Farm-based day care services for people with dementia: quality development through interdisciplinary collaboration

The aim of the project was to provide knowledge for quality development of farm based day care services. The interest in day care services on farms for people with dementia is increasing. The national strategic documents (Demensplan 2015, 2020 and 2025, and Action Plan for "Inn på tunet" 2013-2017) emphasize care farming as a complementary service to meet the need for day care services for the growing elderly population. Care farming can be viewed as a sustainable use of farm resources and to integrate ecosystem services as an additional income for the farmer. To secure sustainable services, the project focused on quality development of the services to make them beneficial for the users and their next of kin, and on elucidating factors that are of key importance for collaboration between the farmer as the private partner and the health care services in the municipalities as the public partner. Triangulation of theoretical and methodological approaches is used. The project is carried out by an interdisciplinary research group (Norwegian University of Live Sciences, Norwegian National Advisory Unit on Ageing and Health, Norwegian Institute of Bioeconomy Research and Center for Rural Research). The project is divided in four work pages (WP). WPA investigated the user perspective, and explored both the characteristics, benefits and experiences among the users and their relatives through qualitative interviews, as well as cross sectional and longitudinal quantitative designs. WPB studied the farm context and the possible unique contribution of the farm to day care services for people with dementia and includes quantitative and qualitative methods. WPC studied the social, institutional and economic aspects of formation, implementation and operation of day care services, and made use of case studies of farms, surveys among farmers and municipalities and economic analysis. WPD ensured dissemination of results in the project. It has produced user targeted visual and written information. Further, innovation forums invite stakeholders in the field for a dialog. The project presents a web-page (www.demensomsorgpagard.no) and a facebook-page where results from the project will be available after the project is closed. At conclusion of the project 10 scientific journal articles have been published, 1 book chapter is accepted, 6 manuscripts are either submitted or drafted and 6 are under preparation. A NIBIO-report on the collaboration between the farmer as a service provider and the municipality is published (WPC). Two PhD theses are completed and one will be submitted in 2021 (WPA), and a 3-year post doctoral project is completed (WPB). An article describes the services on the farms. The paper indicates that farm based day care services have similar structure to ordinary day care services for people with dementia, but that activities and content vary among the farm based services themselves. Common for the data is that the services invite to spend time outdoors, that the social component is important in the services and that the farm services are experiences as meaningful for the users. The users quality of life is high, but changes over time is not different to what is observed in ordinary day care. We have organized regional seminars in south-east part of Norway and in Trøndelag in 2018 and 2020 to elicit stakeholders experiences on what is essential for sustainable day care services over time (WPD), and one closed seminar with key representatives for service providers and municipalities (WPC). Scientific papers and manuscripts with the international partners in Ireland and the Netherlands have been published, where we summarize common experiences with farm based dementia care. In January 2020, the project opened a photo exhibition that was meant to visit several locations accompanied by local and regional meetings based on the results in the project. Due to the CoVid-19 pandemic these plans had to be cancelled. A closing conference was organized in October 2020 with invited guest. Streaming of the event made it possible for other people to follow the presentations. There are made five short film based on the results from the project. The Governments Dementia Plan 2025 has included the project results in their recommendations for further development of farm based services for people with dementia.

Prosjektet har framskaffet kunnskap om gården som arena for dagaktivitetstilbud for personer med demens med relevans for ulike sluttbrukere. Mange brukere av tilbudene og deres pårørende har ønsket å bidra til å utvikle gode omsorgstjenester og gi av sin erfaring om gårdstilbudet. Prosjektet har gitt tilbydere av tilbudene, kommunal sektor, organisasjoner og offentlige rådgivere økt kunnskap om tilbudet. Nettverkssamlinger og lokale møter har bidratt til refleksjoner på tvers av aktører. Prosjektets resultater er trukket fram i HODs Demensplan 2025 og i prosjekt i LMDs Inn på tunet løftet II. Resultater er tilgjengelig på prosjektets nettside. Det er vektlagt formidling på norsk og til nasjonale sluttbrukere. Prosjektet har dokumentert ny kunnskap av internasjonal betydning på feltet og forskernettverk i Europa er videreutviklet. Overføring av kunnskap om hva som gir brukeren en god dag på gården til bruk i ordinære dagtilbud har vært påpekt. Prosjektet har utdannet 4 stipendmottakere.

The interest in day care services on farms for people with dementia (PWD) is increasing. National strategic documents (Demensplan 2015, Action Plan for "Inn på tunet" 2013-2017) point to care farming as a complementary service to meet the need for day care services for the growing elderly population. Care farming can be viewed as a sustainable use of farm resources and to integrate ecosystem services as an additional income for the farmer. The project is divided in 4 work pages (WP) and aims to contribute to quality development of the services and elucidate factors that are of key importance for collaboration between the farmer as the private and the health care services in a municipality as the public partner. Triangulation of theoretical and methodological approaches is used in the project carried out by researchers in agricultural and health sciences, sociology and economy, and with an advisory board of people with related to farm based day care for PWD. WPA investigate the user perspective, and explores both the characteristics, benefits and experiences among the users and their relatives through qualitative and cross sectional and longitudinal quantitative designs. WPB studies the farm context and what might be the unique contribution of the farm to day care services for PWD and includes quantitative methods (video recording, Dementia Care Mapping, interviews). WPC studies the social, institutional and economic aspects of formation, implementation and operation of day care services, and makes use of case studies of farms, surveys among farmers and municipalities and economic analysis. WPD adds development of user targeted visual and written communications on farm based day care services and innovation forums to the project. The forums invites users and their relatives, farmers, health care personnel, and governmental stakeholder to a dialog, all with experience on farm based day care for PWD, and the outcome of these forums will be used in other WP.