Clothing and dementia: A neglected dimension?

Personhood as projection: the value of multiple conceptions of personhood for understanding the dehumanisation of people living with dementia

We examine the concept of personhood in relation to people living with dementia and implications for the humanity of care, drawing on a body of ethnographic work. Much debate has searched for an adequate account of the person for these purposes. Broad contrasts can be made between accounts focusing on cognition and mental faculties, and accounts focusing on embodied and relational aspects of the person. Some have suggested the concept of the person is critical for good care; others suggest the vexed debates mean that the concept should be abandoned. We argue instead that the competing accounts illuminate the very tensions in personhood which are manifest for all of us, but especially for people living with dementia, and argue that our account has explanatory power in shedding light on how precisely dehumanisation and constraints on agency may arise for people living with dementia, and for staff, within an institutional context.

Clothing the Clown: Creative Dressing in a Day-center for People with Dementia in the Netherlands

Creatief met clowns is a creative and art-based workshop for people living with dementia that invites participants to join in a collaborative process of creating an outfit and clothing a clown. In this article, I look at what happened in workshop sessions and how this mattered to those involved, including what participants with dementia valued about the activity - by listening to what they had to say, but also by attending to their performative, creative and affective ways of engaging in Creatief met Clowns. To further articulate values that came up in practice, I analyzed my findings in terms of the quality of psychosocial relations, the role of embodiment, material aspects, and playfulness in person-centered care. By combining an ethnographic study of art-based care-practice with a value-sensitive theoretical reflection on empirical findings, my approach offers an alternative to problematic efforts to quantify the value of art in person-centered dementia care.

Cognitivism ageing: The Alzheimer conundrum as switched ontology & the potential for a new materialist dementia

Following recent regulatory approvals for anti-Alzheimer's monoclonal antibodies, this paper considers the contemporary role of cognitivism in defining the ontological commitments of dementia research, as well as movements away from cognitivism under the umbrella of 4E cognitive science. 4E cognitive theories, extending cognition into bodies, their environs, and active relations between the two, share potentially fruitful affinities with new materialisms which focus on the co-constitution of matter in intra-action. These semi-overlapping conceptual positions furnish some opportunity for an ontological alternative to longstanding cognitivist commitments, particularly to the isolated brain as a material catalyst for commercial interventions. After outlining mainstream cognitivism and its shortcomings, I explore 4E and new materialism as possibly transformative conceptual schemas for dementia research, a field for which cognitivist imaginings of cognitive decline in later life have profound and often regrettable ramifications. To realise this new materialist dementia, I sketch out a cognitive ontology based on Barad's agential realism. This facilitates a reassessment of the biggest conundrum in dementia research - the lack of neat correlation between (apparently material) neuropathology and (apparently immaterial) cognitive impairment - alongside the continued failure of efforts to develop effective interventions. It also gives social researchers working on cognitive decline in later life an opportunity to reappraise the nature of social science as a response to such phenomena. If cognition and cognitive ageing are reimagined as an emergent characteristic of intra-acting matter, then new materialist social science might be at least as conducive to salutogenic interventions as the neuropsychiatric technoscience that dominates the contemporary dementia research economy despite continual failures. I argue that a new materialist cognitive ontology could help us think beyond an ageing cognitivism and, by extension, beyond the Alzheimer conundrum.

Situational expectations and surveillance in families affected by dementia: organising uncertainties of ageing and cognition

Recent political processes have rendered people with dementia an increasingly surveilled population. Surveillance is a contentious issue within dementia research, spanning technological monitoring, biomarker research and epidemiological data gathering. This paper explores surveillance in the relationships of people affected by dementia, how older relatives both with and without diagnoses are surveilled in everyday interactions, and the importance of expectations in guiding surveillance. This paper presents data from 41 in-depth interviews with people affected by dementia living in the community in the United Kingdom. Agedness was a key contributor to expectations that a person may have dementia, based on previous experiences, media accounts and wider awareness. Expectations provoked surveillance in interactions, with participants looking for signs of dementia when interacting with older relatives. Older people also enacted self-surveillance, monitoring their own behaviour. Various actions could be attributed to dementia because interpretation is malleable, partly vindicating expectations while leaving some uncertainties. Expectant surveillance transformed people's experiences because they organised their own actions, and interpreted those of others, in line with pre-existing meanings. The ability to interpret behaviours to fit expectations can bring coherence to uncertainties of ageing, cognition and dementia, but risks ascribing dementia to many older people who straddle those uncertainties.

