Measuring and Monitoring “Living Well” in Dementia: Development of the Well-being in Dementia Inventory (WiDI)

Introduction
Well-being is increasingly recognised as a core outcome in dementia care; however, existing measures largely focus on hedonic aspects such as mood or comfort. Meaning-based (eudaimonic) well-being, encompassing purpose, autonomy and engagement, remains poorly defined and difficult to assess in people with dementia, particularly due to cognitive impairment and limitations in self-report. This study describes the development and validation of the Well-being in Dementia Inventory (WiDI), a novel proxy-rated measure designed to capture deeper dimensions of well-being in this population.

Method
WiDI was developed for use with people living with dementia in both residential and community settings. The tool was evaluated using proxy data from carers of 174 care home residents and 420 individuals living in the community. Psychometric analyses examined the underlying factor structure, internal consistency and measurement stability across care settings, age and gender. Convergent validity was assessed through associations with established well-being measures commonly used in non-dementia populations.

Results
Analyses supported a six-domain structure of meaning-based well-being: Self-Sufficiency, Functional Mastery, Goal-Based Mastery, Purposeful Engagement, Positive Interactions and Constructive Self-Perspective. This structure was stable across demographic groups and care contexts. WiDI demonstrated good internal reliability and showed expected correlations with existing well-being measures, indicating strong construct validity.

Conclusion
WiDI provides a reliable, multidimensional assessment of meaning-based well-being in people with dementia, extending beyond symptom-focused or mood-based approaches. Its applicability across care settings supports a more holistic, person-centred understanding of well-being, with potential benefits for clinical practice, research and policy aimed at improving quality of life in dementia care.