Choosing make believe : pretence or re-orientatation in the care of individuals living with dementia?

McCormick, Sheila

Abstract

‘The stage presents things that are make-believe; presumably real life presents things that are real and sometimes not well-rehearsed’ (Goffman, E. 1959, preface).


As a student nurse, one quickly learns two strategies when caring for individuals with severe dementia. At moments when the disease creates a sense of confusion and subsequent distress, one choice is to attempt re-orientation, to facilitate the person’s reconnection with their present place and time. Another strategy is to engage in the world experienced only by that individual in that moment, to become their sister, their childhood friend, their mother, choosing to characterise a person seen only by the individual living with dementia. I have often wondered about that choice, to agree to play a part in a reality withheld from me, a reality only accessible to and accessed by the person in my care. How, instinctively, did I grow to recognise when to re-orientate and when to become the other character in the ‘scene’ and why did that decision, often taken in the spur of the moment, prevent distress, agitation and, at times, aggression?

As a theatre scholar, I now question the decision to perform in a different light and in relation to current trends in the care of individuals with dementia that formally adopt a level of performance. As a case study, I will explore Hogewey, a residential care home in Holland that embraces a unique practice, creating an entire world for its residents, remote from the rest of society, in an attempt to, as some nursing scholars suggest, minimise disability and maximise ‘wellbeing by providing a physical and social environment congruent with people’s lifestyles’ (Jenkins C and Smythe, A. 2013, p.14). I introduce Hogewey not to highlight its uniqueness, but to explore the potentiality of a conscious decision to avoid reorientation in favor of the alternative, to engage with rather than deny the many alternative realities produced in the mind of the individual with dementia.

Reference List
Goffman E. (1959) The Presentation of Self in Everyday Life, New York: Ancor Books
Jenkins C and Smythe, A. (2013) ‘Reflections on a visit to a dementia care village’ Nursing Older People. 25, 6, pp.14-19.

Citation

McCormick, S. (2015, January). Choosing make believe : pretence or re-orientatation in the care of individuals living with dementia?. Presented at Representing Dementia: a symposium exploring representations of dementia within the arts and popular imagination, Royal Holloway, London

• Presentation Conference Type: Other
• Conference Name: Representing Dementia: a symposium exploring representations of dementia within the arts and popular imagination
• Conference Location: Royal Holloway, London
• Start Date: Jan 31, 2015
• Deposit Date: Mar 22, 2016
• Additional Information: Event Type : Conference