Understanding How Day Programs Work as Care in the Community for People Living with Dementia and their Families

• Author / Creator

  Symonds-Brown, Holly

• In Canada, most people living with dementia live at home, with family, friends and neighbours providing most of the care. While often mentioned in policy as an ideal, it seems that ‘care in the community’ is much more elusive to implement in practice for people with dementia and their families. Day programs are an example of a community care intervention considered an essential support for both people with dementia and family caregivers. Despite their frequent reference in policy, over 40 years of research on day programs for people with dementia have resulted in ambiguous findings and concerns regarding the under-theorization and limited analysis of their effects. The research question for this study was: How do day programs work as ‘care in the community’ for people with dementia living at home and their families? Related to this question were two objectives: First, to explore the ways in which day programs affect the everyday life of people with dementia living at home and their families and second, to understand how day program care practices relate with other formal and family care practices for the person with dementia. To answer these questions, an ethnography guided by material semiotics was used to focus on the sociomaterial care practices of family and day programs for the person with dementia. Using methods of participant observation, interview and document analysis, four people with dementia attending one of two day programs in the Edmonton region, were followed for six to nine months in their daily life with family members in their home, in the community and at the day program. Several findings were highlighted: 1) The day program is a contested space with multiple, precariously coordinated enactments 2) Working as a health technology, day programs configure and are configured within specific care arrangements with effects on both people with dementia and family members’ subjectivity, agency and relations to space. 3) The day programs’ possibilities for care and social inclusion were limited by the broader normativities of community infrastructure. These findings are practically relevant to the growing movement for planning dementia-friendly communities. They also give rise to questions regarding the cosmopolitics of ‘care in the community’ and what comes to matter when the practices of home, formal care, and community infrastructures come together.

• Subjects / Keywords

  • Dementia
  • Day Programs
  • Community Care
  • Material Semiotics

• Graduation date

  Fall 2021

• Type of Item

  Thesis

• Degree

  Doctor of Philosophy

• DOI

  https://doi.org/10.7939/r3-zwxp-0886

• License

  This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.