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Bodywork in dementia care: recognising the commonalities of selfhood to facilitate respectful care in institutional settings

Published online by Cambridge University Press:  02 April 2013

FIONA KELLY
FIONA KELLY*
Affiliation:
School of Applied Social Science, University of Stirling, UK.
*
Address for correspondence: Fiona Kelly, School of Applied Social Science, University of Stirling, Stirling FK9 4LA, UK. E-mail: fiona.kelly@stir.ac.uk
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Abstract

This paper draws on two data sources (Kelly's ethnographic study and a British Broadcasting Corporation television programme) to explore the practice of bodywork in the care of frail people with dementia in institutional settings. It explores the complexity of engaging in bodywork, particularly work that is distasteful to the care-worker, and shows how non-recognition of the selfhood of the person with dementia can result in practices that are demeaning and potentially abusive to those in receipt of such work. In contrast to a person-centred approach that urges practitioners to acknowledge people with dementia as unique individuals, with unique needs, wishes, abilities and desires, this paper argues for the use of Sabat's Selfs 1–3 construct to look for commonalities of selfhood, enabling care workers to recognise aspects of themselves in their patients as they carry out care, thereby facilitating care that empathically respects their patients' dignity and potential for vulnerability. Thus, it aims to advance theory and improve practice by arguing for the necessity of putting selfhood at the forefront of bodywork in order to facilitate respectful care that dignifies rather than objectifies the person.

Keywords

dementia practicerecognising commonalities of selfhoodinstitutional carebodywork
Type
Articles
Information
Ageing & Society , Volume 34 , Issue 6 , July 2014 , pp. 1073 - 1090
Copyright
Copyright © Cambridge University Press 2013 

