1. DEMENTIA FRIENDLY, AGE FRIENDLY – WHAT DOES IT MEAN
DEMENTIA FRIENDLY, AGE FRIENDLY – WHAT DOES IT MEAN? MAREE MCCABE CEO ALZHEIMER’S AUSTRALIA VIC

2. ALZHEIMER’S AUSTRALIA VIC
Metropolitan Melbourne
Victoria’s peak dementia body
Independent, not-for-profit
Member of Alzheimer’s Australia
Funded by government and
community donations
Around 135 staff
More than 120 volunteers
Almost 100 staff
Supporting >12,000 people living with dementia, their families and carers
Educating >15,000 medical professionals, aged care workers, carers
120 volunteers
Regional Victoria

3. WHAT IS DEMENTIA?
Dementia - a broad term used to describe a loss of memory, intellect, rationality, social skills and physical functioning
Alzheimer’s disease - most common form of dementia, approximately 50-70% of all dementia cases
Different types of dementia: Dementia with Lewy Bodies, Vascular Dementia

4. The Australian context
Over 332,000 Australians have dementia NOW
Almost 1 million Australians will have dementia by 2050
But why is it so important to have dementia friendly communities in Australia?
We know that there are already some 332,000 people living with the disease
Based on the current rate of dementia, by 2050 almost 1 million Australians will have dementia – putting pressure on the health and ageing sectors as well as formal and informal care.

6. WHAT IS A DEMENTIA-FRIENDLY COMMUNITY?
“A dementia-friendly community is a place where people living with dementia are supported to live a high quality of life with meaning, purpose and value”
In 2014, people with dementia told us that:
41%
Wished they had more social contact with people in the community
48%
Have had difficulty communicating with staff in stores
The growing numbers of people living with dementia will require a shift in how we respond to the needs of people living with dementia in the community.
The majority of people with dementia live in the community. Often people feel socially isolated and wish that they had more opportunities to interact with people in the community and to participate in social or other activities.
With the support of their employer, community, local businesses and organisations, neighbours, and friends and family members, people with dementia can continue to do many of the things they did before they received a diagnosis.
In 2014, Alzheimer’s Australia conducted its first national survey of people with dementia identifying priorities for tackling the stigma and social isolation associated with dementia in the community.
People with dementia identified the following priority areas in creating dementia-friendly communities:
1. Increasing community awareness and understanding about dementia
2. Improving access to social activities and opportunities for engagement including volunteering
3. Employment opportunities or support to remain employed
4. Access to appropriate health and care services to support them to continue to live at home for as long as possible
5. Access to affordable and convenient transportation options
6. Improved physical environments including appropriate signage, lighting and colours
57%
Are afraid of becoming lost 6 6

8. DFCs IN AUSTRALIA
Based on this feedback and international work, Alzheimer’s Australia has undertaken a number of steps to support Australian communities to be more dementia friendly:
First Steps to a dementia-friendly Australia is a collection of examples from across Australia that highlight what being dementia friendly means in practice and shows that the small things can make a big difference to a person with dementia life. First Steps aims is to inspire other communities and organisations to see these practical examples and take the next steps towards being dementia-friendly [KS – you could mention here that you have a limited number of copies for people who are interested – take maybe 50 with you? or that people can access all the publications on the web]
The toolkit for communities provides community councils with information on how to include the needs of people with dementia in their town planning, as well as actions plans to help community groups such as the local football club and RSL to become dementia friendly.
The toolkit for businesses gives practical tips and information on how to train staff to better understand dementia, language guidelines to communicate with people with dementia, and ways to involve people with dementia in volunteering and employment.
Alzheimer’s Australia, Kiama Municipal Council and the University of Wollongong are working together to make Kiama dementia friendly – and there are plenty of communities in Victoria who are interested in incorporating dementia friendly principles.
[KS - you could mention here that we are looking to create a toolkit that is specifically designed to help local governments identify and incorporate DF principles and also explain how these principles to relate to age friendly principles – this is dependent on HACC funding though so you may not want to talk about it] 8 8