Presentation of the clothed self on the hospital ward: an ethnographic account of perceptual attention and implications for the personhood of people living with dementia

This study contributes to our understanding of the 'medical gaze' and its impact on the ways in which people living with dementia experience care during a hospital admission. Visual perception has a powerful effect on our emotional and moral reactions to others. One aspect of how we perceive and respond to others is through clothing, which relates strongly to class and social position. Our focus is on exploring the ways in which patient clothing may affect the perceptions and response of others, and self-perception and resulting behaviour. We draw on ethnographic research within acute hospital wards in five hospitals across England and Wales, examining the everyday organisation and delivery of care to people living with dementia. People living with dementia are a significant population who have poor experiences and outcomes of care within the acute setting. Our data suggest that the twin aspects of clothing and appearance-of self-perception, and of perception by others-may be especially important in the fast-paced context of an acute ward environment, where patients living with dementia may be struggling with the impacts of an additional acute medical condition within in a highly timetabled, regimented, and unfamiliar environment of the ward, and where staff perceptions of them may feed into clinical assessments of their condition and subsequent treatment and discharge pathways.

A Narrative Care approach for persons living with dementia in institutional care settings

AIMS AND OBJECTIVES

We will provide insights in the theoretical background and key concepts of a Narrative Care approach, such as narrative cultures, narrative curiosity, narrative co-composition and narrative reflective practice.

BACKGROUND

Care understood as narrative practice underscores the importance of experiences and how these shape identities. Important to the quality of care in institutional care settings is the ability of care providers to cope with complexities and uncertainties in older adults' stories, which can be realised by attending to ways that foster and co-compose evolving and forward-looking narratives. Recognising these ongoing co-compositions means that persons living in institutional care settings and care providers live, tell, retell and relive their experiences. A change in the current institutional culture is necessary to implement care as narrative practice. To support such a change, approaches are needed that foster a focus on experiences and relationships and make relational ethics central to care.

METHODS

The proposed Narrative Care approach is the result of an iterative development process involving a literature review, interviews with, and observations of, care providers, dialogues with an advisory committee, and consultation with experts.

MAIN CONTRIBUTIONS

The proposed Narrative Care approach aims to help care providers (a) to recognise the importance of curiosity in a person's verbal and embodied narratives-especially for those living with dementia; (b) to take note of individual experiences in all of their complexity and uncertainty; (c) to respect these narratives; (d) to open up spaces to co-compose new narratives; and (e) to allow care providers to engage in narrative reflective practices that shape who they are and are becoming.

CONCLUSION

The introduced approach responds to the need of implementing strategies to think and work narratively in institutional care settings.

IMPLICATIONS FOR PRACTICE

Narrative Care has the potential to reshape task-oriented, technical notions of care. Concepts such as embodied narratives, relational ethics, narrative co-composition and narrative reflective practice must be integrated in the education of all care providers.

Wandering as a Sociomaterial Practice: Extending the Theorization of GPS Tracking in Cognitive Impairment

Electronic tracking through global positioning systems (GPSs) is used to monitor people with cognitive impairment who "wander" outside the home. This ethnographic study explored how GPS-monitored wandering was experienced by individuals, lay carers, and professional staff. Seven in-depth case studies revealed that wandering was often an enjoyable and worthwhile activity and helped deal with uncertainty and threats to identity. In what were typically very complex care contexts, GPS devices were useful to the extent that they aligned with a wider sociomaterial care network that included lay carers, call centers, and health and social care professionals. In this context, "safe" wandering was a collaborative accomplishment that depended on the technology's materiality, affordances, and aesthetic properties; a distributed knowledge of the individual and the places they wandered through, and a collective and dynamic interpretation of risk. Implications for design and delivery of GPS devices and services for cognitive impairment are discussed.

