Current policy emphasises the importance of 'living well' with dementia, but there has been no comprehensive synthesis of the factors related to quality of life (QoL), subjective well-being or life satisfaction in people with dementia. We examined the available evidence in a systematic review and meta-analysis. We searched electronic databases until 7 January 2016 for observational studies investigating factors associated with QoL, well-being and life satisfaction in people with dementia. Articles had to provide quantitative data and include ⩾75% people with dementia of any type or severity. We included 198 QoL studies taken from 272 articles in the meta-analysis. The analysis focused on 43 factors with sufficient data, relating to 37639 people with dementia. Generally, these factors were significantly associated with QoL, but effect sizes were often small (0.1-0.29) or negligible (<0.09). Factors reflecting relationships, social engagement and functional ability were associated with better QoL. Factors indicative of poorer physical and mental health (including depression and other neuropsychiatric symptoms) and poorer carer well-being were associated with poorer QoL. Longitudinal evidence about predictors of QoL was limited. There was a considerable between-study heterogeneity. The pattern of numerous predominantly small associations with QoL suggests a need to reconsider approaches to understanding and assessing living well with dementia.

Over the years there have been advances in the quality of care provision for people with dementia. How to measure the impact of care on the person with dementia has challenged researchers as, until recently, no evaluation tool offered a comprehensive overview of the behaviour patterns and well-being of persons with dementia. Dementia Care Mapping (DCM) is a tool used by care practitioners and researchers to capture both the process (behaviours) and outcome (well-being) of care and is therefore of use as a tool to evaluate quality of care. This study aims to assess, through DCM, the experience of dementia care provision in residential and nursing homes in two voluntary organizations in England. The data illustrates similarities in the well-being and behaviour patterns of 76 persons with dementia living in six care settings throughout England. Examples of instances when people with dementia were "put down" and when well-being was enhanced, are outlined. The homes in the study were meeting the physical care but not the broader psychosocial care needs of the observed residents. The action taken by the organizations as a result of the DCM evaluations is summarized.

This paper examines key challenges and strategies for including older people with dementia in an ethnographic study of quality of life in institutional care settings. The methods of interview and observation are described in relation to meeting four research challenges: verbal communication impairment, memory loss, decision-making capacity, and emotional disposition. A range of strategies for privileging the voice of the person with dementia is recommended which include: using different methods bespoke to each person with dementia; greater flexibility and time; preliminary meetings with the person with dementia; discussions with formal and informal carers; and research training. The researchers also conclude that the use of observation and interview are 'meaning-making occasions' which are qualitatively different but equally valuable for understanding quality of life in care settings.

In recent years walking interviews have emerged as a valuable alternative to the standard research interview, particularly in studies related to place, community, and the urban environment (Clark and Emmel 2010). Although there is little literature on the use of walking interviews with people who have dementia, the method is particularly appropriate for this participant group, due to the strong memories for place and past events that are usually retained by people with dementia, even when short term memory deteriorates (Chaudhury 2008). Narrative biography work with people who have dementia shows a repeated tendency to use geographical markers as ¿signposts¿ to particular memories (Bryce et al 2010). In 2010 the authors piloted the use of walking interviews with three people with dementia within a care home environment. The film record of the process suggests that the combination of physical movement and reminiscence which was involved both facilitated and enhanced communication for people with dementia. These findings led to the present work which is based on walking interviews with people who have dementia in places which have particular meaning for them, such as the street where they grew up; the school they attended; a former workplace; public park; sports ground or other familiar space. The oral presentation will include film clips, contrasting ¿static¿ communication with each participant, with his or her verbal production, or non-verbal communication, in response to environmental prompts and recovered sights and sounds. In addition, we will draw on the film data to explore a series of thought-provoking questions related to changing inner and outer landscapes, the vagaries of memory, and the psychogeography of dementia. Can the frequently pathologised ¿wandering¿ of people with dementia in time and space be rehabilitated using situationist concepts such as the dérive and the flaneur?

