths of Australian Males. Canberra: Department of Health and Ageing, Commonwealth of Australia.Google Scholar
Baker, S, Warburton, J, Hodgkin, S and Pascal, J (2017) The supportive network: rural disadvantaged older people and ICT. Ageing & Society 37, 12911309.CrossRefGoogle Scholar
Baker, P (2015) A Review of the National Men's Health Policy and Action Plan 2008–2013. Dublin: Health Service Executive.Google Scholar
Baker, P, Dworkin, SL, Tong, S, Banks, I, Shand, T and Yamey, G (2014) The men's health gap: men must be included in the global health equity agenda. Bulletin of the World Health Organization 92, 618620.CrossRefGoogle ScholarPubMed
Bartlett, R, Gjernes, T, Lotherington, AT and Obstefelder, A (2018) Gender, citizenship and dementia care: a scoping review of studies to inform policy and future research. Health & Social Care in the Community 26, 1426.CrossRefGoogle ScholarPubMed
Blackstock, K, Innes, A, Cox, S, Smith, A and Mason, A (2006) Living with dementia in rural and remote Scotland: diverse experiences of people with dementia and their carers. Journal of Rural Studies 22, 161176.CrossRefGoogle Scholar
Bowes, A, Dawson, A and McCabe, L (2018) RemoDem: delivering support for people with dementia in remote areas. Dementia 17, 297314.Google ScholarPubMed
Braun, V and Clarke, V (2006) Using thematic analysis in psychology. Qualitative Research in Psychology 3, 77101.CrossRefGoogle Scholar
Bryce, H (2013) Navigating multiple roles as a researcher in a Photovoice project. Groupwork 22, 3348.CrossRefGoogle Scholar
Carone, L, Tischler, V and Dening, T (2016) Football and dementia: a qualitative investigation of a community based sports group for men with early onset dementia. Dementia 15, 13581376.CrossRefGoogle Scholar
Chevalier, JM and Buckles, D (2013) Participatory Action Research: Theory and Methods for Engaged Inquiry: New York, NY: Routledge.CrossRefGoogle Scholar
Cohen-Mansfield, J, Marx, MS, Dakheel-Ali, M, Regier, NG and Thein, K (2010) Can persons with dementia be engaged with stimuli? American Journal of Geriatric Psychiatry 18, 351362.CrossRefGoogle ScholarPubMed
Connell, RW (2005) Masculinities, 2nd Edn. Cambridge: Polity Press.Google Scholar
Connell, RW and Messerschmidt, JW (2005) Hegemonic masculinity: rethinking the concept. Gender and Society 19, 829859.CrossRefGoogle Scholar
Connell, R and Pearse, R (2015) Gender: In World Perspective, 3rd Edn. Cambridge: Polity.Google Scholar
Cordier, R and Wilson, NJ (2014) Community-based Men's Sheds: promoting male health, wellbeing and social inclusion in an international context. Health Promotion International 29, 483493.CrossRefGoogle Scholar
Coston, B and Kimmel, M (2013) Aging men, masculinity and Alzheimer's: caretaking and caregiving in the new millennium. In Kampf, A, Marshall, BL and Petersen, A (eds), Ageing Men, Masculinities and Modern Medicine. London: Taylor & Francis, pp. 191200.Google Scholar
Courtenay, WH (2000) Constructions of masculinity and their influence on men's well-being: a theory of gender and health. Social Science & Medicine 50, 13851401.CrossRefGoogle ScholarPubMed
Cutler, C (2018) Quality of Life and Digital Gaming Technology: The Benefits of a Technology Based Intervention for Community Dwelling People with Dementia (PhD thesis). Bournemouth University, Bournemouth, UK.Google Scholar
Cutler, C, Hicks, B and Innes, A (2016) Does digital gaming enable healthy aging for community-dwelling people with dementia? Games and Culture 11, 104129.CrossRefGoogle Scholar
Department for Environment, Food and Rural Affairs (2015) Defining Rural Areas. London: Department for Environment, Food and Rural Affairs.Google Scholar
Dewing, J (2008) Process consent and research with older persons living with dementia. Research Ethics Review 4, 5964.CrossRefGoogle Scholar
Dove, E and Astell, AJ (2017) The use of motion-based technology for people living with dementia or mild cognitive impairment: a literature review. Journal of Medical Internet Research 19, e3. doi:10.2196/jmir.6518.CrossRefGoogle ScholarPubMed
Dugmore, O, Orrell, M and Spector, A (2015) Qualitative studies of psychosocial interventions for dementia: a systematic review. Aging & Mental Health 19, 955967.CrossRefGoogle ScholarPubMed
Dupuis, SL, Kontos, P, Mitchell, G, Jonas-Simpson, C and Gray, J (2016 b) Re-claiming citizenship through the arts. Dementia 15, 358380.CrossRefGoogle ScholarPubMed
