Integrating neighbourhood walkability perceptions of people living with dementia in urban design and planning in British Columbia, Canada

Abstract

Urban design and planning play an important role in supporting the out-of-home activity participation of people living with dementia. Studies show discrepancies in planners' understanding of the perceptions, motivations, and needs of people living with dementia related to environmental support. This study explores 1) how people living with dementia perceive neighbourhood environmental support for outdoor walking, and 2) how the recommendations for neighbourhood environmental support made by people living with dementia are understood by municipal professionals. Sequential semi-structured sit-down and video-documented go-along interviews were conducted with (N = 14) community-dwelling people living with mild to moderate dementia in Metro Vancouver, British Columbia. Thematic analysis of text and video data helped generate evidence summaries that were used to conduct semi-structured interviews (N = 4) and a focus group (N = 3) with municipal professionals. Participants living with dementia recommended enhancing walkability by 1) repairing and widening sidewalks, 2) delineating separate paths for pedestrians and micromobility, 3) improving places for rest and respite, 4) augmenting visibility and safety at street crossings, and 5) maintaining distinctiveness and stability of the urban form. Thematic analysis of professionals' responses to the walkability appraisals of participants living with dementia reflected 1) empathy and understanding, 2) knowledge of existing planning measures and willingness to introduce new measures, and 3) concerns regarding feasibility and implementation. Findings underscore the need to centre research on the experiential knowledge of people living with dementia to enable planners to anticipate people's needs and experiences and make informed decisions to ensure that outdoor public spaces are dementia-inclusive.