Dementia-Friendly Communities and Business Engagement: Navigating Stigma, Building Inclusive Environments, and Advancing Social Work Interventions for Older Adults with Dementia

As global populations age and dementia prevalence accelerate at an unprecedented rate, the responsibility for fostering inclusive and supportive environments for people living with dementia (PWD) must extend beyond the healthcare system to include businesses and community institutions as essential partners. In this shifting paradigm, the field of social work is uniquely positioned to lead equity-driven efforts that ensure these everyday settings uphold the dignity, autonomy, and right to age in place for PWD, while promoting their full social inclusion. This study investigated the experiential and psychological factors influencing dementia awareness and dementia-friendly behaviors among staff in community-based businesses designated as dementia-friendly. Grounded in the Theory of Planned Behavior (TPB) and the Person-Centered Dementia Care (PCDC) framework, the research makes a novel theoretical and empirical contribution by extending both models into non-clinical, community-oriented environments. Data were collected from 492 employees and volunteers across dementia-friendly businesses in the United States using a 34-item awareness scale encompassing six domains: knowledge, attitudes, perceptions, social norms, intentions, and self-reported behaviors. Three aims guided the analysis: (1) to examine the impact of training mode and time since training on dementia awareness; (2) to evaluate how the type and duration of prior dementia exposure influence dementia awareness levels; and (3) to assess the predictive utility of TPB constructs -- attitudes, subjective norms, and perceived behavioral control (PBC), in shaping intention and behavior toward PWD. Results showed that participants trained over one year prior demonstrated significantly higher awareness than those more recently trained, challenging assumptions about knowledge decay and underscoring the importance of experiential reinforcement. A robust dose-response relationship also emerged between dementia exposure and awareness, with the highest scores reported among those with both personal and professional experience. Regression analyses confirmed that subjective norms and PBC, rather than attitudes, significantly predicted intention, and that both intention and PBC were strong predictors of behavior. These findings carry important implications for workforce development, social work leadership, and dementia-friendly policy and infrastructure. The study advocates a shift from episodic informational sessions to sustained, relational, and contextually embedded training models. By operationalizing TPB and PCDC within community-based business settings, this research advances the dementia-friendly movement and initiates a scholarly dialogue around recognition and practice standards in non-clinical business environments. Future research should adopt longitudinal and equity-oriented designs to further examine disparities in awareness and build upon the theoretical foundations presented here. As one of the first studies to investigate dementia-friendly behaviors among staff in U.S. businesses designated as dementia-friendly, this work positions everyday community spaces as critical platforms for advancing cognitive inclusion, social accountability, and the well-being of aging populations.

Author dc:creator

• Ionescu, Elena

Contributors dc:contributor

• Cheung, Monit
• Trejo, Laura
• Robbins, Susan P

• Sociology

Language dc:language

English

Handle dc:identifier.uri

https://hdl.handle.net/10657/19607

OAI identifier oai:identifier

oai:tdl-ir.tdl.org:10657/19607