Envisioning bodies and architectures of care: Reflections on competition designs for older people

Architects shape future dwellings and built environments in ways that are critical for aging bodies. This article explores how assumptions about aging bodies are made manifest in architectural plans and designs. By analysing entries for an international student competition Caring for Older People (2009), we illustrate the ways in which aged bodies were conceived by future architectural professionals. Through analysing the architectural plans, we can discern the students' expectations and assumptions about aging bodies and embodiment through their use of and reference to spaces, places and things. We analyse the visual and discursive strategies by which aged bodies were represented variously as frail, dependent, healthy, technologically engaged and socially situated in domestic and community settings, and also how architects inscribed ideas about care and embodiment into their proposals. Through our analysis of these data we also attend to the non-representational ways in which design and spatiality may be crucial to the fabrication of embodied practices, atmospheres and affects. We end by reflecting on how configurations and ideologies of care can be reproduced through architectural spaces, and conclude that a dialogue between architecture and sociology has the potential to transform concepts of aging, embodiment and care.

Dressing disrupted: negotiating care through the materiality of dress in the context of dementia

This paper explores how the materiality of dress mediates and shapes practices of care in the context of dementia. Earlier research called for an approach to conceptualising care that recognised the role played by everyday artefacts. We extend this to a consideration of dress and dressing the body in relation to people with dementia that involves the direct manipulation of material objects, as well as the materiality of bodies. The paper draws on an ESRC funded study Dementia and Dress, which examined experiences of dress for people with dementia, families and care-workers using ethnographic and qualitative methods. Our analysis explores the process of dressing the body, the physicality of guiding and manipulating bodies into clothing, dealing with fabrics and bodies which 'act back' and are resistant to the process of dressing. We consider how the materiality of clothing can constrain or enable practices of care, exploring tensions between garments that support ease of dressing and those that sustain identity. Examining negotiations around dress also reveals tensions between competing 'logics' of care (Mol ).

Rethinking musicality in dementia as embodied and relational

With the biomedicalisation and the pharmaceuticalisation of dementia, music programs, as with other arts- and leisure-based programs, have primarily been implemented as non-pharmacological means to generate social and behavioural changes. We argue that understanding and fully supporting the musicality of persons living with dementia requires engagement with citizenship discourse. Specifically we draw on a model of relational citizenship that recognizes that corporeality is a fundamental source of self-expression, interdependence, and reciprocal engagement. We articulate this argument with reference to the musicality of two residents living with dementia in long-term residential care; one example is drawn from an ethnographic study of selfhood in dementia and the other is from a study of elder-clowning. Relational citizenship brings a new and critical dimension to the discourse on music, ageing, and the body in contemporary society. It further highlights the ethical imperative to fully support musicality through institutional policies, structures and practices.

Modernising patient clothing: a Florence Nightingale Foundation project

Christine Fitzgerald, Matron at The Hillingdon Hospitals NHS Foundation Trust (currently on secondment) discusses a project to boost patient self-esteem and dignity through the clothing provided for them to wear.

Residents' engagement in everyday activities and its association with thriving in nursing homes

AIM

To describe the prevalence of everyday activity engagement for older people in nursing homes and the extent to which engagement in everyday activities is associated with thriving.

BACKGROUND

Research into residents' engagement in everyday activities in nursing homes has focused primarily on associations with quality of life and prevention and management of neuropsychiatric symptoms. However, the mere absence of symptoms does not necessarily guarantee experiences of well-being. The concept of thriving encapsulates and explores experiences of well-being in relation to the place where a person lives.

DESIGN

A cross-sectional survey.

METHOD

A national survey of 172 Swedish nursing homes (2013-2014). Resident (n = 4831) symptoms, activities and thriving were assessed by staff using a study survey based on established questionnaires. Descriptive statistics, simple and multiple linear regression, and linear stepwise multiple regression were performed.

