Improving social inclusion for Canadians with dementia and their carers through Sharing Dance.
Funded by the Canadian Institutes of Health Research, the Alzheimer Society of Canada, and the Canada Research Chairs program (Mark Skinner, Trent University; Rachel Herron, Brandon University).
GOAL: To investigate the potential to improve social inclusion for people with dementia and their carers through the expansion of Canada’s National Ballet School Sharing Dance with Seniors program
This study examines the potential of dance to improve social inclusion for people living with dementia and carers. Research suggests that arts-based programs can improve the health of people living with dementia and carers; however, little is known about how these programs might address barriers to social inclusion. Addressing barriers requires the development and evaluation of accessible, non-stigmatizing and affordable programs that facilitate social inclusion across the continuum of institutional, community and household care settings.
This study involves a qualitative sequential pilot study of the innovative Baycrest NBS Sharing Dance Seniors program underway in non-metropolitan regions of two Canadian provinces, Peterborough, Ontario and Brandon (Westman) Manitoba.
The four-year pilot study involves multiple sites in each of the two regions, including a dress rehearsal (phase one) at a single community site, a community expansion phase (phase two), and an institutional phase (phase three).
Table one outlines the timeline for the project expansion for Ontario and Brandon pilot phases. The phases are unified by a consistent method of data collection and programming.
The Peterborough pilot study involves research at multiple study sites (seven total) in the Westman region (see Figure 1) in four phases.
PHASE ONE
Dress Rehearsal
In April 2017, Trent University, NBS, and Community Care worked collaboratively to test the first streamed group session of the Baycrest NBS Sharing Dance Seniors program for active seniors over eight weeks (P1). The “dress rehearsal” took place at the Chemung office in Ennismore, ON. A project planning meeting was held at Trent University in July 2017 to discuss the outcomes of the dress rehearsal and plan the expansion of the program (P2) in September 2017.
PHASE TWO (P2)
Community Expansion
Branch offices in Apsley, Ennismore, Havelock, Lakefield and Millbrook participated in the community care expansion, which took place from September to November for one hour every Wednesday morning. From March to May, 2018.
Summary of data collected at each site (P2)
PHASE THREE (P3)
Institutional Settings
P3 was implemented at branch offices in Apsley, Ennismore, Lakefield, and Millbrook, with the expansion to one institutional setting at William Place Retirement Residence in Lindsay (see Figure 2.) Table one outlines the timeline for the Peterborough project expansion as well as subsequent research exploring the experiences of older people with dementia and carers in Brandon, Manitoba. The phases are unified by a consistent method of data collection and program evaluation.
Summary of data collected at each site (P3)
The Brandon pilot study involves research at multiple study sites (six total) in the Westman region (see Figure 1) in four phases.
PHASE ONE
Dress Rehearsal
In phase one, in January 2018, Brandon University, NBS, and the Alzheimer Society worked collaboratively to test the first videostream group session of the Sharing Dance Seniors program with people living with dementia. The eight week program, which ran from January-March 2018, entailed 45-minute sessions every Wednesday morning at the Alzheimer Society office in Brandon, MB.
PHASE TWO (B2)
Community Expansion
The community and institutional expansion for phase two of the Brandon Pilot (B2) was held at three sites including the Prairie Oasis Community Centre in Brandon, the Minnedosa 50+ Activity Centre, and Country Meadows Personal Care Home in Neepawa, MB (See Figure 2) from September 2018 to November 2018. Brandon University, NBS, and the Alzheimer Society worked collaboratively to implement phase two using videostreaming at set times for each location.
Summary of data collected at each site (B2)
PHASE THREE (B3)
Institutional Settings
Currently in progress (May 2019), the data collection for Phase Three is taking place at five institutional settings while including one community setting at the Prairie Oaisis Community Centre in Brandon. Country Meadows Personal Care Home in Neepawa, along with Personal Care Homes in Killarney, Minnedosa, Hamiota, and Carberry are the participating institutions.
Our definition of social inclusion as a multi-dimensional process and outcome draws on a conceptual framework developed at the Irish Centre for Social Gerontology by Walsh and colleagues (2012). Recognizing the often-unidimensional limitations of existing models, this framework suggests that social inclusion is best understood by looking at the dynamic linkages between social relations, access to services, financial resources, transportation and mobility, safety and security, macro-economic forces, place and community characteristics, individual capacities, and life-course trajectories. Walsh et al provide a multi-layered, multi-dimensional approach to inclusion that emphasizes the relationship between individual and structural factors in producing inclusion. Their framework is successful in illustrating how people and organizations can shape programs, practices, policies, and attitudes to more fully include those who experience exclusion, but it is not attentive to the embodied and experiential nature of inclusion. This study adopts and expands Walsh et al.’s [4] framework, which has not yet been used to explore the experiences of people living with dementia or of carers.
