Challenges and opportunities in designing dementia-friendly communities with local governments

Background: Communities that do not accommodate the needs and preferences of people with dementia can exacerbate disability and isolation. Although dementia-friendly communities (DFCs) were established to foster understanding and acceptance of dementia, the built environment remains underexplored. We identified the challenges and opportunities for fostering dementia-enabling environments among community planners. Method: This study is set in South-West Sydney, Australia, where a DFC is being established. The policies of seven local governments were analysed for actions that aligned with Dementia Australia’s 41 DFC recommendations: 13 for social, 14 for outdoor, and 14 for indoor environments. An online workshop was then held with 30 community planners to raise awareness for dementia-enabling environments. Participants were surveyed about their dementia beliefs and attitudes. Facilitated discussions identified challenges and opportunities for designing DFCs. Qualitative and quantitative data across all sources were triangulated. Result: Although none of the local government policies specifically mentioned dementia, up to 20/41 DFC actions were met. Most of these were in social engagement (with ≤10/13 recommendations met by each local government). Less action was taken on outdoor and indoor environments (with ≤9/14 outdoor and ≤4/14 indoor recommendations met by up to six local governments). Although beliefs and attitudes about dementia among planners were generally positive, only 48% indicated that they had a good understanding of it and nearly 80% noted they would feel anxious and depressed about a diagnosis. Key DFC challenges included a lack of awareness and conflicting priorities between government bodies. Opportunities included engaging with universities to conduct demographically relevant awareness raising, facilitate multisectoral collaboration, developing an evidence-base, and involving service providers to engage with the dementia community. Conclusion: This study triangulated data to identify gaps in community planning efforts, confirming that more action is required to design dementia-friendly communities. We are now leading a multisectoral collaboration to educate community planners and the public, and are advocating for the recognition of dementia-friendly environments in government plans. This study provides practical guidance to assist planners with DFC designs.