RESULTS

The most commonly occurring everyday activities were receiving hugs and physical touch, talking to relatives/friends and receiving visitors, having conversation with staff not related to care and grooming. The least commonly occurring everyday activities were going to the cinema, participating in an educational program, visiting a restaurant and doing everyday chores. Positive associations were found between activity engagement and thriving, where engagement in an activity program, dressing nicely and spending time with someone the resident likes had the strongest positive association with resident thriving.

CONCLUSIONS

Engagement in everyday activities can support personhood and thriving and can be conceptualized and implemented as nursing interventions to enable residents to thrive in nursing homes.

Citizenship, human rights, and dementia: Towards a new embodied relational ethic of sexuality

Sexual citizenship and sexual rights scholarship have made important contributions to broadening citizenship and more fully accommodating rights related to sexuality. However, this scholarship has concentrated primarily on the sexuality and intimacy-related needs of younger people and those who are not cognitively impaired. Consequently, it has inadvertently served to marginalize persons living with dementia who reside in long-term residential care settings. We argue that supporting sexual rights for persons with dementia requires a particular human rights ontology for citizenship-one that recognizes that corporeality is a fundamental source of self-expression, interdependence, and reciprocal engagement. This is an ontology that underpins our model of relational citizenship and that grounds our articulation of an ethic of embodied relational sexuality. In our view, this ethic offers important direction for the development of policy, legislation, and clinical guidelines to support sexual rights for persons with dementia in long-term residential care.

Assembling the salon: Learning from alternative forms of body work in dementia care

This article explores the labour and experiences of a hitherto entirely overlooked section of the dementia care workforce: care-based hairdressers. Reporting on findings from the ESRC-funded 'Hair and Care' project, the analysis and discussion focus upon the 'doing of hair' in the context of dementia care. The authors challenge existing assumptions and approaches to the management of appearance in dementia care, arguing for greater recognition of the subjective and culturally meaningful qualities of a visit to the salon. The article draws upon a wider debate on body work as a framework for the discussion, and considers the employment and working conditions of this largely hidden group of workers in the care system. The article offers an account of the praxis of care-based hairdressing, with particular attention paid to narrative, intercorporeal and place-making practices in the salon, showing how a particular approach to the body shapes the labour, relationships and activities that unfold within it. The authors argue that as an alternative form of body work much can be learned from hairdressing that can inform and enhance the provision of dementia care.

Life story work with persons with dementia in nursing homes: A Grounded Theory study of the perspectives of care staff

In Germany, the use of life story work as an approach to care in nursing homes has not been implemented successfully. Using Grounded Theory, we explored care staff’s understandings of life story work when caring for persons with dementia. Thirty-six staff from seven nursing homes participated in semi-structured interviews or group discussions. In this paper we discuss new aspects and theoretical connections between understandings and practices of life story work. For some participants, obtaining ‘true facts’ about a resident’s course of life was considered the most important topic. Others highlighted the importance of narratives as well as embodied stories told by persons with dementia, as aspects that generated emotionally meaningful situations. Delivering sound life story work can be challenging for care staff working with persons with dementia. To enhance care in nursing homes, the importance of life story work needs to be further developed.

Witnessing a body in decline: Men's and women's perceptions of an altered physical appearance

There has been a tendency within the literature to ignore how men and women who are very ill and at the end of life perceive and experience their visibly altered bodies. This article aims to provide new insights about this matter. A qualitative research approach was adopted. In-depth interviews were conducted with 10 hospice patients, 20 family members, and 20 members of hospice staff. Findings reveal that because of masculine and feminine norms, physical appearance is more a matter of concern to women than to men who are close to death. This contradicts theories that suggest that patients experience a disinvestment on their sense of masculinity and femininity alongside the process of bodily deterioration and decay prior impending potential death.

