Dementia: Why is it important for tourism?
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>> There are some 850,000 people currently living with dementia in Britain and this number is set to rise dramatically, forecast to reach around one million by 2025.
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Dementia: Why is it important to tourism?
Dementia: Why is it important to tourism? There are some 850,000 people currently living with dementia in Britain and this number is set to rise dramatically, forecast to reach around one million by 2025. As a result, destinations and tourism businesses need to understand the needs of this growing market and respond positively to ensure people with dementia and their carers have a beneficial experience when they’re on holiday in the UK. This guide explains what dementia is and how it affects people. It includes relevant current research along with case studies and examples of how businesses and destinations have adapted to make people with dementia feel welcome. There are also some useful downloadable resources and creative ideas and tips that a tourism businesses might want to consider. But the key to responding to people with dementia is providing good customer care – taking the time to understand and respond to the needs of the individual and their carer.
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Background This brief guide, is designed to give businesses in the visitor economy advice, information and resources on becoming dementia friendly. The NCTA has produced it in collaboration with Bournemouth University’s Faculty of Management and the University of Exeter Business School. Leisure and tourism holidays are important and can be beneficial for people with dementia and their carers, providing a break and offering different experiences. Dementia is not a disability and research has demonstrated that remaining active can slow the progression of dementia and provide a change from routine. This short guide
offers a series of insights and bite-sized chunks of information aimed at highlighting the importance of dementia for tourism-related businesses. The guide contains web links to the growing body of research as well as free factsheets and downloadable resources to increase the tourism industry’s awareness and move towards becoming more dementia friendly. This guide is relevant to businesses across the entire visitor economy, irrespective of size, type and sub-sector, and to all those who work in a customer facing role.
Challenging Dementia As already stated, about 850,000 people are currently living with dementia in the UK and the number is expected to double in the next 30 years. By 2025, this figure is forecast to reach about 1 million, and by 2050 to around 2 million. The Government recognises the importance of this growth, making it a major political focus. One of the aspirations set out in the Prime Minister’s Challenge on Dementia for 2020 is that “all businesses should be encouraged and supported to become dementia friendly” (Department of Health 2015: page 7).
The Prime Minister’s Challenge on Dementia can be viewed at: https://www.gov.uk/government/ uploads/system/uploads/ attachment_data/file/414344/ pm-dementia2020.pdf
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Dementia:Guide Dementia Why is it important to tourism?
What is dementia? As the Prime Ministers’ Challenge sets out, dementia is a blanket term that is used to describe a group of brain disorders of which Alzheimer’s disease is the most common. All types of Dementia involve mental decline that: • Occurs from a higher level i.e. the person didn’t always have a poor memory • Interferes with usual activities and daily life • Affects more than one of the following:
• Day to day memory
• Language
• Visuospatial function – the ability to understand symbols, maps and so on
• Executive function - the ability to plan, reason, solve problems and similar
• Orientation – losing track of time and place
Dementia is a progressive condition which means that symptoms become more severe over time. Dementia affects everyone differently, no two people with dementia are the same. Dementia is not solely associated with older people, about 40,000 people under 65 have dementia. Nonetheless, the probability of developing dementia increases with age, with the chance of developing the disease doubling every five years after age 65.
For more information on what dementia is, the Alzheimer’s Society provides an excellent free downloadable information sheet, available at: http://www.alzheimers.org.uk/site/scripts/ documents_info.php?documentID=106
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Ageing and accessible tourism Ageing and accessible tourism markets are important sectors coastal destinations and businesses need to consider particularly in terms of product development, marketing and customer service. The population is increasingly ageing and the demand for accessible tourism is growing so responding positively to their needs will help the visitor economy to grow. Spending on overnight and day trips by parties with at least one disabled visitor was, according to VisitEngland, more than £12 billion in 2013. VisitEngland refers to this as the ‘purple pound’ and research on the value and volume of domestic tourism can be downloaded at: https://www.visitengland.com/sites/default/files/ accessibility_market_size_and_value.pdf According to this research, customers are more likely to take longer trips, spend more and may be more loyal to destinations and businesses. ACCESSIBLE TOURISM FOR ALL Alongside the development of an ageing population and disability issues is the growing recognition that certain conditions such as dementia (which is NOT a disability) pose specific challenges for the visitor economy. This is largely based on the wider accessibility agenda that organisations
such as VisitEngland have championed in seeking to make tourism accessible for all. VisitEngland offersome useful advice on how to make business more accessible, see: https://www.visitengland.com/biz/ advice-and-support/businesses/ providing-access-all There are certain strands of accessible tourism that exist already and which are helping to make tourism businesses and the visitor economy more dementia aware. People living with varying degrees of dementia, especially those in the early stages of the disease, along with their carers, interact with a series of visitor-facing businesses, becoming dementia friendly is all about making these experiences meaningful without adding stress. It’s vital to know how to respond effectively and accommodate their needs and requirements so all guests can enjoy their visits to the full.