Dupuis, SL, Gillies, J, Carson, J, Whyte, C, Genoe, R, Loiselle, L and Sadler, L (2012) Moving beyond patient and client approaches: mobilizing ‘authentic partnerships’ in dementia care, support and services. Dementia 11, 427452.CrossRefGoogle Scholar
Dupuis, S, McAiney, CA, Fortune, D, Ploeg, J and Witt, LD (2016 a) Theoretical foundations guiding culture change: the work of the Partnerships in Dementia Care Alliance. Dementia 15, 85105.CrossRefGoogle ScholarPubMed
Fenney, A and Lee, TD (2010) Exploring spared capacity in persons with dementia: what WiiTM can learn. Activities, Adaptation & Aging 34, 303313.Google Scholar
Flick, U (2014) An Introduction to Qualitative Research. London: Sage.Google Scholar
Genoe, MR (2010) Leisure as resistance within the context of dementia. Leisure Studies 29, 303320.CrossRefGoogle Scholar
Genoe, MR and Singleton, JF (2006) Older men's leisure experiences across their lifespan. Topics in Geriatric Rehabilitation 22, 348356.CrossRefGoogle Scholar
Hammer, JH, Vogel, DL and Heimerdinger-Edwards, SR (2013) Men's help seeking: examination of differences across community size, education, and income. Psychology of Men & Masculinity 14, 6575.CrossRefGoogle Scholar
Hicks, B (2016) Exploring the Use of a Commercial Digital Gaming Technological Initiative to Enable Social Inclusion for Community-dwelling Older Men with Dementia in Rural England (PhD thesis). Bournemouth University, Bournemouth, UK.Google Scholar
Hicks, B and Miller, L (2012) Research to Inform the Development of a Guide for Online Activities for People with Dementia: London: Social Care Institute for Excellence.Google Scholar
Hulko, W (2009) From ‘not a big deal’ to ‘hellish’: experiences of older people with dementia. Journal of Aging Studies 23, 131144.CrossRefGoogle Scholar
Hurd, Clarke L and Bennett, E (2013) ‘You learn to live with all the things that are wrong with you’: gender and the experience of multiple chronic conditions in later life. Ageing & Society 33, 342360.Google Scholar
Hurd, Clarke L and Lefkowich, M (2018) ‘I don't really have any issue with masculinity’: older Canadian men's perceptions and experiences of embodied masculinity. Journal of Aging Studies 45, 1824.CrossRefGoogle Scholar
Joddrell, P and Astell, AJ (2016) Studies involving people with dementia and touchscreen technology: a literature review. JMIR Rehabilitation and Assistive Technologies 3, e10. doi:10.2196/rehab.5788.CrossRefGoogle ScholarPubMed
Kahlbaugh, PE, Sperandio, AJ, Carlson, AL and Hauselt, J (2011) Effects of playing wii on well-being in the elderly: physical activity, loneliness, and mood. Activities, Adaptation & Aging 35, 331344.Google Scholar
Kaufman, M (1994) Men, feminism, and men's contradictory experiences of power. In Brod, H and Kaufman, M (eds), Theorizing Masculinities. Thousand Oaks, CA: Sage, pp. 142163.CrossRefGoogle Scholar
Keating, N, Eales, J and Phillips, JE (2013) Age-friendly rural communities: conceptualizing ‘best-fit’. Canadian Journal on Aging 32, 319332.CrossRefGoogle Scholar
Kenigsberg, PA, Aquino, JP, Bérard, A, Brémond, F, Charras, K, Dening, T, Droës, RM, Gzil, F, Hicks, B, Innes, A, Nguyen, M, Nygård, L, Pino, M, Sacco, G, Salmon E., van der Roest H, Villet, H, Villez, M, Robert, P and Manera, V (in press) Assistive technologies to address capabilities of people with dementia: from research to practice. Dementia. Available online doi:10.1177/1471301217714093.Google Scholar
Kenigsberg, P-A, Aquino, J-P, Berard, A, Gzil, F, Andrieu, S, Banerjee, S, Bremond, F, Buee, L, Cohen-Mansfield, J, Mangialasche, F, Platel, H, Salmon, E and Robert, P (2016) Dementia beyond 2025: knowledge and uncertainties. Dementia 15, 621.CrossRefGoogle ScholarPubMed
Keyes, SE, Clarke, CL, Wilkinson, H, Alexjuk, EJ, Wilcockson, J, Robinson, L, Reynolds, J, McClelland, S, Corner, L and Cattan, M (2016) ‘We're all thrown in the same boat…’: a qualitative analysis of peer support in dementia care. Dementia 15, 560577.CrossRefGoogle Scholar
Kimmel, MS (1996) Manhood in America. New York, NY: Free Press.Google Scholar
Kolanowski, A, Litaker, M, Buettner, L, Moeller, J and Costa, JPT (2011) A randomized clinical trial of theory-based activities for the behavioral symptoms of dementia in nursing home residents. Journal of the American Geriatrics Society 59, 10321041.CrossRefGoogle ScholarPubMed