‘Gonna make yer gorgeous’: Everyday transformation, resistance and belonging in the care-based hair salon

This paper makes a contribution to an emerging debate on dementia and citizenship through a focus on the everyday experiences of women living with dementia and in receipt of care. In particular, a link is drawn between hairdressing and citizenship in the context of dementia care. Informed by a wider debate over the importance of an emplaced, embodied and performative approach to citizenship, the authors highlight the way that intersecting forms of resistance unfold in the salon. The Hair and Care project, as the name implies, focused upon hair care and styling in the context of a wider consideration of appearance and how it is managed and what it means for people living with dementia. With a focus upon the routine, mundane and thereby often unproblematised aspects of everyday life in/with care, the discussion draws together two key ideas concerned with the interplay of power and resistance: Essed’s (1991) theory of ‘everyday discrimination’ and Scott’s (1985) notion of ‘everyday resistance’. The findings illuminate the creative and collective forms of agency exercised by older women living with dementia, in the context of their relationships with one another and with the hairdressers whose services and support inspire their loyalty and patronage. Findings from the study point to the link between (inter-)personal practices of appearance management and a wider set of social conditions that are manifest in the on-going struggle over time, space and bodies in dementia care.

When Actions Speak Louder Than Words: Extending the Reach of Qualitative Data Collecting

Through the lens of a study exploring dementia care partnering, the purpose of this methods article is to focus on the role of artifacts and embodied data in data collection. In addition, it illustrates how to use a range of data collecting methods. The article identifies benefits of additional data collecting methods to research and care. These include the need to expand data collecting methods beyond spoken word, integrate a range of data collecting approaches into research courses across disciplines, increase support of qualitative research, and advocate for greater inclusivity in research. Data collecting approaches can also have implications for quality of life among persons often excluded from research-building endeavors. They can contribute to the unfolding of new findings, which can influence care practices.

Materialising memories: exploring the stories of people with dementia through dress

In this article, we use clothes as a tool for exploring the life stories and narratives of people with dementia, eliciting memories through the sensory and material dimensions of dress. The article draws on an Economic and Social Research Council-funded study, ‘Dementia and Dress’, which explored everyday experiences of clothing for carers, care workers and people with dementia, using qualitative and ethnographic methods including: ‘wardrobe interviews’, observations, and visual and sensory approaches. In our analysis, we use three dimensions of dress as a device for exploring the experiences of people with dementia:kept clothes, as a way of retaining connections to memories and identity;discarded clothes, and their implications for understanding change and loss in relation to the ‘dementia journey’; andabsent clothes, invoked through the sensory imagination, recalling images of former selves, and carrying identity forward into the context of care. The article contributes to understandings of narrative, identity and dementia, drawing attention to the potential of material objects for evoking narratives, and maintaining biographical continuity for both men and women. The paper has larger implications for understandings of ageing and care practice; as well as contributing to the wider Material Turn in gerontology, showing how cultural analyses can be applied even to frail older groups who are often excluded from such approaches.

Dementia, women and sexuality: How the intersection of ageing, gender and sexuality magnify dementia concerns among lesbian and bisexual women

There is a growing appreciation of the significance of socio-cultural context for the experiences of an individual living with dementia. There is, too, an emergent awareness that dementia is a gendered issue, disproportionately affecting women compared with men. However, little attention has been given as yet to the experiences of lesbian and bisexual women living with dementia. This article addresses this gap in knowledge, exploring the significance of the intersection of ageing, gender and sexuality for lesbian and bisexual women with dementia. It suggests that stigma and social marginalisation associated with dementia and with ageing, gender and sexuality intersect to compound the social exclusion of lesbians and bisexual women. This has implications for early diagnosis and treatment. Moreover, community care policy, which is predicated on heterosexist norms fails to take into account older lesbians and bisexual women's support networks and so is less likely to be attuned to their needs. Residential care provision is perceived by older lesbians and bisexual women as being heteronormative at best and homophobic at worst. Services which do not recognise, validate and support their identities will compound their anxiety, confusion and distress. This may be contrary to Equality and Human Rights legislation and UK social policies. This paper draws upon, and analyses, extracts from a range of authorship, synthesising the material to present novel insights into the significance of gender and sexuality for the experience of dementia and dementia care.

