We conduct independent research and
evaluation in the social services, health
and education sectors
Dementia Day Programmes Research
Overview
• What is dementia?
• Aim
• Research methods
• Introduction to photovoice
• Experiences with photovoice
• Research findings
What is dementia?
As the population ages, the number of people with dementia
also grows. Dementia describes a collection of symptoms
which are progressive and incurable including memory loss,
problems with reasoning and communication skills and a
reduced ability to carry out daily activities.
Research aim
We aimed to find out what are the elements that
make up an effective client-focused day
programme for people living with dementia?
Methods
• International literature review (Australia, UK and
USA)
• Field work in two sites (Hamilton and South
Auckland)
• Document review – organisational documents
• Clients - structured observations and photovoice
• Family and significant others – survey and telephone
interviews
• Day programme staff - interviews and online
questionnaires
• Drivers – interviews
• Stakeholder interviews
What is photovoice?
A process by which people can identify, represent,
and enhance their community through a specific
photographic technique.
Using images created and composed by research
participants, allows them to capture questions to be
asked about not only their understanding of the
image but also the context and circumstances of its
production.
Why use photovoice?
 Photovoice (Wang & Burris, 1997) is a
qualitative research method that has been used
effectively with vulnerable and marginalized
populations.
We wanted to give ‘a voice’ to people living with
dementia who attended a Day Programme.

Moyle (2010), the influence of age, extent of
cognitive impairment and activity limitation with
dementia can impact on the level of participation
and should be used with care.

This method might therefore be more effective with
early-onset dementia patients, but involvement of
the caregiver in the interpretation of photos can be
very effective, as discussed by Wiersma (2011).
Using photovoice
Photovoice as a data collection method
requires clear instructions to participants on
the number of photos to be captured during
a specified period of time and on the
purpose of the images.
Photovoice
The participants:
• Eight clients (person living with dementia)
• Eight family caregiver(s)
• Driver (on the day the photovoice exercise
took place)
• Several Support Workers from the day programme
(on the day the photovoice exercise took place)
10 photographic situations
 At home – prior to going to the Day Programme
 Leaving home – being driven to the venue
 At the Day programme
 Going home – being driven home
 At home – after the day programme
Photovoice experiences
Capturing a day in the life the person living with
dementia was a cooperative exercise.
The client had those people they loved and
trusted workers share their experiences.
Family members could see that having photos
of their loved one doing activities during the day
gave them insight and opportunity to discuss
with them.
Photovoice - moments in time
“At the back of the house on the deck by our
garden. My wife is having difficulty with the
camera.”
“I read the paper while I wait for my wife to
drive me to Enliven.”
“Sanding the shed in preparation for painting.
Discussing with other clients about the project.”
Photovoice experiences
“I liked the way she got up early and is excited to go. I
observed she is not nervous as she used to be going to
Enliven. I thought she was happy”
“ X is trying on jewellery at the studio we visited today – and
she likes what she has chosen.”
“X meets the musician who is here to entertain us.”
“X arrives home and gives her daughter-in-law a cuddle. Mum
at home 20 minutes after Enliven and looks very happy
watching rugby league”.
Engagement with activities
The photovoice data supported the interview data on the importance
of a variety of activities throughout the day to enable clients to
engage with others in groups and one-to-one. Activities included:
 Physical exercise sessions and walking
 Arts and crafts-related activities and music/singing
 Cooking/baking and gardening
 Individual activities (e.g. reading the newspaper or magazines)
 Group-based games (e.g. board games, pétanque, bingo)
 Watching DVDs and using the internet/computers
 Visits/outings to places of interest and shopping
 Group meals
 Interaction with animals
 Interaction with children
 Conversations between participants
What did we learn about photovoice?
• The clients participated with the help of those closest to
them – it was inclusive and supportive.
• Providing guidelines to participants was essential and
supporting them through the process.
What did we learn about photovoice?
• Thinking about a client’s day and suggesting 10 key
situations for photos to be taken made it easier for data
analysis.
• The participants selected the moments to take photos
within the 10 situations and they reflected client’s
experiences and what the participants thought was
important to convey.
Reflecting on the evaluation methodologies
• The international literature review
• The document review
• The participants
• The fieldwork
• The report
Researching with vulnerable people
The approach to research ‘on’ people – especially
those with health and disability concerns is often
questioned
and
advocates
for
participatory
approaches to research increasingly emphasise
the importance of research methods that facilitates
the involvement of these individuals.
The elements identified as core to effective day
programmes:
 improved client functioning;
 caregiver benefits;
 a competent workforce;
 and cultural responsiveness.
Thank you
Dr Annie Weir, and Dr Richard Griffiths
Impact Research NZ
Website www.impactresearch.org.nz
M 027 612 4335
Email: annie@impactresearch.org.nz