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References

Alzheimer's Disease International 2009. World Alzheimer Report 2009. Alzheimer's Disease International, London.Google Scholar
Babad, E., Birnbaum, M. and Benne, K. 1983. The Social Self: Group Influences on Personal Identity. Sage, Thousand Oaks, California.Google Scholar
Behuniak, S. 2011. The living dead? The construction of people with Alzheimer's disease as zombies. Ageing & Society, 31, 1, 70–92.Google Scholar
Bradford Dementia Group 1997. Dementia Care Mapping Manual. Seventh edition, Bradford Dementia Group, University of Bradford, Bradford, UK.Google Scholar
British Broadcasting Corporation 2012. Panorama: Undercover Elderly Care. BBC1, 23 April. Available online at http://www.bbc.co.uk/iplayer/episode/b01gybn7/Panorama_Undercover_Elderly_Care/ [Accessed 1 May 2012].Google Scholar
Brooker, D. 2007. Person-centred Dementia Care: Making Services Better. Jessica Kingsley Publications, London.Google Scholar
Brunero, S., Lamont, S. and Coates, M. 2010. A review of empathy education in nursing. Nursing Inquiry, 17, 1, 64–73.Google Scholar
Care Commission and Mental Welfare Commission 2009. Remember I'm Still Me: Care Commission and Mental Welfare Commission Joint Report on the Quality of Care for People with Dementia Living in Care Homes in Scotland. Care Commission and Mental Welfare Commission, Dundee and Edinburgh.Google Scholar
Care Quality Commission (CQC) 2012. The State of Health Care and Adult Social Care in England in 2011/12. The Stationery Office, London.Google Scholar
Coe, A. B. and Anthony, M. 2005. Understanding bodywork for the patient with cancer. Clinical Journal of Oncology Nursing, 9, 6, 733–9.Google Scholar
Cohen, D. and Eisdorfer, C. 1986. The Loss of Self: A Family Resource for the Care of Alzheimer's Disease and Related Disorders. W. W. Norton & Company, New York.Google Scholar
Cohen, L. 2011. Time, space and touch at work: body work and labour process (re)organisation. Sociology of Health & Illness, 33, 2, 189–205.Google Scholar
Cohen, M., Halevy-Levin, S., Gagin, R., Priltuzky, D. and Friedman, G. 2010. Elder abuse in long-term care residences and the risk indicators. Ageing & Society, 30, 6, 1027–40.Google Scholar
Davis, D. 2004. Dementia: sociological and philosophical constructions. Social Science & Medicine, 58, 2, 369–78.Google Scholar
Department of Health 2009. Living Well with Dementia: A National Dementia Strategy. Department of Health, London.Google Scholar
Descartes, R. 1640/2002. Meditations on the first philosophy in which the existence of God and the distinction between mind and body are demonstrated. In Wilkinson, R. (ed.), Minds and Bodies. The Open University, Milton Keynes, UK, 155–9.Google Scholar
Dewing, J. 2002. From ritual to relationship: a person-centred approach to consent in qualitative research with older people who have a dementia. Dementia, 1, 2, 157–71.Google Scholar
European Court of Human Rights 2003. Convention for the Protection of Human Rights and Fundamental Freedoms as Amended by Protocol No. 11. European Court of Human Rights, Strasbourg, France. Available online at http://www.echr.coe.int/NR/rdonlyres/D5CC24A7-DC13-4318-B457-5C9014916D7A/0/EnglishAnglais.pdf [Accessed 18 May 2012].Google Scholar
Gale, N. 2011. From body-talk to body-stories: body work in complementary and alternative medicine. Sociology of Health & Illness, 33, 2, 237–51.Google Scholar
Gubrium, J. and Holstein, J. 1999. The nursing home as a discursive anchor for the aged body. Ageing & Society, 19, 5, 519–538.Google Scholar
Harman, L. 1987. The Modern Stranger: On Language and Membership. Mouton de Gruyter, Berlin.Google Scholar
Harnett, T. and Jonson, H. 2010. That's not my Robert! Identity maintenance and other warrants in family members’ claims about mistreatment in old-age care. Ageing & Society, 30, 4, 627–47.Google Scholar
Hochschild, A. 1983. The Managed Heart. University of California Press, Berkeley, California.Google Scholar
Hogg, C. and Warne, T. 2010. Ordinary people, extraordinary voices: the emotional labour of lay people caring for and about people with a mental health problem. International Journal of Mental Health Nursing, 19, 5, 297–306.Google Scholar
Home Office 1998. Human Rights Act 1998. The Stationery Office, London. Available online at http://www.opsi.gov.uk/ACTS/acts1998/ukpga_19980042_en_1. [Accessed 12 March 2013].Google Scholar
Hughes, B. 2002. Bauman's strangers: impairment and the invalidation of disabled people in modern and post-modern cultures. Disability and Society, 17, 5, 571–84.Google Scholar
Innes, A. 2009. Dementia Studies: A Social Science Perspective. Sage, London.CrossRefGoogle Scholar
Kelly, F. 2007. Well-being and expression of Self in dementia: interactions in long-term wards and creative sessions. PhD thesis, University of Stirling, Stirling, UK.Google Scholar
