ABSTRACT

Engagement in meaningful occupation is important to health and well-being. People living with dementia are challenged in engagement due to consequences of their disease and environmental barriers. In Europe, there is increasing interest in addressing these challenges by transforming care services into dementia-friendly contexts such as dementia towns. It is unclear, however, how engagement in occupation occurs within a dementia town. This study applies a narrative, ethnographic approach to explore how people with moderate dementia engage in occupation in the context of a Danish dementia town, and how meaning is related. Data were generated and analysed based on the “narrative in action” approach. We produced in-depth knowledge of engagement and meaning through participant observations by following nine persons for an extended period while they participated in occupations in the everyday life of the dementia town. The narrative analysis revealed an overarching narrative of “moments of meaning – possibilities for engagement” that illustrated the thin line between potential engagement and deprivation from occupation. The stories that emerged in the analysis showed how people with dementia enacted meaning through occupation. Meaningful engagement seemed to be a way for people with dementia to connect to self, others, and place. The enacted narratives display the significance for people with dementia of being able to enact their story and thus create meaning from everyday life situations. However, the process of being engaged in occupation depended on co-creation with others, who supported the enactment process by drawing on the person’s occupational biography.

摘要

从事有意义的职业对健康和幸福很重要。由于疾病和环境障碍的后果，痴呆症患者在参与方面面临挑战。在欧洲，人们越来越有兴趣通过将护理服务转变为痴呆症城镇等对痴呆症友好的环境来应对这些挑战。然而，目前尚不清楚在痴呆症城镇中如何参与职业。本研究采用叙事、人种学方法来探索中度痴呆症患者如何在丹麦痴呆症城镇的背景下从事休闲活动，以及意义之间的关系。数据是根据“行动中的叙述”方法生成和分析的。我们通过参与者观察深入了解了参与度和意义，通过长期跟踪 9 个人，他们参与了痴呆症小镇日常生活中的职业。叙事分析揭示了“意义时刻 - 参与的可能性”的总体叙事，说明了潜在参与和职业剥夺之间的细线。分析中出现的故事显示了痴呆症患者如何通过休闲来表达意义。有意义的参与似乎是痴呆症患者与自我、他人和地方建立联系的一种方式。所制定的叙述显示了痴呆症患者能够演绎他们的故事从而从日常生活中创造意义的重要性。然而，