Background Dementia friendly initiatives share similarities with the age-friendly movement in a focus on active engagement and creating a good quality of life for older adults. Dementia friendly initiatives offer a welcoming optimistic narrative in dementia studies by embracing dignity, empowerment, and autonomy to enable well-being throughout the dementia trajectory. Purpose The purpose of this review is to explore the current science of dementia friendly initiatives, identify gaps, and inform future research. Method Quantitative, qualitative, and conceptual/theoretical peer-reviewed dementia friendly research literature were evaluated for their current evidence base and theoretical underpinnings. Results The dementia friendly initiatives research base is primarily qualitative and descriptive focused on environmental design, dementia awareness and education, and the development of dementia friendly communities. Person-centered care principles appear in dementia friendly initiatives centered in care settings. Strong interdisciplinary collaboration is present. Research is needed to determine the effect of dementia friendly initiatives on stakeholder-driven and community-based outcomes. Due to the contextual nature of dementia, the perspective of persons with dementia should be included as dementia friendly initiatives are implemented. Theory-based studies are needed to confirm dementia friendly initiative components and support rigorous evaluation. Dementia friendly initiatives broaden the lens from which dementia is viewed.

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The need to provide evidence-based, person-centered care for long-term care (LTC) residents, which often include individuals with dementia, has led to a surge of interest in the implementation of individualized music (IM) programs. An exploratory study was conducted over a 6-month period using the Promoting Action on Research in Health Systems (PARiHS) framework to examine the implementation of an IM program with 19 residents in a LTC facility. All residents using IM had the device available at the end of the program, and 53% received IM at least two times per week. Qualitative analysis of stakeholder interviews with six staff members and three residents after using the PARiHS framework as an implementation guide revealed two themes: Overcoming Resistance to Innovation and Person-Centered Care Through IM. Identification of barriers and facilitators through the PARiHS elements of evidence, context, and facilitation supported the IM implementation process and should enable its replication in other facilities. [Journal of Gerontological Nursing, 44(8), 29-38.].

Objectives: The primary objective of this evaluation is to determine the impact of virtual reality (VR) distraction on acute and chronic pain in Veterans within the Veterans Affairs Health Care System (VA). A secondary objective is to determine the impact of VR on the experience of stress and anxiety in Veterans utilizing VR for the indication of pain. A third objective is to develop an understanding of the Veteran experience of using VR in a healthcare setting.Methods: This prospective, pretest-posttest mixed methods assessment was performed at a VA medical center from August 30, 2019 to November 23, 2020. VR experiences lasted between 10 and 30 min utilizing an immersive head-mounted display with multiple, autonomously chosen virtual environments. Qualitative data was collected concurrently to provide context to quantitative measures which included pain scores and stress/anxiety levels. Data from 79 participants was included in this analysis. Data included pre- and post-VR session Defense and Veterans Pain Rating Scale and stress/anxiety levels.Results: Results for the cohort demonstrated a statistically significant decrease in pain intensity (p <0 .001) with an average 12% decrease in pain levels and an 92% reduction in anxiety for those in concurrent pain.Conclusion: VR as a non-pharmacological adjunct or alternative modality, appears to be a viable option for improving pain management and reducing anxiety in Veteran populations across various age ranges, and levels of acuity and chronicity. VR was found to be an effective distraction from pain, a pleasurable experience for the majority, and opened the door to other non-pharmacological modalities in a Veteran population.

Older adults’ preference to age in place, coupled with an increasing prevalence of dementia, creates an imperative to address home safety risks that occur due to cognitive impairment. Providing caregivers with home safety items and education can facilitate ageing in place for older adults living with dementia. In 2015–2017, we examined barriers and facilitators within 17 policy documents and dementia guidelines of the United States (US) Veterans Health Administration pertinent to implementation of a home safety toolkit (HST) for Veterans living with dementia. The documents were issued from 2000 to 2015. Directed qualitative content analysis of these documents guided by themes from stakeholder interviews revealed two key implementation barriers: a focus on physical rather than cognitive risks when determining medical necessity for home equipment, and a focus on rehabilitation and treatment rather than prevention. Mandates for person‐centred care planning, including comprehensive assessment, interdisciplinary collaboration, staff education and a focus on population health in primary care facilitate HST implementation. Content analysis can identify policy‐level barriers that slow innovation and facilitators that can increase access to care that support ageing in place.