ABSTRACT CREATING MEANING FOR PEOPLE LIVING WITH DEMENTIA THROUGH NATURE: EXPLORING THE PROCESS OF BIRD TALES by Jennifer Dibert Meaningful programming for people living with dementia is becoming an increasingly important topic as we prepare for a population that is older than ever before, for the risk of having Alzheimer’s disease or related dementia increases with age. Designing programs for people with dementia that incorporate multisensory stimulation and take into consideration psychosocial factors is critical in providing meaningful programs for this unique population. Bird Tales is a new, innovative multisensory program that aims to connect people living with dementia to nature and to encourage social interaction. This report presents a process evaluation of the program implemented as an intergenerational program. The findings highlight three main themes: (1) The Bird Tales program guide is helpful, but needs improvement; (2) Building relationships with the local community improves interaction and breaks down stereotypes about dementia; and (3) There is room for growth to program conceptualization. CREATING MEANING FOR PEOPLE LIVING WITH DEMENTIA THROUGH NATURE: EXPLORING THE PROCESS OF BIRD TALES A Thesis Submitted to the Faculty of Miami University in partial fulfillment of the requirements for the degree of Master of Gerontological Studies Department of Sociology and Gerontology by Jennifer Dibert Miami University Oxford, Ohio 2015 Advisor ________________________ Dr. Suzanne Kunkel Reader: _________________________ Dr. Sara McLaughlin Reader: _________________________ Dr. Katherine Abbott Table of Contents Background ..................................................................................................................................... 1 Statement of the Problem ......................................................................................................... 1 Literature Review .................................................................................................................... 3 Introduction to Bird Tales ...................................................................................................... 11 Bird Tales Implementation ........................................................................................................... 13 Research Methods ......................................................................................................................... 16 Research Objectives ............................................................................................................... 16 Research Design .................................................................................................................... 17 Participants ............................................................................................................................ 18 Data Collection ...................................................................................................................... 19 PDSA Model .................................................................................................................................. 19 Leader Feedback ............................................................................................................................ 19 Resident Feedback ......................................................................................................................... 20 Volunteer Feedback ....................................................................................................................... 21 Overall Evaluation ......................................................................................................................... 21 Data Analysis ......................................................................................................................... 21 PDSA Model .................................................................................................................................. 21 Descriptive Statistics ...................................................................................................................... 23 Validity .................................................................................................................................. 23 Findings......................................................................................................................................... 24 Objective 1 ............................................................................................................................. 24 Strengths of the Bird Tales Program .............................................................................................. 24 Improvements Made to the Bird Tales Program ............................................................................ 31 Resources Needed for the Bird Tales Program .............................................................................. 34 Barriers to Delivering the Bird Tales Program .............................................................................. 35 Objective 2 ............................................................................................................................. 37 Resident Response to the Bird Tales Program ............................................................................... 37 Volunteer Response to the Bird Tales Program ............................................................................. 39 Conclusions ................................................................................................................................... 41 Lessons Learned .................................................................................................................... 42 Bird Tales Program Guide ............................................................................................................. 42 Community Relationships and Meaningful Interactions ............................................................... 43 ii Let it Grow, Let it Grow, Let it Grow ............................................................................................ 43 Limitations ............................................................................................................................. 44 Future Directions ................................................................................................................... 45 References ..................................................................................................................................... 46 Appendix ....................................................................................................................................... 51 Exhibit 1. Bird Card Example ............................................................................................... 51 Exhibit 2. Activity Lesson Example ...................................................................................... 52 Table 2. Attendance ............................................................................................................... 53 Table 3. Attendance Frequencies 1 ........................................................................................ 53 Table 4. Attendance Frequencies 2 ........................................................................................ 53 Exhibit 3. Bird Tales Process................................................................................................. 54 Exhibit 4. Resident Feedback Form....................................................................................... 55 Exhibit 5. Volunteer Feedback Form..................................................................................... 56 Exhibit 6. Program Evaluation Forms ................................................................................... 57 Table 5. Resident Feedback Summary .................................................................................. 58 Table 6. Volunteer Feedback Summary ................................................................................ 58 Table 7. Overall Evaluation Summary .................................................................................. 59 Figure 3. Overall Evaluation Summary ................................................................................. 60 Exhibit 7. Volunteer Feedback Quotes .................................................................................. 61 Exhibit 8. Program Evaluation Quotes .................................................................................. 63 Exhibit 9. Bird Tales Experience Reflection ......................................................................... 64 iii List of Tables Table 1. Benefits from Spending Time in Nature .................................................................... 9 Table 2. Attendance ............................................................................................................... 53 Table 3. Attendance Frequencies 1 ........................................................................................ 53 Table 4. Attendance Frequencies 2 ........................................................................................ 53 Table 5. Resident Feedback Summary .................................................................................. 58 Table 6. Volunteer Feedback Summary ................................................................................ 58 Table 7. Overall Evaluation Summary .................................................................................