Project: Extending active life for older people with cognitive impairment through innovations in the visitor economy of the natural environment (ENLIVEN)

Elderly couple walking their dog across a bridge

Project overview

ENLIVEN is a 3-year project based at the University of Exeter, with an expert team from Brunel, Hertfordshire, Manchester Metropolitan and Bradford Universities, Innovations in Dementia and The Sensory Trust, working with businesses and organisations to make the well-being benefits of outdoor activity more accessible to older people with cognitive impairment. People with dementia and their families say that experiencing nature helps them in lots of ways. But they also say there are many barriers to getting out as much as they would like. ENLIVEN asks: what can be done to make outdoor places easier for older people with dementia and their family members to visit?

ENLIVEN contributes to the programme goal of increasing healthy life expectancy and quality of life for people with cognitive impairment and their families by promoting engagement with the natural environment through business innovation. Our focus is on increasing access to outdoor nature-based activity and reducing inequality of access as a means of improving quality of life, slowing or preventing cognitive decline, and maintaining activity, independence and social connection, in pursuit of adding five years of healthy active life.

Building on increased awareness of the value of nature arising from the COVID-19 pandemic, the project contributes to post-COVID recovery by benefitting older people while providing businesses with a competitive advantage in developing new market potential. Our project team are working with businesses and organisations that manage sites and access to nature-based outdoor activity to co-design and develop new services and experiences. We are working in partnership with older people with cognitive impairment to understand their aspirations, preferences and needs.

ENLIVEN’s objectives are to:

  • Understand the perspectives of older people with cognitive impairment and their families, businesses and organisations providing access to nature-based outdoor activity, and available research evidence, to identify directions for innovation.
  • Use this understanding to co-design and implement innovative and sustainable initiatives that enable businesses to reduce barriers to participation and inequalities in access.
  • Evaluate these business initiatives to provide evidence about the kinds of changes that successfully encourage increased participation of older people with cognitive impairment across a range of contexts and environments.
  • Use the knowledge gained to enhance the capacity of businesses and organisations in the outdoor visitor economy to meet the needs of older people with cognitive impairment.

Engagement with older people

Meaningful engagement of people who will be the beneficiaries of the initiatives resulting from our work is central to this project. Partner organisation Innovations in Dementia (ID) are national leaders in engaging and involving people with dementia and ensuring they have a voice. ID facilitate the Dementia Engagement and Empowerment (DEEP) network, which brings together diverse groups of people living with cognitive impairment around the UK comprising over 1000 individual members. Partner organisation Sensory Trust (ST) brings expertise in nature-based engagement with people with cognitive impairment and optimising the associated well-being benefits, a model now being widely shared around the UK.

Through longstanding collaboration, we have developed approaches to involvement in research projects that go beyond the traditional Patient and Public Involvement (PPI) model to ensure effective, inclusive participation. We will employ three specific approaches: bringing experts by experience directly into the project leadership team; developing an involvement network; and using creative arts-based approaches to reach out to people who might not readily volunteer to join an involvement group or see themselves as advising on research projects.

We will use creative, arts-based approaches to promote wider engagement in ENLIVEN. Artists will work with diverse DEEP groups to produce and exhibit artwork promoting awareness of the benefits of outdoor nature-based activity and how barriers to this may be overcome. Where feasible, groups will link directly with participating businesses and create visual resources to support the initiatives being implemented, such as visual displays that could be placed in the environment to support wayfinding. We build on experience in an ESRC-funded knowledge exchange initiative which evolved into The Unfurlings, a series of banners for hope and change created by groups of people with dementia that have been exhibited nationally.

Working with business

ENLIVEN will work closely with outdoor site managers and businesses to support the co-development of new services, innovations and experiences that make the well-being benefits of outdoor activity in the natural environment more accessible to older people with cognitive impairment and their families. Many businesses want to make things better, but need guidance to enable them to do so. ENLIVEN is working collaboratively with business partners to identify bespoke solutions and initiatives, such as audience development, outdoor wayfinding, engagement with visitors and other innovations, that facilitate more accessible, enjoyable and stimulating experiences. In some cases, site managers  might work with others or engage with a ‘supply chain’ involving infrastructure providers covering for example transport, technology or specialist training. We will offer small grants to support businesses in developing innovative ideas and/or to enable them to implement selected initiatives.

ENLIVEN’s two Knowledge Exchange Officers, based in the Business School at the University of Exeter, will work with each business on a one-to-one basis, including spending a period of time in residence to facilitate trialling of new initiatives.  Our Knowledge Exchange Forum will provide a platform to bring together our businesses and partners, including older people with cognitive impairment, to share knowledge, practices, and aspirations.  We are also developing a supportive infrastructure to curate a ‘community of practice’ for our business partners, which aims to facilitate new connections, support, mutual learning and collaboration between businesses. ENLIVEN will work with businesses to support the development of an accreditation and recognition scheme. We will integrate the evidence gained throughout the project to co-produce a toolkit of online and printed resources for businesses, social enterprises, statutory and third-sector organisations, and national and local business associations, and resources to address the perspective and needs of older people with cognitive impairment and their families.

Diversity and environments of ageing

ENLIVEN’s partner sites cut across a diverse geographical remit. We are engaging with businesses in the Southwest, Greater London, Pembrokeshire, the Peak District, Lancashire and beyond. Our partners provide access to a wide and varied range of outdoor environments. They include urban nature sites, large historic gardens, flower farms, local foraging and fishing businesses and community gardens. By working with partners in these diverse environments, we aim to co-develop bespoke solutions and innovations that will benefit older people with cognitive impairment who wish to access outdoor spaces which are closer to home, as well as those which may be further afield.

ENLIVEN involves people living in areas of greater deprivation and builds on our existing links with groups in the north-west and north-east of England as well as rural Cornwall. We emphasise inclusion of people from minority ethnic groups, building on connections established during the living well with dementia ‘IDEAL’ project led by Professor Linda Clare.  We are committed to using diverse channels including local and special-interest radio and press, as well as social media, to raise awareness of the project and encourage diversity in participation.

View our full list of partners here:

Linda Clare

Project Lead

Professor Linda Clare
Dr Katie Ledingham
Programme Manager/Senior Research Fellow
Hannah Cameron
Project Administrator

Project partners