Leahey, A and Singleton, JF (2011) Utilizing therapeutic recreation to empower persons with Alzheimer's in a day center. Therapeutic Recreation Journal 45, 135146.Google Scholar
Leng, FY, Yeo, D, George, S and Barr, C (2014) Comparison of iPad applications with traditional activities using person-centred care approach: impact on well-being for persons with dementia. Dementia 13, 265-273.CrossRefGoogle ScholarPubMed
Levant, RF and Habben, C (2003) The new psychology of men: application to rural men. In Stamm, B (eds), Rural Behavioural Health Care: An Interdisciplinary Guide. Washington, DC: American Psychological Association, pp. 171180.CrossRefGoogle Scholar
Lorenz, K, Freddolino, PP, Comas-Herrera, A, Knapp, M and Damant, J (2019) Technology-based tools and services for people with dementia and carers: mapping technology onto the dementia care pathway. Dementia. Available online doi:10.1177/1471301217691617.CrossRefGoogle ScholarPubMed
McParland, P, Kelly, F and Innes, A (2017) Dichotomising dementia: is there another way? Sociology of Health & Illness 39, 258269.CrossRefGoogle ScholarPubMed
Meiland, F, Innes, A, Mountain, G, Robinson, L, van der Roest, H, García-Casal, JA, Gove, D, Thyrian, JR, Evans, S, Dröes, RM and Kelly, F (2017) Technologies to support community-dwelling persons with dementia: a position paper on issues regarding development, usability, effectiveness and cost-effectiveness, deployment, and ethics. JMIR Rehabilitation and Assistive Technologies 4, e1. doi:10.2196/rehab.6376.CrossRefGoogle ScholarPubMed
Milligan, C, Payne, S, Bingley, A and Cockshott, Z (2015) Place and wellbeing: shedding light on activity interventions for older men. Ageing & Society 35, 124149.CrossRefGoogle Scholar
Nyman, SR and Szymczynska, P (2016) Meaningful activities for improving the wellbeing of people with dementia: beyond mere pleasure to meeting fundamental psychological needs. Perspectives in Public Health 136, 99107.CrossRefGoogle ScholarPubMed
Orrell, M (2012) The new generation of psychosocial interventions for dementia care. British Journal of Psychiatry 201, 342343.CrossRefGoogle ScholarPubMed
Oyebode, JR and Parveen, S (2016) Psychosocial interventions for people with dementia: an overview and commentary on recent developments. Dementia.Google ScholarPubMed
Phinney, A, Dahlke, S and Purves, B (2013) Shifting patterns of everyday activity in early dementia experiences of men and their families. Journal of Family Nursing 19, 348374.CrossRefGoogle ScholarPubMed
Phinney, A, Kelson, E, Baumbusch, J, O'Connor, D and Purves, B (2016) Walking in the neighbourhood: performing social citizenship in dementia. Dementia 15, 381394.CrossRefGoogle ScholarPubMed
Ravneberg, B (2012) Usability and abandonment of assistive technology. Journal of Assistive Technologies 6, 259269.CrossRefGoogle Scholar
Reason, P and Bradbury, H (2008) The Sage Handbook of Action Research: Participative Inquiry and Practice, 2nd Edn. London: Sage.CrossRefGoogle Scholar
Regan, JL (2016) Ethnic minority, young onset, rare dementia type, depression: a case study of a Muslim male accessing UK dementia health and social care services. Dementia 15, 702720.CrossRefGoogle ScholarPubMed
Robson, C (2011) Real World Research: A Resource for Users of Social Research Methods in Applied Settings. Chichester, UK: Wiley.Google Scholar
Roland, KP and Chappell, NL (2015) Meaningful activity for persons with dementia: family caregiver perspectives. American Journal of Alzheimer's Disease and Other Dementias 30, 559568.CrossRefGoogle ScholarPubMed
Sandberg, LJ (2018) Dementia and the gender trouble? Theorising dementia, gendered subjectivity and embodiment. Journal of Aging Studies 45, 2531.CrossRefGoogle ScholarPubMed
Schneider, B (2012) Participatory action research, mental health service user research, and the hearing (our) voices projects. International Journal of Qualitative Methods 11, 152165.CrossRefGoogle Scholar
Slevin, KF and Linneman, TJ (2010) Old gay men's bodies and masculinities. Men and Masculinities 12, 483507.CrossRefGoogle Scholar
Sloan, C, Conner, M and Gough, B (2015) How does masculinity impact on health? A quantitative study of masculinity and health behavior in a sample of UK men and women. Psychology of Men & Masculinity 16, 206217.CrossRefGoogle Scholar