Walsh, K., O’Shea, E., and Scharf, T. (2012) Social Exclusion and Ageing in Diverse Rural Communities. Irish Centre for Social Gerontology, Galway.
An innovative, community-oriented dance program, Sharing Dance Seniors is a joint venture between Canada’s National Ballet School (NBS) and Baycrest Health Sciences.
The Sharing Dance Seniors program* is unique in Canada and internationally in its aim to make dance accessible to older adults with a range of physical and cognitive abilities, including people living with dementia. The program involves a suite of remotely instructed (streamed) dance sessions to participants in institutional and community settings with on-site facilitators supporting participants.
Unlike dance therapy that aims to ameliorate specific symptoms this program focusses on guiding participants through an accessible creative and artistic experience. For example, opportunities are provided for participants to express their life-stories through movement, which is a key goal of the narrative dance approach. Sharing Dance Seniors aims to provide participants with a dance experience as similar as possible to that of any traditional dance class, while simultaneously prioritizing accessibility to older adults with physical and or cognitive challenges.
These objectives are distinct from dance therapy, which specifically aims to improve neuropsychiatric symptoms such as agitation and cognitive and physical functioning, largely overlooking what are considered ‘softer’ positive benefits including empowerment, communication and creative self-expression, communal spirit, pleasurable experience, and sociability. The aims of the dance program align directly with this study’s interest in social inclusion as they prioritize expressive capacities and social interaction in the group rather than positioning these processes and outcomes as secondary to physical and cognitive outcomes.
*The Sharing Dance Seniors program is now titled Sharing Dance Older Adults. Click to learn more about how this program has grown since this research project.
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Learn more about the research team.
Research Assistants
Heidi Burns, Trent University | Amber Colibaba, Trent University | Sylvia Dick, Trent University | Justin Sutton, Trent University | Stephan Warrener, Brandon University | Megan Wrathall, Brandon University
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1) To explore the experiences of older people living with dementia and their carers participating in the Sharing Dance program as they relate to understanding the multiple dimensions of social inclusion across the care continuum in urban and rural settings
2) Assess the effectiveness of the multi-modal delivery of the Sharing Dance program as it relates to enhancing social inclusion processes and outcomes across the care continuum in urban and rural settings
3) Identify the challenges of expanding (scaling up) the Sharing Dance program as they relate to experiential, programmatic and contextual factors that influence the success or failure of the program as it relates to social inclusion across the care continuum in urban and rural settings
The following research methods will focus on participants’ experiences and what they can tell us about social inclusion and how social inclusion among people living with dementia can be supported:
This study involves a qualitative sequential pilot study of the innovative Baycrest NBS Sharing Dance Seniors program underway in non-metropolitan regions of two Canadian provinces, Peterborough, Ontario and Brandon (Westman) Manitoba. It focuses on the remotely-instructed delivery of the program in care facilities, community centres and households. The study involves five phases of observations, diaries, focus groups and interviews with program participants (people living with dementia), carers, coordinators, instructors and volunteers as well as critical reflections among research investigators and knowledge users. NVivo based thematic and narrative analyses of the qualitative data will produce new knowledge about the experiences, effectiveness and challenges of the dance program that will inform understanding of whether and in what ways it increases social inclusion and quality of life for older people living with dementia and carers. The findings will identify opportunities for program expansion and support the further development of arts-based approaches.
The observations include detailed descriptions of the actions, expressions, and interactions of participants in the program to inform our analysis of multiple dimensions of social inclusion, particularly those related to social relations, mobility, and safety. For example, observations focus on the degree and nature of social interaction as well as safety (e.g., comfort with dance moves, fellow participants and the facilitator).
“Near the end we were all getting better at it and that made quite a difference.”
Brandon Participant
Diaries with program participants are used to explore the lived experiences of the program as they relate to processes and outcomes of social inclusion People living with dementia and carers record their personal experiences throughout the program in a weekly semi-structured journal using written, oral and/or video communication (paper booklets and iPads). Researchers assist people living with dementia with their diaries after the program, as needed. Diary questions focus on elucidating elements of social inclusion within the participants’ and carers’ experiences (e.g., changes in social connections over the course of the program, barriers to participation due to transportation and mobility issues, financial issues and safety concerns) to enhance the other data collected regarding social inclusion in depth and with contextual sensitivity.
