What Is a Dementia-Inclusive Community?

Sadie Harmon, dementia-inclusive communities director  
Credit: Kirk Waller

One of the most exciting aspects of Sadie Harmon’s work is that she is creating new ways to communicate with and carry out the wishes of people with dementia who are living at home and active in their communities. Last August she joined Elder Care Alliance, a network of five senior living communities in California’s Bay Area. Programs she has been piloting extend ECA’s dementia-friendly support beyond its five special care facilities into San Francisco neighborhoods. The innovative work centers on improving the quality of life for people with dementia by giving them greater access to arts and culture. 

Editor’s Note: This interview has been edited for length and readability.

Laura B. Hayden: Welcome to SevenPonds, Sadie. Your work sounds unique, but before we get into the particulars, I need to ask you exactly what a dementia-inclusive community is.

Sadie Harmon: Sure. Dementia-inclusive communities provide community-based support for people living with dementia. The support can be everything from neighbors, family and friends helping people who have dementia and are living at home, to more community-based initiatives like making cities and streets more accessible. This could be accomplished by having really clear signage and having adequate public transportation. Businesses can be made aware of how to better welcome and serve people with dementia. It all falls under the dementia-friendly community umbrella.

Laura: It sounds as if a dementia-inclusive community exists outside of an assisted-living or memory center.

Sadie: Exactly! And the reason we call our programs “dementia-inclusive” instead of “dementia-friendly” is because there really is an emphasis on bringing people living with dementia into the planning process of these communities as partners. This goes beyond just thinking about what would make a community accessible. We strive to find out what the people living with dementia actually want — directly from them.

To do this we have to ask ourselves: How do we reach people with dementia who are living in their homes in the community who maybe aren’t currently accessing services or aren’t able to access as many services as they would like?

The person responding to Sadie’s prompt may draw
a flower, cat or dog or knitting needles for example
Credit: 123peppy.com

Laura: Is this something new?

Sadie: I wouldn’t say that it’s totally new. The dementia-friendly networks definitely have input from the well community, care partners and some people with dementia. So that’s not to say this is a totally new model for us — but my focus is working with the people living with dementia.

What does feel new to me is the way we are using art. That is pretty exciting to me. I have an MFA in interdisciplinary studio art. I also focused on community-based art and research. I am not an art therapist! So this program really thinks about art and culture as something that we all share and that brings people together — even if those members of the community do not identify themselves as artists. So I really work with that relationship we all have to art and culture as an access point.

Laura: How do you encourage the person with dementia to participate in the planning process?

Sadie: The example I usually use is this: Typically if you are planning a new community center you may send out a survey. Or you hold a public forum that people are invited to attend. Maybe you plan to have break-out discussions or group work. But written or verbal language is often not the best way to communicate with people with dementia

Bringing art to this process brings people who maybe are not comfortable with traditional surveys into the discussion. That’s why we use art as a starting point. It’s really accessible. It’s really open-ended.

Laura: Can you give me an example?

Sadie: I’ve been piloting one program with another colleague who is an art therapist. We use a lot of templates and creative prompts. I have one that says “If I could design my own neighborhood, this is what I would like it to look like.” Then it just provides a line on the paper that looks like it could be a road — or it could be a river — or something else. The person responding to the prompt may draw flowers (which would suggest to us a garden). A dog or cat would suggest a pet-friendly area. Or maybe the line would remind someone of yarn and they’d draw knitting needles (which would indicate a knitting class).

Sadie includes people living with dementia in community planning, using art and culture as a way to access their input
Credit: Bill Harmon

Join Sadie and me next week when she talks more about the partnerships she has established with people living with dementia and their communities using art.