Solari, CA and Solomons, L (2012) The World Cup effect: using football to engage men with dementia. Dementia 11, 699702.CrossRefGoogle Scholar
Span, M, Hettinga, M, Vernooij-Dassen, M, Eefsting, J and Smits, C (2013) Involving people with dementia in the development of supportive IT applications: a systematic review. Ageing Research Reviews 12, 535551.CrossRefGoogle ScholarPubMed
Spindler, E (2015) Beyond the Prostate: Brazil's National Healthcare Policy for Men, EMERGE Case Study 1. Brighton, UK: Promundo-US, Sonke Gender Justice and the Institute of Development Studies.Google Scholar
Szymczynska, P, Innes, A, Mason, A and Stark, C (2011) A review of diagnostic process and postdiagnostic support for people with dementia in rural areas. Journal of Primary Care & Community Health 2, 262276.CrossRefGoogle ScholarPubMed
Tannenbaum, C and Frank, B (2011) Masculinity and health in late life men. American Journal of Men's Health 5, 243254.CrossRefGoogle ScholarPubMed
Thompson, EH Jr and Bennett, KM (2015) Measurement of masculinity ideologies: a (critical) review. Psychology of Men & Masculinity 16, 115133.CrossRefGoogle Scholar
Thompson, EH Jr and Langendorefer, KB (2016) Older men's blueprint for ‘being a man’. Men and Masculinities 19, 119147.CrossRefGoogle Scholar
Tolson, D and Schofield, I (2012) Football reminiscence for men with dementia: lessons from a realistic evaluation. Nursing Inquiry 19, 6370.CrossRefGoogle ScholarPubMed
Townsend, L, Sathiaseelan, A, Fairhurst, G and Wallace, C (2013) Enhanced broadband access as a solution to the social and economic problems of the rural digital divide. Local Economy 28, 580595.CrossRefGoogle Scholar
Twigg, J (2020) Dress, gender and the embodiment of age: men and masculinities. Ageing & Society 40, 105125.Google Scholar
Upton, D, Upton, P, Jones, T, Jutlla, K, Brooker, D and Grove, H (2011) Evaluation of the impact of touch screen technology on people with dementia and their carers within care home settings. Project Report. Department of Health West Midlands.Google Scholar
Waling, A and Fildes, D (2017) ‘Don't fix what ain't broke’: evaluating the effectiveness of a Men's Shed in inner-regional Australia. Health & Social Care in the Community 25, 758768.CrossRefGoogle ScholarPubMed
Wentzell, EA (2013) Maturing Masculinities: Aging, Chronic Illness, and Viagra in Mexico. Durham, NC: Duke University Press.CrossRefGoogle Scholar
White, A (2011) The state of men's health in Europe: how do we compare in the UK? Trends in Urology & Men's Health 2, 1216.CrossRefGoogle Scholar
White, A, de Sousa, B, de Visser, R, Hogston, R, Madsen, SA, Makara, P, Richardson, N and Zatonski, W (2011) The State of Men's Health in Europe Report. Brussels: European Commission.Google Scholar
Whitehouse, PJ (2014) The end of Alzheimer's disease – from biochemical pharmacology to ecopsychosociology: a personal perspective. Biochemical Pharmacology 88, 677681.CrossRefGoogle ScholarPubMed
Wiersma, E and Chesser, S (2011) Masculinity, ageing bodies, and leisure. Annals of Leisure Research 14, 242259.CrossRefGoogle Scholar
Wiersma, EC, O'Connor, DL, Loiselle, L, Hickman, K, Heibein, B, Hounam, B and Mann, J (2016) Creating space for citizenship: the impact of group structure on validating the voices of people with dementia. Dementia 15, 414433.CrossRefGoogle ScholarPubMed
Wilson, NJ and Cordier, R (2013) A narrative review of Men's Sheds literature: reducing social isolation and promoting men's health and well-being. Health & Social Care in the Community 21, 451463.CrossRefGoogle ScholarPubMed
Wilson, NJ, Cordier, R, Doma, K, Misan, G and Vaz, S (2015) Men's Sheds function and philosophy: towards a framework for future research and men's health promotion. Health Promotion Journal of Australia 26, 133141.CrossRefGoogle ScholarPubMed
Yousaf, O, Grunfeld, EA and Hunter, MS (2015) A systematic review of the factors associated with delays in medical and psychological help-seeking among men. Health Psychology Review 9, 264276.CrossRefGoogle ScholarPubMed
Zeisel, J, Reisberg, B, Whitehouse, P, Woods, R and Verheul, A (2016) Ecopsychosocial interventions in cognitive decline and dementia: a new terminology and a new paradigm. American Journal of Alzheimer's Disease & Other Dementias 31, 502507.CrossRefGoogle Scholar