This paper discusses the exploratory process of making a short digital film with two women with early-onset dementia in a day care setting. The film was produced as part of a larger participatory video (PV) pilot project within the day centre. My main subject here is the adaptations to the standard PV process which I made in order for the two women, Pam and Carol*, to be able to take active part. These adjustments took account of their individual abilities related to cognition, physical mobility and social confidence. I discuss the development of an asynchronous approach, which involved my going out into the local community to capture images of Leeds City Market using a mini-camcorder (Flipcam) and the subsequent addition, at the day centre, of voice-over commentary by the two women in response to the visual images they saw on screen. Extracts from their film narrative presented here suggest that participation in the film-making process helped to reconstruct their sense of cultural identity and social engagement. The resulting short film is now being disseminated to Dementia Studies degree students by way of their social networking site.

This paper reports on the evaluation of the Enriched Opportunities Programme in improving well-being, diversity of activity, health, and staff practice in for people with dementia. Participants were 127 residents with a diagnosis of dementia or enduring mental health problems in three specialist nursing homes in the UK. A repeated measures within-subjects design was employed, collecting quantitative and qualitative data at three points over a twelve-month period in each facility with follow-up 7 to 14 months later. Two-way ANOVAs revealed a statistically significant increase in levels of observed well-being and in diversity of activity following the intervention. There was a statistically significant increase in the number of positive staff interventions but no change in the number of negative staff interventions overall. There was a significant reduction in levels of depression. No significant changes in anxiety, health status, hospitalisations, or psychotropic medication usage were observed. The Enriched Opportunities Programme demonstrated a positive impact on the lives of people with dementia in nursing homes already offering a relatively good standard of care, in a short period of time. The refined programme requires further evaluation to establish its portability.

In the UK it is established that health and social care services for people with dementia from black and minority ethnic communities need to move towards providing evidence-based culturally appropriate care. At present, however, the evidence base available to guide professionals working with people with dementia from diverse ethnic and cultural groups is limited, and beliefs about dementia and the type of treatment and support needed have received little attention. Consequently this creates problems for service providers faced with appropriately supporting people with dementia and their families from black and minority ethnic communities.

Dementia has been a latecomer to the field of service user involvement. Although there are now beginning to be welcome signs of improvement in the inclusion of the service-user voice, at present those with milder cognitive impairment, those who are still living at home, and those who come from white, professional backgrounds are over-represented. The BSc/MSc Dementia Studies programmes at the University of Bradford recruit part-time students who are already employed in the field of dementia care. The majority of students work in long-term or intermediate care, with smaller sub-groups working in the community, in acute care and on general hospital wards. The client groups with dementia they encounter in these settings are diverse, and tend to have different needs and perspectives from those articulated by mainstream service user groups. For this reason we have been seeking to develop an inclusive approach to service user involvement in the degree programmes we run, in order to ensure that the whole range of experiences of dementia is covered. Over the last five years this has involved developing an outreach programme in order to involve people with dementia in the environments where they spend their time, rather than restricting service user involvement to on-site activities at the University. This presentation showcases one such project which involved members of the course team working with clients attending a resource centre for older people with dementia to develop a series of short film clips (Bay Tree Voices) which were then embedded into the course learning materials in order to model alternative approaches to communication. The presentation includes formal and informal evaluations of these film-based teaching resources from service users, students and care staff.

This paper is concerned with a variety of contemporary representations of dementia in both mainstream made-for-box-office cinema and in TV soap and drama. Such representations frequently draw on familiar tropes of global memory loss, violence and aggression, extreme dependency on heroic carers, catastrophic prognosis, and early death. Whilst such narrative devices may be excusable to some extent in film made for purposes of entertainment, the producers have considerable responsibility for public awareness and understandings of dementia, which, we would argue, should be discharged in a socially responsible way, rather than purely in order to achieve dramatic effect. Moreover, it has been widely argued in recent years (eg Alexander et al 2005) that film of this nature can be used ¿as it stands¿ in the education of health and social care practitioners. Instead, we would argue that students and practitioners need to learn the basic principles of representation theory, in order to understand and critique how film works to influence and socially construct views of health, illness and regimes of truth around them, paying central attention always to the question of whose interests are served by the representation in question.