Anthropology, Dementia, and Front Line practice.

So, I should be writing reflections (this is a key aspect of student nurse learning) or starting my final assignment. Instead, I find myself procrastinating on Facebook.

The two seem to have come together. A certain Dementia Specialist Nurse recently Lucy posted a TEDx video of Engage and Create founder, Rachel. Rachel speaks of moving from a career in advertising and marketing to running her own social enterprise to bring art, music and discussion to people living with dementias. I find her approach, and determination, particularly inspiring. She speaks of spending hours and hours in care homes, trying and failing to interact with people with dementias in different ways, before coming to methods that worked.

To me, this is simply applied anthropology – participating in and simultaneously observing a group of people over an extended period of time in order to draw out meanings and patterns. (For those of you who are interested in anthropological practice, Judith Okely’s book is an excellent place to begin). It’s an extremely hard, time-consuming, and valuable approach. In a world which focuses research on clearly definable outcomes, such work is sadly insight rich yet research finance poor.

It’s therefore all the more important to draw attention to such approaches, and the benefit that they can have in improving care for all patients, yet especially those with dementias. Rachel’s video outlines the need to support and train front-line carers to facilitate meaningful activities and discussions with patients with dementias, especially given that these patients receive, on average, two minutes of meaningful interaction each day from carers who have had around one-hour of dementia training.

It’s not just about anthropology, either. I would define anyone working in an ‘anthropological’ way as loosely carrying out a form of applied anthropology. Yet this is not a widely-held academic stance within the discipline. Further, at no point does Rachel identify as an anthropologist herself – I am simply reading her work through my own anthropological lens.

One aspect of Rachel’s work is that there is ‘no right or wrong’ in art, which enables the patients with dementias that she supports to focus on their response to an art piece, rather than a need to remember something they can’t. Well, in arts more broadly (English Studies, Social Science, Art etc.), there is also no need for a ‘right’ or ‘wrong’ answer.

I remember being shocked by the amount of structure when I first worked as a Health Care Assistant – patients measured by quantitive tools and charts, all of them scored every few hours or days (depending on their purpose). Though important, this seemed completely at odds with my own background in English and Anthropology. Where was the meaning in all this? What does it mean for the patient?

So, this is why the work of people like Rachel is so important. Those of us in the arts sometimes take the qualitative for granted. Those of us in nursing, medicine and sciences sometimes take the quantitative for granted. So dementias, though at times terrible for those who suffer from them, remain a challenge for best practice in care: How do we sit at the juncture of arts and science and blend the two most effectively to play to their strengths? How do we support the ‘true heroes’ (to quote Rachel) – the front-line carers – to deliver such an approach?

I am reminded of Lucy’s own work pioneering a three-day dementia training course in a tertiary NHS Trust, for people at all levels and within all areas of the organisation. The course included theoretical study of areas of the brain affected by dementias and awareness of the many types of the disease and their different symtoms and effects (a reason I talk often of ‘dementias’ rather than ‘dementia’), and blended this scientific theoretical approach with simulations of the experience of dementias, group discussions, and reflections.

So, in short, there is a place for arts grads in science and science grads in the arts. It’s also why we need to continue recruiting some student nurses once they’ve already studied and worked in different fields, despite the bursary cuts. But that’s a whole different blog post and debate.

If there is an opportunity to become involved in the work of Engage and Create that fits around an already busy schedule, I’d be interested in hearing about it.

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