Measuring meaning-based well-being in individuals with dementia: the creation and validation of the well-being in dementia inventory

Abstract

Despite growing attention to well-being in dementia, few studies have defined meaning-based (eudaimonic) well-being in this population, mainly due to challenges posed by cognitive decline and self-report limitations. We developed and validated a novel tool for measuring meaning-based well-being in individuals with dementia, particularly those receiving residential or home care. The study included two samples: carers of 174 care home residents and carers of 420 community-dwelling individuals for whom respondents reported dementia. The Well-being in Dementia Inventory (WiDI) assesses six core dimensions: Self-Sufficiency, Functional Mastery, Goal-Based Mastery, Purposeful Engagement, Positive Interactions and Constructive Self-Perspective. Confirmatory Factor Analysis established the WiDI's six-factor structure, underscoring its multidimensional nature and equivalence across community-dwelling individuals, regardless of gender, age group (younger-old/mid-older-old), or care context (family or professional). The scale exhibited high internal and inter-rater reliability, though very low scores in the care home sample inflated these statistics. Concurrent validity was confirmed through strong correlations with adapted indices of meaning-based well-being (e.g. the Scales of Psychological Well-being and the Mental Health Continuum Short Form, commonly used in non-dementia samples), indicating the WiDI's conceptual consistency. These findings clarify how meaning-based well-being can be assessed in individuals with dementia and introduce the WiDI as a reliable and valid tool for assessing well-being, suggesting broad applicability across care settings. These results have important implications for practice and policy, advocating a meaning-based approach to well-being assessments that ensures holistic, personalised care by focusing on key indicators of life quality.