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Dementia: Why is it important to tourism?
Dementia and the Visitor Economy Research on the challenges that people affected by dementia face in the visitor economy is limited but Bournemouth University has recently published two studies which demonstrated the range of issues. This is the first major research on tourism and dementia globally.
DEVELOPING DEMENTIA FRIENDLY TOURISM DESTINATIONS: AN EXPLORATORY ANALYSIS The barriers to dementia friendly tourism were explored through semi structured interviews with 20 tourism businesses in Greater Bournemouth – Bournemouth, Poole and Christchurch. Results suggested that: • B usinesses had limited awareness of dementia and confused it with old age • T heir personal exposure to dementia affects their attitude • T here was some stigma attached to being known as dementia friendly • B usinesses were already annoyed at costs required to meet Equality Act so reluctant to spend more • S ome were prepared to make an extra effort to accommodate people with dementia
BARRIERS TO LEISURE PARTICIPATION FOR PEOPLE WITH DEMENTIA AND THEIR CARERS: AN EXPLORATORY ANALYSIS OF CARERS AND PEOPLE WITH DEMENTIA’S EXPERIENCES. Five focus groups held in Dorset with a mix of people with dementia, their carers and other older people explored the challenges of accessing tourism and leisure. The report identified the following key problems: • L ack of reliable public transport if visitors / carers can no longer drive • L ack of (?) confidence in relation to access to suitable public toilets • C oncern that the person with dementia might get lost The basic needs for a successful day out are; familiar easy surroundings, toilets, good eating and drinking facilities, somewhere to rest and supportive staff.
The full report can be downloaded here:
The full report can be downloaded here:
http://eprints.bournemouth.ac.uk/21119/
http://eprints.bournemouth.ac.uk/22245/
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How have businesses and destinations responded to the dementia challenge? Within the visitor economy, numerous examples of businesses and initiatives exist of best practice in tailoring experiences for people with dementia and their carers including: There are some specialist companies that offer holidays specifically to those with dementia either alone or with their carers and can be accessed through the Tourism For All website. As well as disabled access, companies such as Dementia Adventure, Amy’s Care and The Mede offer qualified staff to support the person with dementia and their carer. Internationally, the example of the New York Museum of Modern Art with its Guide The MoMA Alzheimer’s Project: Making Art Accessible to People with Dementia. A Guide for Museums is widely acknowledged as an example of best practice. As well as offering a very successful programme at the Museum there are guidelines for other museums wanting to develop art programmes of their own for people with dementia. In the UK, a number of locations screen films in cinemas to help with reminiscence therapy such as in Plymouth. Here classic films are shown in a comfortable environment during the day. The Dartmoor Search and Rescue Team are developing guided walks for people with dementia and their carers. However, it is recognised that a more holistic approach to the visitor economy is needed to address the issue of dementia awareness, rather than limited examples in specific areas. At a national, regional and local level, the Dementia Action Alliance works to improve the lives of people affected by dementia.
At a local level, Local Dementia Action Alliances (DAA) comprise organisations and communities that work together to create dementia friendly communities. The DAA’s website contains a range of useful resources on existing Local Dementia Action Alliances that businesses might wish to join, as well as information on how to set one up. Businesses can join their local Dementia Action Alliance for free by making a public commitment by submitting an online plan outlining the steps they plan to take to improve the lives of people with dementia. A dementia-friendly logo can be used in business premises. See: http://www.dementiaaction.org.uk/join_the_ alliance There are numerous alliances covering many parts of the UK and these are growing at a significant rate. These groups reflect the impetus needed through local action to make communities more dementia friendly. These steps embrace what the Joseph Rowntree Foundation have argued is a positive risk-taking approach that encourages the notion of active ageing as advocated by the World Health Organisation, so that people with dementia are not confined to their homes and encouraged to live normal lives through reducing perceived and actual barriers.