“I was impressed at how well the residents engaged in it, especially ones that don’t engage very often. That was rewarding.”
Personal Care Home Staff, Brandon
Focus groups with program participants and carers as well as with program coordinators, instructors and volunteers are moderated regarding the effectiveness of the program delivery and the challenges of implementing the program. This allows for an examination of the breadth of experiential, programmatic and contextual factors that influence the effectiveness of the program to improve social inclusion. The focus groups explore similarities and differences among the modes of delivery, care settings, and geographic locales, and include discussion questions about broader contextual influences on social inclusion (e.g., impact of changing economic circumstances and community dynamics such as volunteerism on access to services).
“People are allowed to work at their ability and are encouraged to do what they can, how they can.”
Peterborough Participant
Interviews with program participants and carers as well as with program coordinators, instructors and volunteers will explore the effectiveness of the multi-modal program delivery and identify the challenges of implementing the program (Objectives 2 and 3). In-depth, 90-minute audio-recorded interviews with a sub-set of program participants, and all of the coordinators, instructors and volunteers will explore the success and/or failure of the program in relation to experiential, programmatic and contextual factors that influence the effectiveness of the program to improve social inclusion. Semi-structured interview questions will explore in greater depth the key issues and connections among the multiple dimensions of social inclusion that emerge from the focus group discussions.
“Dance is like another language, it sort of draws people together.”
Brandon Participant
Critical reflections among the research investigators and knowledge users will serve to identify opportunities and promising practices for expanding the program in various types of community and collaborative settings (Objective 3). In-depth reflections regarding the challenges and opportunities experienced and/or observed by the research team (comprising the investigators, knowledge user collaborators from NBS, and research personnel) are recorded as part of weekly one-hour meetings to build a reflective dataset as the program expands through the pilot phases (i.e., P1 to P4, B1 to B4). A semi-structured guide is designed to elicit conceptual, methodological, empirical and applied issues for discussion and critical reflection.
Sequential and iterative qualitative data analysis will take place during the multi-phased data collection to support the refinement of research instruments as well as communication of preliminary findings with community partners. Management and analysis of all phases of the study will be supported by Nvivo 11 software. Thematic content analysis of text-based observations as well as diaries will inform the focus group discussions of the effectiveness and challenges of the Sharing Dance Seniors program. Building on the observational and diary phases, thematic analyses of focus group transcripts inform the in-depth inquiry of emergent social inclusion themes in interviews. Thematic analysis of the recorded researcher and knowledge user reflections will provide the foundation for narratives of promising practices relating to the development and implementation of the research design as well as the implementation and expansion of the dance program. These analyses will inform a series of knowledge exchange reports and seminars for each phase of the pilot studies that will be disseminated to participants, community leaders and knowledge users (see Table 1).
This study is approved by the Research Ethics Boards at Trent University and Brandon University, and by participating organizations according to their governance procedures. The perspectives of people living with dementia and carers are incorporated throughout the study (from design to dissemination) and the study adheres to the ethical considerations when including people with dementia.
Skinner, M. W., Herron, R. V., Bar, R. J., Kontos, P., & Menec, V. (2018). Improving social inclusion for people with dementia and carers through sharing dance: a qualitative sequential continuum of care pilot study protocol. BMJ open, 8(11).
Improving social inclusion for people with dementia and carers through sharing dance: a qualitative sequential continuum of care pilot study protocol
https://bmjopen.bmj.com/content/8/11/e026912.info
Kontos, P., Grigorovich, A., Kosurko, A., Bar, R. J., Herron, R. V., Menec, V. H., & Skinner, M. W. (2020). Dancing with dementia: Exploring the embodied dimensions of creativity and social engagement. The Gerontologist.
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Kosurko, A., Herron, R. V., Skinner, M. W., Bar, R. J., Kontos, P., Grigorovich, A., & Menec, V. (2020). Opportunities and Challenges of Digital Delivery of Sharing Dance Seniors for Social Inclusion. Romanian Journal of Communication and Public Relations, 22(2), 23-37.
