**3.2. Study setting**

Throughout New Zealand there are 22 Alzheimers Societies whose role is to promote education and awareness, and to provide support and advocacy for people with dementia and their caregivers. Kirkman [29] surveyed and collected interview data from 48 women employed as community workers with Alzheimers Societies throughout New Zealand. Despite their low pay, part-time work and the lack of recognition of their professional qualifications, many workers were satisfied with their role as they felt they were making a difference for people with dementia and their families. Overall, Kirkman found a "gendered" patterning of paid and unpaid care for people with dementia commenting that this "reflects the traditional view that women are carers both inside families and outside them as well" and that "what is needed as we plan for the dementia epidemic' is recognition of the value of the work that

In New Zealand home support services are predominately offered by non-government organisations (NGOs) that offer a range of home support services (from personal care to respite care for carers). The NGOs often have receive government funding for eligible clients Needs Assessment and Service Coordination Co-ordination service (NASC) via the District Health Boards who are funded by the Ministry of Health. Additionally, NGOs attract self-funded clients. NGOs are

guided by the implementation of the New Zealand Dementia Care Framework [25].

**for people living with dementia and their caregivers**

grate into the National Dementia Care Framework?

**3.1. Research design**

152 Cognitive Disorders

approach ([30], p. 4).

**3. Research on factors that constitute effective home support services** 

Impact Research New Zealand was commissioned by Presbyterian Support Northern (PSN), a large NGO delivering social services to the upper half of the North Island in New Zealand to undertake research aimed at identifying: What factors constitute effective restorative home support services for people with dementia and their caregivers? How do these factors inte-

A case study design was undertaken, data was collected from key sites in the upper half of the North Island. Case studies allow researchers to focus on the case, in this instance on key Enliven sites in the upper North Island. Case study allows for a holistic and real world

In an attempt to answer the overarching research question the research, a mixed methods were utilised [31]. Two stages of data collection were employed to identify the key factors that constitute effective restorative home support services for people living with dementia and caregivers. In stage one, a literature review was undertaken to identify the research evidence for best practice in home support care. A literature review is a critical examination of the research evidence and enables researchers to place their research question in context with previous research findings, refine research methods and analysis, avoid unnecessary replication of previous studies, and build upon previous research evidence [32]. A combination of New Zealand and international research literature was incorporated into the review, with a particular focus upon home support services incorporating restorative care principles. International research

women have done as paid and unpaid cares" ([29], p. 14).

Enliven first delivered restorative home- support services under the Community First restorative model established in Hamilton in 2002, as a Ministry of Health funded 'Ageing in Place' pilot programme. In 2009, Enliven was successful in securing a contract to deliver Auckland District Health Board's Enhanced Home Support Services for people over 65 years. This contract introduced a (restorative-like) strengths-based approach promoting client independence using formal goal setting and flexible packages of funding to ensure a right place and right time experience for older people.

Over time Enliven restorative home support services have progressively been expanded across the PSN region to include five DHB areas: Auckland, Counties Manukau, Waikato, Lakes, and Bay of Plenty. During this time Enliven has continued to build capacity to support clients who might otherwise be in residential care to remain in their own homes, and this encompasses people living with various high and complex needs including dementia.

Additionally, Enliven has incorporated restorative principles within its day programmes – as a component of socialisation and mobility goals, as well as providing mental stimulation and general enjoyment. Day programmes also assist caregiver needs and stress, through providing respite time.