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Dementia Guide
Case Studies:
Plymouth Dementia Action Alliance The exemplar of Plymouth demonstrates what can be achieved in helping businesses to become more accessible, inclusive and able to develop local solutions where action is required to overcome specific barriers. The University and City Council have joined with business leaders to identify ways of improving the lives of people with dementia through positive action. See: http://www.dementiaaction.org.uk/local_alliances/1961_plymouth_dementia_action_alliance
Torbay – the most dementia friendly resort The most advanced tourism destination in pioneering dementia action is Torbay in Devon. Torbay’s DAA was formed in 2012 with the ambition of becoming the first dementia friendly resort and it has signed up about 120 local businesses to share knowledge and information to make the resort more dementia friendly. See: http://tdaa.co.uk/
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Resources for Businesses Various resources exist to help businesses in understanding how to be more dementia friendly. For most businesses, the emphasis of becoming dementia-friendly is on providing the best customer service rather than making expensive adaptations to the physical environment. Training and advice is freely available and there are many downloadable guides on the web.
The Alzheimer’s Society has produced a very useful guide. How to help people with dementia: A guide for customer-facing staff This is highly relevant for staff working in all tourism businesses. It would be useful to have this to hand at reception or to include the principles within staff training but the key things to remember are summarised below.
The Local Government Association supports the development of dementia friendly communities and it has published a toolkit to help businesses and organisations at: http://www.local.gov.uk/c/document_library/get_file?uuid=b6401bb0-31a8-4d57-823b1fde6a09290e&groupId=10180 The development of a dementia friendly community should consider four aspects of the community – Place, People, Resources and the Networks but central to all of these should be the voices of people with dementia and their carers. What Lloyds Bank has done – case study An interesting case study on a large organisation: https://www.alzheimers.org.uk/site/scripts/news_article.php?newsID=1839 Small changes businesses can make to become dementia-friendly (film) An audio visual resource specifically developed for small businesses can be seen at: https://www.youtube.com/watch?v=Fz8ACEu7Lho
Awareness and training The Dementia Friends Initiative aims to change attitudes to dementia by helping people to understand more about it and finding out about ways everyone can help. Individuals can become a Dementia Friend or a Champion, while organisations can also sign up giving access to further resources and advice. Details at: https://www.dementiafriends.org.uk/ 10
Dementia Guide
Top-tips for helping a person with dementia! Offer understanding and reassurance Communicate clearly Body language and physical contact • Make eye contact • Make sure that your body language and facial expressions match what you are saying. • Never stand too close or stand over someone to communicate. • Do not cover your mouth. The person should be able to see your face clearly. Talking • Speak clearly and calmly. • Use short, simple sentences. • Speak at a slightly slower pace. • Avoid speaking sharply or raising your voice. • Don’t talk about people with dementia as if they are not there or talk to them as you would to a young child. Listening • Listen carefully to what the person is saying, and give them plenty of encouragement. • If you haven’t understood fully, tell the person what you have understood and check with them to see if you are right.
Be aware of the environment Bear in mind the following points: • Objects that are shiny, patterned or reflective can cause people with dementia to mistake what they are seeing. • Features such as lighting, mirrors, shadows, steps and patterned walls and floors might cause problems for some people with dementia. • If someone with dementia has increased difficulty with reading or processing visual information they may not recognise instructions or signs, be able to read maps or timetables, or know where they should put things. What is obvious to you may not be so to them. • There may be a wide variety of noises in your workplace that could cause alarm
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Ideas to help business become more dementia friendly
These are all ideas that might help visitors with dementia to feel more comfortable in unfamiliar surroundings: • M ake sure your signage for public areas such as toilets, restaurants and bars is clear and unambiguous • Display pictures and photographs of familiar figures from the past on the walls • M ake available picture books or photo albums with recognisable famous people and places from earlier times • P lay popular classics from the past through your sound system in one of your lounges • P rovide twiddle mats - a knitted mat with interesting bits and bobs attached to it. These help to soothe restless hands and minimise agitation. • P rovide other activities such as jigsaw puzzles, reminiscence cards, painting projects or spa balls designed specifically for customers with dementia and available through http://www.active-minds.co.uk/ • D ecorate one or two of your bedrooms in vintage style specifically for visitors with dementia
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