Herron, R., Bar, R., & Skinner, M. (Eds.). (2022). Dance, Ageing and Collaborative Arts-Based Research (1st ed.). Routledge. https://www.taylorfrancis.com/books/oa-edit/10.4324/9781003260691/dance-ageing-collaborative-arts-based-research-rachel-herron-rachel-bar-mark-skinner?_gl=1*1pp3tw5*_gcl_au*ODc4MzE4MjQ1LjE3NDYxMjU0MjM.*_ga*MTkyNDUxNTEwMS4xNjc4MjAzNjQ4*_ga_0HYE8YG0M6*MTc0NjEyNTQyMy4xMy4wLjE3NDYxMjU0MjMuNjAuMC4w
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Kosurko, A., Skinner, M., Herron, R., Bar, R. J., Grigorovich, A., Kontos, P., & Menec, V. (2020). 27 Rural gerontechnology Arts-based insights into rural ageing and the. Rural Gerontology: Towards Critical Perspectives on Rural Ageing.
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Herron R, Skinner M, Kontos P, Menec V, Bar R. Beyond therapy: Exploring the potential of dance to improve social inclusion for people with dementia. In Hunt R, Atkinson S (eds), Geohumanities and Health, Springer. (in press, 2019).
All Pilots Final Report 2021
Kosurko, A., Skinner, M., Herron, R. Kontos, P., Menec, V., Bar, R., & Grigorovich, A. (2021) Improving social inclusion for Canadians with dementia and carers through Sharing Dance: Final Report. Trent University, Peterborough, ON.
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Brandon Phase Three Report 2020
Kosurko, A. Herron, R., Skinner, M., Kontos, P., Menec, V., & Bar, R. (2020) Improving social inclusion for Canadians with dementia and carers through Sharing Dance: Brandon pilot phase three report. Trent University, Peterborough, ON.
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Brandon Phase Two Report 2019
Kosurko, A. Herron, R., Skinner, M., Kontos, P., Menec, V., & Bar, R. (2019) Improving social inclusion for Canadians with dementia and carers through Sharing Dance: Brandon pilot phase two report. Trent University, Peterborough, ON.
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Brandon Phase One Report 2018
Warrener, S., Wrathall, M., Skinner, M., Herron, R. Kontos, P., Menec, V., & Bar, R. (2017) Improving social inclusion for Canadians with dementia and carers through Sharing Dance: Brandon pilot phase one report. Brandon University, Brandon, MB.
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Peterborough Phase Three Report 2018
Kosurko, A. Herron, R., Skinner, M., Kontos, P., Menec, V., & Bar, R. (2018) Improving social inclusion for Canadians with dementia and carers through Sharing Dance: Peterborough pilot phase three report. Trent University, Peterborough, ON.
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Peterborough Phase Two Report 2018
Warrener, S., Wrathall, M., Skinner, M., Herron, R. Kontos, P., Menec, V., & Bar, R. (2017) Improving social inclusion for Canadians with dementia and carers through Sharing Dance: Peterborough pilot phase two report. Brandon University, Brandon, MB.
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Gerontological Society of America Annual Scientific Meeting
Austin, Texas, 2019
Paper Presented:
Exploring the critical contributions of arts-based approaches in rural dementia care
Herron, R, Skinner, M., Kosurko, A., Kontos, P., Menac, V., Bar, R.