Kelly, F. 2010 a. Recognising and supporting self in dementia: a new way to facilitate a person-centred approach to dementia care. Ageing & Society, 30, 1, 103–24.Google Scholar
Kelly, F. 2010 b. Abusive interactions: research in locked wards for people with dementia. Social Policy & Society, 9, 2, 267–77.Google Scholar
Kelly, F. and Innes, A. 2012. Citizenship and human rights in dementia care nursing. International Journal of Older People Nursing, 8, 1, 61–70 doi:10.1111/j.1748-3743.2011.00308.x.Google Scholar
Kitwood, T. 1997. Dementia Reconsidered: The Person Comes First. Open University Press, Buckingham, UK.Google Scholar
Kontos, P. and Naglie, G. 2007. Bridging theory and practice: imagination, the body, and person-centred dementia. Dementia, 6, 4, 549–69.Google Scholar
Longhurst, R. 2001. Bodies: Exploring Fluid Boundaries. Routledge, London.Google Scholar
Morse, J., Barrett, M., Mayan, M., Olson, K. and Speirs, J. 2002. Verification strategies for establishing reliability and validity in qualitative research. International Journal of Qualitative Methods, 1, 2, 13–22.Google Scholar
Myhrvold, T. 2006. The different other – towards an including ethics of care. Nursing Philosophy, 7, 3, 125–36.Google Scholar
Norwegian Ministry of Health and Care Services 2008. Dementia Plan 2015 Making the most of the good days. http://www.alzheimer-europe.org/Policy-in-Practice2/National-Dementia-Plans/Norway [Accessed 5 February 2013].Google Scholar
Office of Public Sector Information 2005. Mental Capacity Act 2005. Available online at http://www.legislation.gov.uk/ukpga/2005/9/pdfs/ukpga_20050009_en.pdf [Accessed 18 May 2012].Google Scholar
République Française 2008. Plan Alzheimer 2008–2012. Available online at http://www.plan-alzheimer.gouv.fr/-44-measures-.html [Accessed 20 December 2012].Google Scholar
Sabat, S. 2001. The Experience of Alzheimer's Disease: Life Through a Tangled Veil. Blackwell Publishers, Oxford.Google Scholar
Sabat, S. 2002. Surviving manifestations of selfhood in Alzheimer's disease: a case study. Dementia, 1, 25–36.Google Scholar
Sabat, S. 2006 a. Mind, meaning and personhood in dementia: the effects of positioning. In Hughes, J., Louw, S. and Sabat, S. (eds), Dementia: Mind, Meaning and the Person. Oxford University Press, Oxford, 286–302.Google Scholar
Sabat, S. 2006 b. Implicit memory and people with Alzheimer's disease: implications for caregiving. American Journal of Alzheimer's Disease and Other Dementias, 21, 1, 11–14.Google Scholar
Sabat, S. and Collins, M. 1999. Intact social, cognitive ability and selfhood: a case study of Alzheimer's disease. American Journal of Alzheimer's Disease, 14, 1, 11–19.Google Scholar
Sabat, S. and Harré, R. 1992. The construction and deconstruction of self in Alzheimer's disease. Ageing & Society, 12, 4, 443–61.CrossRefGoogle Scholar
Sameroff, A. and MacKenzie, M. 2003. Research strategies for capturing transactional models of development: the limits of the possible. Development and Psychopathology, 15, 3, 613–40.Google Scholar
Schiamberg, L., Oehmke, J., Zhang, Z., Barboza, G., Griffore, R., Von Heydrich, L., Post, L., Weatherill, R. and Mastin, T. 2012. Physical abuse of older adults in nursing homes: a random sample survey of adults with an elderly family member in a nursing home. Journal of Elder Abuse & Neglect, 14, 1, 65–83.Google Scholar
Schneider, J., Scales, K., Bailey, S. and Lloyd, J. 2010. Challenging Care: The Role and Experience of Health Care Assistants in Dementia Wards. National Institute for Health Research Service Delivery and Organisation programme. Available online at http://panicoa.org.uk/sites/assets/challenging_care.pdf [Accessed 23 August 2012].Google Scholar
Scottish Government 2011. Standards of Care for Dementia in Scotland. The Scottish Government, Edinburgh.Google Scholar
Scottish Parliament 2000. Adults with Incapacity (Scotland) Act 2000. The Stationery Office, Edinburgh. Available online at http://www.scotland.gov.uk/Publications/2006/03/07090322/0 [Accessed 18 May 2012].Google Scholar
Stonequist, E. 1937. The Marginal Man: A Study in Personality and Culture Conflict. Russell and Russell, New York.Google Scholar
Twigg, J. 2000. Bathing – The Body and Community Care. Routledge, London.Google Scholar
Twigg, J. 2006. The Body in Health and Social Care. Palgrave Macmillan, Basingstoke, UK.Google Scholar
Twigg, J., Wolkowitz, C., Cohen, R. and Nettleton, S. 2011. Conceptualising body work in health and social care. Sociology of Health & Illness, 33, 2, 171–88.Google Scholar
Vanlaere, L., Coucke, T. and Gastmans, C. 2010. Experiental learning of empathy in a care-ethics lab. Nursing Ethics, 17, 3, 325–36.Google Scholar
Widding Isaksen, L. 2002. Toward a sociology of (gendered) disgust: images of bodily decay and the social organization of care work. Journal of Family Issues, 23, 7, 791–811.Google Scholar