Staying safe at home in winter: case studies of people with dementia

This thesis presents the findings of a constructivist multiple case study design of six people with dementia's experience of trying to stay warm and safe at home during winter. People with dementia have been found to experience a higher rate of morbidity and mortality during the winter months (Liddell et al., 2016; ONS, 2015), though the reasons for these increased rates are unknown. This programme of research aimed to explore and understand the challenges that people with dementia have in keeping warm and safe in their own home during winter. This study was conducted in the winter and early spring of 2014/15 between October and April, in a post-industrial Northern city of England. Semi-structured interviews with a person with dementia and relevant family caregivers form the core of the data in each case. Data from interviews was supported by observations, and temperature and humidity readings, both inside and outside of the home. Consent of people with dementia was secured through a Process Consent method (Dewing, 2007 and 2008b), which aimed to maximise the capacity of a person with dementia to consent to participation. Through thematic and inter-case analysis an overarching thematic framework emerged of people 'Trying to stay safe in winter', though the progression of dementia and old age. Three themes describe this framework: 'Losing me', 'Hanging on', and 'Winter wellbeing’. Taken together these themes tell a narrative of people trying to stay safe in winter while trying to hang on to a sense of self, and control over their lives. This thesis argues for greater support for people with dementia who live in their own home, without the support of family members. Such support should be on-going from the point of diagnosis and take a person centred approach. Additionally, existing advice material for caregivers should be updated to better reflect the challenges people with dementia have staying warm and safe at home in winter.