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RaDAR Knowledge Network in Rural and Remote Dementia Care
Saskatoon SK, 2019
Invited keynote address:
Rural Dementia Care: From Challenges to Innovative Solutions
Herron, R., (2019)
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Qualitative Research in Communication International Conference
Bucharest, Romania, 2019
Paper Presented:
Challenges and opportunities of social inclusion for older adults through digitally delivered dance in rural Canadian communities
An Kosurko, Trent University; Rachel Herron, Brandon University; Mark Skinner, Trent University; Rachel Bar, Ryerson University, Canada and Canada's National Ballet School, Canada; Pia Kontos, Toronto Rehabilitation Institute - University Health Network, Canada; Verena Menec, University of Manitoba, Canada
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International Medical Geography Symposium
Queenstown, New Zealand, 2019
Paper Presented:
Encountering the transformative potential of Sharing Dance for people living with dementia and carers across spaces of care
Rachel Herron, Brandon University, Canada; Mark Skinner, Trent University, Canada; An Kosurko, Trent University, Canada; Rachel Bar, Ryerson University, Canada and Canada’s National Ballet School, Canada; Pia Kontos, Toronto Rehabilitation Institute – University Health Network, Canada; Verena Menec, University of Manitoba, Canada
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Canadian Association of Geographers, Annual General Meeting
Winnipeg, Manitoba, 2019
Paper Presented:
Seniors’ experiences of social inclusion through sharing dance in rural Manitoba and Ontario, a parallel pilot study
An Kosurko, Trent University, Canada; Mark Skinner, Trent University, Canada; Rachel Herron, Brandon University, Canada; Pia Kontos, Toronto Rehabilitation Institute – University Health Network, Canada; Verena Menec, University of Manitoba, Canada: Rachel Bar, Ryerson University, Canada and Canada’s National Ballet School, Canada
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Canadian Association of Geographers/International Geographical Union Pre-Conference Workshop on Health, Healthcare and the Environment
Kingston Ontario., 2019
Paper Presented:
Improving social inclusion for people with dementia and carers through sharing dance
Mark Skinner, Trent University, Canada; Rachel Herron, Brandon University, Canada; Verena Menec, University of Manitoba, Canada; Rachel Bar, Ryerson University, Canada and Canada’s National Ballet School, Canada
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International Federation on Ageing
Toronto, Ontario., 2019
Paper Presented:
Connecting rural communities and older people with dementia through dance
Rachel Herron, Brandon University, Canada; Mark Skinner, Trent University, Canada; Rachel Bar, Ryerson University, Canada and Canada’s National Ballet School, Canada; Pia Kontos, Toronto Rehabilitation Institute – University Health Network, Canada; Verena Menec, University of Manitoba, Canada
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Prairie Association of Geography Annual Meeting
Hecla Island., Manitoba
Paper Presented:
Improving social inclusion through Sharing Dance: Insights from Brandon Manitoba, 2018
Rachel Herron, Brandon University, Canada; Mark Skinner, Trent University, Canada; Rachel Bar, Ryerson University, Canada and Canada’s National Ballet School, Canada; Pia Kontos, Toronto Rehabilitation Institute – University Health Network, Canada; Verena Menec, University of Manitoba, Canada
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TrentAging2019
Trent University, Peterborough, Ontario, Canada, 2019
Panel:
Exploring Social Inclusion, Embodiment and Citizenship through Dance for Older People Living with Dementia and their Carers
Papers Presented:
Examining Older People’s Experience of Social Inclusion through Sharing Dance
An Kosurko, Trent University, Canada; Mark Skinner, Trent University, Canada; Rachel Herron, Brandon University, Canada; Pia Kontos, Toronto Rehabilitation Institute – University Health Network, Canada; Verena Menec, University of Manitoba, Canada: Rachel Bar, Ryerson University, Canada and Canada’s National Ballet School, Canada
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Promising Practices for Sharing Dance for Older People and Carers through Community-Based Research: Challenges and Opportunities, Capacity and Creativity
Rachel Bar, Ryerson University, Canada and Canada’s National Ballet School, Canada; Rachel Herron, Brandon University, Canada; Mark Skinner, Trent University, Canada; Pia Kontos, Toronto Rehabilitation Institute – University Health Network, Canada; Verena Menec, University of Manitoba, Canada
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Improving Social Inclusion through Sharing Dance: A Focus on Embodied Expression
Mark Skinner, Trent University, Canada; Rachel Herron, Brandon University, Canada; Rachel Bar, Ryerson University, Canada and Canada’s National Ballet School, Canada; Pia Kontos, Toronto Rehabilitation Institute – University Health Network, Canada; Verena Menec, University of Manitoba, Canada; An Kosurko, Trent University, Canada
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Dancing with Dementia: Integrating Citizenship, Embodiment, and Relationality to Support Human Flourishing
Pia Kontos, Toronto Rehabilitation Institute – University Health Network, Canada; Alisa Grigorovich, University of Toronto, Canada; Rachel Herron, Brandon University, Canada; Verena Menec, University of Manitoba, Canada; Mark Skinner, Trent University, Canada
Smooth moves for seniors
CBC The National
VIDEO
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Seniors with dementia find dance classes beneficial
The Brandon Sun
ARTICLE
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Power of dance tapped to help elderly
The Western Producer
ARTICLE
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Dance program for seniors with dementia being offered at four Westman locations
The Brandon Sun
ARTICLE
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Sharing Dance Seniors program includes caregivers and persons with dementia
Brandon University
ARTICLE
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Sharing Dance
Canadian Institutes of Health Research
ARTICLE
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Trent University and Canada's National Ballet School Launch New Program to Study Social Inclusion of People with Dementia
Trent University
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