'Once I had money in my pocket, I was every colour under the sun': using 'appearance biographies' to explore the meanings of appearance for people with dementia

Appearance and the work invested in it by and for people with dementia are a neglected issue within dementia studies. In policy and practice there exists an assumption that the role of supporting a person to manage their appearance is easily assumed by another within caring encounters, only to be subsumed within the daily task-oriented provision of care. This paper reports on interviews conducted as part of the Hair and Care project, which explored questions of appearance and the meanings it holds with people with dementia. The research used 'appearance biographies', a method which allows for a range of topics to be considered about appearance throughout the life course, acting as a conduit for reminiscence and life story work. The paper reports on the key themes and findings from these interviews, discussing them in the context of a wider debate on dementia, self-expression and agency. A key question posed by the authors is whether appearance and the work invested in it are legitimate considerations for dementia care policy and practice. And if so, how should we make sense of this work and what significance should we attach to it? In seeking to answer these questions the authors position the perspectives and experiences of people with dementia as central to their analysis. A narrative framework is suggested as a useful basis on which to understand the work of managing appearance over the life course. The implications for policy and practice are outlined.

Exploring identity and aging: auto-photography and narratives of low income older adults

This study focused on meanings of health, housing, independence and aging among low-income adults age 55 and older who live in, or are on a waiting list for, publicly subsidized rental housing. The purpose was to learn how low-income older adults perceive their independence and health, and how their place of residence contributes to these perceptions, as well as related perceptions of self. Qualitative data were collected using in-person narrative interviews with 45 individuals and a second photo elicitation interview with 31 of these persons. Themes describe how disrupted identities influence subjective thoughts about the aging process, housing, health, and finances, the process of clinicalization, and place identities. These findings highlight the relationship between housing status, dignity, and shifting identities as older adults experience the aging process in a low-income context. This study expands the current scholarship on the relationship between environment and aging as well as our understanding of poverty among older persons. These topics are relevant for new policies and programs to support the aging in place of older persons in subsidized housing. Understanding the life worlds of those who live in or have applied to this form of housing will be instrumental in developing such strategies.

Family caregivers' perspectives on dementia-related dressing difficulties at home: The preservation of self model

Alzheimer's caregiving literature acknowledges dressing as a major daily stressor but research on this topic is negligible. A qualitative grounded theory approach was used to explore Alzheimer's family caregivers' perspectives about issues that arise when their family members lose the ability to dress independently. Three focus groups and seven individual interviews were conducted and audio recorded with 25 information rich caregivers. Constant comparative analyses and coding of the transcripts identified six major themes leading to a 'Preservation of Self Model: Care Recipient to Care Giver' that portrays the caregiving trajectory. Initially, caregivers tried to protect the self dignity of the family member by maintaining usual routines and absorbing blame for difficulties. Dressing 'battles' occurred and caregivers learned management through trial and error. Crossing adult-child-gender role boundaries escalated discomfort. When facing unrelenting demands, concern shifted to preservation of the caregivers' health and self. Results suggest that caregivers would benefit from more pro-active dressing counseling to shorten the trial and error periods, dressing aids more relevant to dementia and more knowledgeable helpers. The preservation model can facilitate understanding of the caregiving trajectory and guide intervention support.

Sighs, smiles, and worried glances: how the body reveals women caregivers' lived experiences of care to older adults

This article reports on findings from microethnographic research that examined the lived reality of women caregivers through detailed observation of their everyday, embodied experiences. The research, which was rooted in the trend in social gerontology to emphasize subjective experience, focused on five women who were providing care to an older adult with a chronic illness or impairment. Four of the five women were caring for a spouse; one was caring for a parent. Observing the women's daily realities revealed tensions and contradictions between their subjective lived experiences and the pressures of the system in which they were functioning. The data revealed a caregiver habitus characterized by the performance of emotional labor. Performance was visible through dissonance between the caregivers' verbal and nonverbal expressions, and pointed to a high degree of emotion and body management. The women consistently put aside their own needs, in what can be considered a divestment in health capital. There was also evidence of merging between the caregiver and care receiver, made visible through tandem movements. The findings lead to implications for practice and for future aging research, including the benefits of observation for enhancing understanding of clients' experiences.

