Aging in Place
with Dementia

______

Linda Casola, Rapporteur

Committee on Population

Board on Behavioral, Cognitive, and
Sensory Sciences

Division of Behavioral and Social
Sciences and Education

Proceedings of a Workshop

NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001

This activity was supported by a contract between the National Academy of Sciences and the National Institute on Aging (HHSN263201800029I/75N98022F00008). Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.

International Standard Book Number-13: 978-0-309-71372-6
International Standard Book Number-10: 0-309-71372-2
Digital Object Identifier: https://doi.org/10.17226/27420

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Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2024. Aging in Place with Dementia: Proceedings of a Workshop. Washington, DC: The National Academies Press. https://doi.org/10.17226/27420.

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PLANNING COMMITTEE FOR A WORKSHOP ON AGING IN PLACE WITH DEMENTIA

EMILY M. AGREE (Chair), Research Professor and Associate Director of the Hopkins Population Center, Johns Hopkins University

JENNIFER AILSHIRE, Associate Professor of Gerontology and Sociology, Assistant Dean of Research, and Associate Dean of International Programs and Global Initiatives, University of Southern California

AMY J. H. KIND, Associate Dean for Social Health Sciences and Programs, University of Wisconsin–Madison

JENNIFER J. MANLY, Professor of Neuropsychology, Columbia University

WENDY A. ROGERS, Khan Professor of Applied Health Sciences, University of Illinois Urbana-Champaign

SARAH L. SZANTON, Dean and Patricia M. Davidson Health Equity and Social Justice Endowed Professor, Johns Hopkins University

WILLIAM A. VEGA, Distinguished Professor and Senior Scholar for Community Health, Florida International University

Staff

MICHAEL SIRI, Project Director

KEVONA JONES, Senior Program Assistant

MALAY K. MAJMUNDAR, Director, Committee on Population

COMMITTEE ON POPULATION

ANNE R. PEBLEY (Chair), University of California, Los Angeles

EMILY M. AGREE, Johns Hopkins University

RANDALL Q.K. AKEE, University of California, Los Angeles

DEBORAH BALK, Baruch College of the City University of New York

COURTNEY C. COILE, Wellesley College

SONALDE DESAI, University of Maryland

KATHARINE M. DONATO, Georgetown University

ROBERT A. HUMMER, University of North Carolina at Chapel Hill

SEEMA JAYACHANDRAN, Princeton University

HEDWIG (HEDY) LEE, Duke University

TREVON LOGAN, The Ohio State University

JENNIFER J. MANLY, Columbia University

JENNA NOBLES, University of Wisconsin–Madison

FERNANDO RIOSMENA, The University of Texas at San Antonio

DAVID T. TAKEUCHI, University of Washington

Staff

MALAY K. MAJMUNDAR, Director

BOARD ON BEHAVIORAL, COGNITIVE, AND SENSORY SCIENCES

TERRIE E. MOFFITT (Chair), Duke University

RICHARD N. ASLIN, Haskins Laboratories

WILSON S. GEISLER, University of Texas at Austin

MICHELE J. GELFAND, Stanford Graduate School of Business

MARA MATHER, University of Southern California

ULRICH MAYR, University of Oregon

KATHERINE L. MILKMAN, University of Pennsylvania

DON OPERARIO, Emory University

ELIZABETH A. PHELPS, Harvard University

DAVID E. POEPPEL, New York University

KARL W. REID, Northeastern University

STACEY SINCLAIR, Princeton University

MO WANG, University of Florida

DUANE WATSON, Vanderbilt University

Staff

DANIEL J. WEISS, Director

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Reviewers

This Proceedings of a Workshop was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process.

We thank the following individual for their review of this proceedings:

Although the reviewer listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the proceedings nor did they see the final draft before its release. We also thank staff member TRACY LUSTIG for reading and providing helpful comments on this manuscript.

The review of this proceedings was overseen by JACQUI SMITH, University of Michigan. She was responsible for making certain that an independent examination of this proceedings was carried out in accordance with standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the rapporteur and the National Academies.

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Acknowledgments

Funding for the workshop was provided by the Division of Behavioral and Social Research of the National Institute on Aging (NIA), and NIA staff provided substantial input to the workshop. The planning committee thanks Elena Fazio, Nicole Kidwiler, Jessica Boten, and Priscilla Novak at NIA for being generous with their time and attention in answering the committee’s questions and providing vital information to develop the scope and content of the workshop.

The planning committee is grateful to all the speakers for sharing their experiences and knowledge by providing high-quality and relevant presentations for this workshop. A video playlist of the workshop as well as links to all presentations can be found at: https://www.nationalacademies.org/event/40481_09-2023_aging-in-place-with-dementia-a-workshop. Finally, the workshop and proceedings would not be possible without help from knowledgeable and talented National Academies of Sciences, Engineering, and Medicine staff, who provided guidance, shared best practices, and assisted in navigating institutional processes and procedures.

This proceedings was prepared by the workshop rapporteur as a factual summary of what occurred at the workshop. The planning committee’s role was limited to planning and convening the workshop. The views contained in the proceedings are those of individual participants and do not necessarily represent the views of all workshop participants, the planning committee, NIA, or the National Academies.

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Contents

Box, Figures, and Tables

1 Introduction

BACKGROUND

OPENING REMARKS

ORGANIZATION OF THIS PROCEEDINGS

REFERENCES

2 Frameworks for Aging in Place

THEORIES OF PLACE AND AGING: AN ENVIRONMENTAL GERONTOLOGY PERSPECTIVE

STRUCTURAL DETERMINANTS OF AGING IN A PLACE: A STORY

FRAMEWORKS FOR AGE- AND DEMENTIA-FRIENDLY COMMUNITY INITIATIVES

DISCUSSION

REFERENCES

3 Community-Level Built Environments and Infrastructure

COGNABILITY: AN ECOLOGICAL THEORY OF NEIGHBORHOODS AND COGNITIVE AGING

DRIVING AND AGING IN PLACE: EMOTIONS, MOBILITY, AND TECHNOLOGY

AGING IN PLACE WITH DEMENTIA-FRIENDLY HOUSING

DISCUSSION

SUMMARY OF WORKSHOP DAY 1

REFERENCES

4 Evaluating Successful Programs

AN INTERVENTIONIST’S PERSPECTIVE

ADOPTING A HOUSING LENS

EVALUATION: TOWARD A VALUE PROPOSITION

DISCUSSION

REFERENCES

5 Social Services and Other Supports

EMERGENCY COMMUNITY RESOURCES

PAID CARE AND FAMILY CAREGIVERS

LOS ANGELES COUNTY AGING AND DISABILITIES DEPARTMENT

DISCUSSION

SUMMARY OF WORKSHOP DAY 2

REFERENCES

6 Social Isolation and Engagement

ADDRESSING SOCIAL ISOLATION

TECHNOLOGY TO SUPPORT SOCIAL ENGAGEMENT

SOCIAL ISOLATION AND SURROGATE DECISION MAKING

DISCUSSION

REFERENCE

7 Research Implications of Community-Based Interventions and Policies

HOME- AND COMMUNITY-BASED PROGRAMS

AN IMPLEMENTER’S PERSPECTIVE

TRANSLATING SCIENCE TO PRACTICE

AN ASSET-BASED APPROACH TO COMMUNITY DEVELOPMENT

DISCUSSION

REFERENCES

Appendix A Workshop Agenda

Appendix B Biographical Sketches for Workshop Planning Committee Members and Speakers

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