ENLIVEN project to foster healthy ageing through nature and community

The new initiative aims to help older people living with dementia become more active, independent and experience a better quality of life, by improving their access to the natural environment.

One of seven research projects funded by UK Research and Innovation (UKRI) that form the Healthy Ageing Social, Behavioural and Design Research Programme (SBDRP), the ENLIVEN project will contribute significantly towards the Healthy Ageing Challenge’s goal of extending healthy, active life expectancy by five years by 2035.

Research has established that, for people with dementia, outdoor activity offers precious benefits, helping individuals maintain independence, social inclusion, and meaningful occupation; stimulate memory and the senses; and enhance identity and self-esteem.

In this context, the ENLIVEN project seeks to address the specific contextual and circumstantial factors which can make the natural environment inaccessible for individuals with cognitive impairment. To do this, The ENLIVEN team will work with businesses, social enterprises and third sector organisations to gain a practical understanding of the barriers these individuals face – from the more immediate, physical obstacles of transport and safety, to more wide-ranging and (often) disproportionately experienced social, cultural and psychological barriers.

With the project now underway, we reached out to its academic leads – Professor Linda Clare, the project’s Chief Investigator, and Dr Joanne Connell, an expert in making visitor economy businesses more hospitable for people living with dementia – to find out more about ENLIVEN.

“Hi Linda and Jo, could you tell us how the ENLIVEN project developed?

Linda: “Since 2014 my group has been working on a large cohort study of people with dementia, called IDEAL, which is now an Alzheimer’s Society Centre of Excellence. When we set the study up we were already thinking about access to nature, and included some questions about accessing green and blue spaces. We found that people with dementia who thought they had green or blue space near where they lived had better quality of life and well-being than those who did not.

“Then Rachel Collins joined the group with [her] background in both environmental studies and health research, which helped us to focus more on the role of the natural environment. It was great to link up with Jo Connell and learn about all the amazing work she had been involved in on making various kinds of spaces and facilities such as heritage sites accessible for people with dementia.”

We found that people with dementia who thought they had green or blue space near where they lived had better quality of life and well-being than those who did not.

Professor Linda Clare

Jo: “My colleague Stephen Page (from Hertfordshire Business School) and I have been working on the interactions between visitor economy organisations and people with dementia since 2015. We have worked with national organisations to develop guidelines and toolkits for visitor attractions, tourist accommodation and heritage sites aiming to make their services more dementia-friendly. We were pleased to join forces with Linda and her team to extend the application of our work.”

Linda: “The call that funded ENLIVEN was a perfect opportunity to bring these various strands of work together. This is where IIB came in, as we needed that expertise to help bring potential partner organisations on board. Our proposal had a really impressive list of potential partners and letters of support, thanks mainly to IIB colleagues Hannah Williams and Michelle Spillar. In the last few months, we’ve been setting up the study and we now have our project manager Katie Ledingham, two researchers, Steven Owen and Stephan Price, and a project administrator, Hannah Cameron, in post or about to start.”

“How does ENLIVEN aim to develop new ways of accessing nature and the outdoors for people living with dementia?”

Linda: “We are going to gather evidence from individuals, groups, businesses and organisations as well as published reports and literature, and work with stakeholders in a knowledge exchange forum to understand current practice and guide new developments.

“We will use the outputs from the knowledge exchange forum to support businesses in generating and implementing innovations aimed at improving access, which will be documented and evaluated. We will work with the knowledge exchange forum to understand what has been learned from this process and produce a toolkit of resources for businesses and individuals. People affected by dementia will be involved in all stages of this process.”

“How will working with external partner organisations help inform the project’s practical application and impact?”

Linda: “Because we’re both working with external partners and involving people affected by dementia from the outset, the project is all about practical application and sharing knowledge. In my more usual field of health research, I’m used to developing interventions, testing them in randomised trials, and then – if they work well – trying to implement them in routine health or social care services, which is often very challenging.

“In ENLIVEN we are working directly with businesses to support them in developing new ideas and enable them to do things differently, so any innovations they make will be relevant and appropriate for their own context, and we will evaluate how they work and then share what we have learned with other businesses who can adapt the ideas for their own settings. It’s much more organic and I think the impact will arise much more directly.”

People affected by dementia will be involved in all stages of this process

Professor Linda Clare

Jo: “Involving businesses as integral partners means we can co-create services that work for those business and for customers, and sharing this more widely to help the sector to make progress in moving towards a more accessible environment.”

“What have you enjoyed most about ENLIVEN – and similar projects you’ve worked on in the past?”

Jo: “Working on a project that people feel is worthwhile and where there is a positive feel about making changes for the better for societal challenges, particularly when looking for external collaborations.”

Linda: “We’re at a very early stage with ENLIVEN, but my experience with other projects [like this] is that external partners are incredibly valuable. They bring different ways of seeing things and I think it makes us more open to a range of approaches and ideas. I’ve learned a lot in our IDEAL Alzheimer’s Centre of Excellence programme, for example, from working with artist Ian Beesley and his team.

“Starting with the germ of an idea they did a fantastic job of engaging people with dementia and finding ways of getting their voice heard, culminating in a very professional touring exhibition and book that showcase the perspectives of people affected by dementia and highlight some of the issues they want to address, such as more accessible public transport, or care systems that are easier to navigate. Whereas in health research we often start with a very well-defined plan and follow it closely, when working with artists it is a real journey of discovery and exploration, and that is very enjoyable.”

 

The Enliven project’s ESRC funding bid was supported earlier this year by Hannah Williams and Michelle Spillar, from the University of Exeter’s Innovation, Impact and Business (IIB) team. If you would like to explore ways of working with the University of Exeter, please contact us here.

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