9. AGE FRIENDLY.DEMENTIA FRIENDLY. THE SAME THING?
Both concepts are about creating an inclusive society that supports everyone’s participation
People with dementia have a cognitive impairment and a very different experience of the world
Dementia-friendly = age friendly but not always the reverse (e.g. managing perceptual disturbances, confusion, agitation, challenging behaviours, memory challenges is associated with dementia, not ageing)
But what is the expectation on local governments and organisations like yourselves? You have already been encouraged to support age friendly principles so why should you add dementia friendly to the mix? Can you be both?
The good news is that there is not a significant difference in outcomes/outputs – generally speaking, if something is designed to be dementia friendly it will be age friendly.
But it is important not to just badge your age friendly initiatives as dementia friendly and be done with it. There are some aspects to consider in the case of dementia that are not normally associated with ageing – e.g. certain behaviours and perceptual disturbances.
And while it is true that we are gradually coming to recognise that older Australians can still make a significant contribution as leaders, employees, volunteers, community members and family members – and that they have a range of experiences and knowledge we can draw on – these qualities are often seen as being negated or removed if the person has dementia.
There is still a perception that people diagnosed with dementia are at the end stage of their life – that they have no or poor memory, are unable to form coherent thoughts, undertake daily activities, engage socially or relate all the experiences that could have been valuable.
This stigma is all too real and is reported by our clients every day – as some of the quotes on this slide demonstrate.
“A person with dementia can at times be simply a little slower at completing day to day tasks and have as much to contribute to society as the next person”
“There needs to be better options for people like me to stay active … If only I could do the things I used to like to do”
“It is like they think I no longer count and I am not a real person anymore” 9 9

10. AWARENESS AND ACTION
Awareness - combat perceptions of stigma in your community:
Establish a local dementia alliance
Involve people affected by dementia in your planning groups or steering committees
Educate your staff
Action – embed your community’s priorities into your broader strategies:
Take a phased approach to civic works
Commit to a specific target that supports an inclusive community
Review current commitments from a dementia friendly perspective
So what can you do?
I see there being two key elements to a dementia friendly communities approach:
Awareness – Awareness of dementia in the community is still comparatively low. The first thing to recognise is that there is not a cookie cutter approach to the creation of a dementia friendly community, the same way that there is not a one size fits all approach to age friendly principles. Your community is unique and reflects the interests and concerns of the people that live in it – so involve them! Establish a local dementia alliance or ensure that your council’s steering/planning groups have representation by someone with dementia. Give people with dementia, their families and carers the opportunity to be active participants and do your bit to challenge the perceived stigma of a dementia diagnosis.
Action – don’t see dementia friendliness as yet another strategy that sits alongside your health, community engagement, or age friendly strategies. It’s about incorporating/overlaying dementia friendly principles into the plans you already have – for example, if you are constructing a new public garden or replanting in an existing one, incorporate dementia friendly principles by choosing plants that are safe and/or edible; that do not have sharp thorns or prickles; that are fragrant; that have circular, even walking paths around them; that have raised garden beds. This makes them more accessible to everyone!

11. A SIMILAR SET OF PRINCIPLES
Dementia friendly and age friendly principles include a focus on:
 Outdoor spaces and buildings
 Transportation
 Housing
 Social participation
 Social inclusion and respect
 Civic participation and employment
 Communication and information
 Community support and health services
The World Health Organisation identified some key areas of focus for age friendly cities – and they apply just as equally to dementia friendly communities, although the activation of these principles may differ slightly if you take a dementia friendly focus.
They include a focus on: [read list]
So, how might we turn these into practical initiatives?

12. DFCs IN YOUR NEIGHBOURHOOD
Principle
Example
Dementia Friendly?
Age Friendly?
Outdoor spaces and buildings
Level non-slip pavements
Longer-timed pedestrian crossings
Public toilets well signed 
Transportation
Accessible vehicles
Easy to read information
Housing
Can be modified as needed
Social participation
Participation with carer or partner
Accessible facilities
Social inclusion and respect
Engaged in decision making
Positive media
Civic participation and employment
Volunteering opportunities
Flexible work arrangements
Communication and information
Plain language that uses words and symbols
Community support and health services
Clear, accessible information
Wide range of services
This table gives some very brief examples of the sorts of things you might consider and how they might fulfil dementia friendly AND age friendly principles.
For example, under buildings we suggest well signed public toilets. This is important for all members of the community and clear signage is necessary for people with vision impairment. A combination of a symbol or drawing along with the word is inclusive for people whose first language is not English as well as for someone with semantic dementia (i.e. they recognise the word but can’t remember the meaning of it).
If you also add/upgrade to a toilet seat that is a different colour from the rest of the toilet, and walls that are a different colour from the toilet and vanity, you are incorporating visual cues that are helpful to someone with dementia.
You might focus on clear directional signage that leads people to key services (police, community services). Or appropriately spaced outdoor seating. Or public buildings that use non-slip flooring and avoid busy carpets.
You might focus on employment and volunteer programs that draw on a range of expertise and abilities. Or work with main street businesses such as banks and shops to increase education and awareness of how dementia might affect someone.
The important thing is that you engage with people affected by dementia in your planning and that you involve them as active members of your community.
And maybe perhaps we will reach a point where we are not focused on age friendly communities or dementia friendly communities but simply communities that are inclusive for everyone.
Thank you.