10 - Building community capacity for dementia in Canada: new directions in new places

Summary

Introduction

Building Capacity for Meaningful Participation by People Living with Dementia is being undertaken in Canada under the umbrella of the federally funded Dementia Community Investment. This four-year Building Capacity Project (2019–23) models a bottom-up cross-sectoral approach to building and connecting community-based activities that provide meaningful opportunities for people with dementia to remain active and socially connected. In this chapter we examine how the project is designed to build practical knowledge from the ‘ground up’, working closely with people who are most directly affected by the issues (especially those with lived experience of dementia), and taking local context into account using methods of asset-based community development and developmental evaluation. Most importantly, this work is being carried out in two very different places, which is allowing us to both leverage our unique strengths and discover the common principles underlying successful approaches that can then be scaled up more broadly, including nationally. Ultimately, the aim is to create and share new knowledge about how this kind of ‘grass roots’ approach can lead to sustainable change at individual, community and institutional levels to promote social inclusion, raise awareness and reduce stigma around dementia.

Recognising the importance of place in this project, we begin by describing where the work is happening. This allows us to make explicit the significance of local contexts, be they geographic, social, economic, cultural or political, which are intrinsic to how we are developing and evaluating the various activities and programmes. We then lay out the principles and evidence that are guiding the project and go on to explain the project design: its overarching objectives, the approach we are taking to implementation and evaluation, and the project activities themselves, including those that are emerging in response to physical distancing measures being taken in the context of the COVID-19 pandemic.

Health and dementia in a Canadian context

Any conversation about dementia finds itself inevitably in the context of health care. In Canada, our health care system is federally funded and provincially administered. Each province oversees its own health insurance plan, which is accountable under the Canada Health Act to provide medically necessary hospital and physician care services to all eligible Canadians.