Moments of meaning: Enacted narratives of occupational engagement within a dementia town

Engagement in meaningful occupation is important to health and well-being. People living with dementia are challenged in engagement due to consequences of their disease and environmental barriers. In Europe, there is increasing interest in addressing these challenges by transforming care services into dementia-friendly contexts such as dementia towns. It is unclear, however, how engagement in occupation occurs within a dementia town. This study applies a narrative, ethnographic approach to explore how people with moderate dementia engage in occupation in the context of a Danish dementia town, and how meaning is related. Data were generated and analysed based on the “narrative in action” approach. We produced in-depth knowledge of engagement and meaning through participant observations by following nine persons for an extended period while they participated in occupations in the everyday life of the dementia town. The narrative analysis revealed an overarching narrative of “moments of meaning–possibilities for engagement” that illustrated the thin line between potential engagement and deprivation from occupation. The stories that emerged in the analysis showed how people with dementia enacted meaning through occupation. Meaningful engagement seemed to be a way for people with dementia to connect to self, others, and place. The enacted narratives display the significance for people with dementia of being able to enact their story and thus create meaning from everyday life situations. However, the process of being engaged in occupation depended on co-creation with others, who supported the enactment process by drawing on the person’s occupational biography.