Participation in everyday occupations and situations outside home for older adults living with and without dementia: Places, familiarity, and risks

Thèse soutenue en 2021

Persons living with dementia face a whole range of problems when participating outside their homes. Participation is understood here as being able to go to and visit diverse places, and perform various activities, creating an experience of engagement in the society. The person-environment relationship theories (like place attachment, place versus space, life spaces, or transactional perspective of occupation), supporting ‘aging in place’ offer a conceptual framework for understanding the unit of analysis as the lived situation. Familiarity of both the activity performed and the place visited is put into tension with perceived risks of going outside home for persons living with a dementia, and their families.

The main aim of the doctoral thesis is to provide new knowledge concerning out-of-home participation for older adults living with early to moderate dementia in comparison to older adults without dementia, with regards to places visited and activities performed.

Four studies comprise the thesis. Study 1 aims at developing a questionnaire on participation in activities and places (ACT-OUT), and translating the Occupational Gap Questionnaire (OGQ) in French. Studies 2, and 4 are based on a common data collection, using cross-sectional quantitative designs with 35 participants with dementia and 35 participants without  dementia. Study 2 aims at describing out-of-home participation, through places visited (ACT-OUT and OGQ). Study 4 questions the idea that participation is linked to a count of places visited, and aims at explaining what could be influencing out-of-home participation using regressions models. Study 3 has an ethnographic qualitative design aiming at better understanding familiarity of places and activities; and how its influence on the maintenance of out-of-home participation.