Dementia initiatives need to accommodate the needs of the community or context where they are being implemented. The initiatives should also consider accommodating diverse abilities, preferences and needs of people living with dementia, care partners and other community members who may participate.

Adaptability: Teams must recognize and respond to the needs of the communities and contexts where they occur. This may include selecting appropriate ‘Plays’ for your context. Alternatively, the ‘Plays’ in this guide may be a starting point that need adaptation to suit the needs of the communities and context. Being attuned to the needs in the community will help the long-term success of dementia initiatives.

Developing a deep understanding of the needs of the community and the participants you are serving is a critical step before finalizing the plan for your initiative. Understanding community needs includes learning what other organizations are delivering dementia initiatives, what resources are available and what gaps people are experiencing.

Changing language, terminology and acronyms for a different context are ways to incorporate adaptability. When adapting an initiative to a different language or ethnocultural group, invest time in learning about the language and terminology preferred by the community. Consider what terms related to dementia are preferred and understood by the communities you are engaging.

To successfully adapt an initiative, experts recommend working through six steps:

Past DCI projects suggest building in buffer time in timelines to accommodate challenges or unanticipated needs that are likely to arise. When unexpected obstacles arise and a change in approach is needed, communicate changes and rationale for changes clearly with project partners.

Read some of the lessons learned from projects like Our Dementia Journey Journal and the Cummings Centre Therapeutic Dementia Care Program for examples of flexibility and adaptability in action.

Fidelity: While adaptability to community needs and flexibility to individual needs are important, it is important to recognize that the evaluation of the ‘Plays’ in this Playbook depend on ‘fidelity’ to the original initiative. Fidelity refers to implementing the initiative as it was previously done (and evaluated upon). If you are adopting something that is evidence-based and want to achieve the same results as the original initiative, fidelity may be important. It can also damage the credibility of an initiative if it isn’t used as designed and doesn’t achieve its intended effects.

Choosing an initiative that most closely matches the needs and goals of your specific community will likely require the fewest adaptations. All contexts are different and there may not be an initiative that is a perfect fit. It is likely that some adaptations will be needed for your community but know that deviations may impact the effectiveness of the intervention and whether existing evaluation results apply.

If you think that substantial changes are needed for your context, consider consulting with the team that developed the intervention to understand their experiences, to ask for their advice, and to consider whether adapting their initiative or simply learning from their experience is the best approach.

Flexibility: Flexibility in dementia initiatives is also important at the individual level. Like everyone, people living with dementia have diverse abilities, preferences and needs that may vary day-to-day and over time. The social and physical environment can also influence the abilities and needs of people living with dementia. Teams should consider how they will support the unique needs of each participant in their programs.


Resources for remaining adaptable and flexible


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