Embodiment and dementia: exploring critical narratives of selfhood, surveillance, and dementia care

In the last decade there has been a notable increase in efforts to expand understandings of dementia by incorporating the body and theorizing its interrelationship with the larger social order. This emerging subfield of dementia studies puts the body and embodied practices at the center of explorations of how dementia is represented and/or experienced. This shift towards a greater recognition of the way that humans are embodied has expanded the horizon of dementia studies, providing the intellectual and narrative resources to examine experiences of dementia, and their interconnections with history, culture, power, and discourse. Our aim in this paper is to critically explore and review dimensions of this expanding research and literature, specifically in relation to three key narratives: (1) rethinking selfhood: exploring embodied dimensions; (2) surveillance, discipline, and the body in dementia and dementia care; and (3) embodied innovations in dementia care practice. We argue that this literature collectively destabilizes dementia as a taken-for-granted category and has generated critical texts on the interrelationship between the body and social and political processes in the production and expression of dementia.

Dress, dementia and the embodiment of identity

The article explores the significance of dress in the embodied experience of dementia, exploring questions of identity, memory and relationship. It suggests that clothing and dress are important in the analysis of the day-to-day experiences of people with dementia, giving access to dimensions of selfhood often ignored in over-cognitive accounts of being. As a result clothing and dress can be significant to the provision of person-centred dementia care. These arguments are explored through ideas of embodied identity, the materialisation of memories, and the maintenance, or otherwise, of appearance in care. The article forms part of the background to an ESRC-funded empirical study exploring the role of clothing and dress in the everyday lives of people with dementia, living at home or in care homes, and of their relatives.

Mixing methods to explore appearance in dementia care

This paper considers approaches to investigating appearance and the work invested in maintaining it within dementia care. Our focus is upon methodological and methods-related issues associated with the challenge of generating knowledge of the embodied worlds of people with dementia. We begin with a brief overview of the literature on appearance and dementia, and consider what it teaches us about the nature of appearance and ways of understanding it. We describe and discuss the mixing of methods for an on-going investigation into hairdressing in dementia care: The Hair and Care project. Based upon the experience of research in care-based hair salons, we argue for a creative use of methods in dementia studies as an avenue to better engaging with the embodied experiences of people with dementia and, as a result, understanding how people use their bodies and senses to create meaningful worlds.

[Dementia in documentary film: Mum by Adelheid Roosen]

This article draws attention to the fact that documentaries do not simply reproduce the reality that film and audience share but always present a particular view of this reality. This implies that organizations in Alzheimer care, education, and research that often recommend documentaries to inform people about dementia should take into account that these films might reinforce negative stereotypes inducing fear of dementia. An in-depth analysis of the Dutch short documentary Mum, directed by Adelheid Roosen, illustrates that the body of ideas of the personhood movement in dementia research can be translated into an artistic form. By highlighting instead of veiling its means of production, the documentary stimulates viewers to imagine people with dementia as other than lost selves. The original version of this article in The Gerontologist was made available April 26, 2012.

Design and dementia: A case of garments designed to prevent undressing

This article focuses on garments used in care environments. We investigate a patient overall, developed for the care of people with severe memory problems, severe learning difficulties and brain injuries. The aim of the use of a patient overall is to prevent undressing in socially inappropriate situations and/or to stop the user from removing an incontinence pad. This article is based on interviews of designers of medical textiles and patients and family carers in Finland. Both designers and patients found patient overalls to be infantilizing and stigmatizing for the user but accepted the basic functions of the product. We report results of a design project aimed at designing a new type of garment that takes into account the technical requirements but provides a more dignified look and opportunities for activity. We discuss the ethical issues concerning the use of this kind of product in the care of people with dementia.