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McMahon K, Clark IN, Stensæth K, Wosch T, Odell Miller H, Bukowska A, Baker FA. A qualitative systematic review of the experiences of sharing music for people living with dementia and their family care partners: the thread of connection. Arts Health 2023; 15:229-256. [PMID: 36224535 DOI: 10.1080/17533015.2022.2128381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 09/01/2022] [Accepted: 09/14/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND There is a global need for interventions that support the wellbeing of people living with dementia and their family care partners. Studies show that shared musical activities may achieve this. Our systematic review aimed to synthesise existing research exploring dyads' experiences of shared musical activities across a range of contexts. METHOD From 31 October 2020 we searched PubMed, PsycInfo, CINAHL Complete, EMBASE, RILM, Web of Science Core Collection, Google Scholar and ProQuest Dissertations & Theses for studies published up to 14 April 2021, and hand searched five music therapy journals plus citation lists. Thirteen qualitative studies reporting on dyads' experiences and perspectives of shared musical activities across a range of settings were included. Studies with mixed populations or mixed modality interventions were excluded. We analysed the final studies using thematic synthesis, engaging in reflective discussions and reflexivity throughout. The quality of included studies was assessed using the CASP qualitative checklist. This study is registered on PROSPERO: CRD42020169360. RESULTS Six themes were identified from 13 studies: 1) shared musical activities support wellbeing for people living with dementia, 2) music groups become ecological systems, 3) shared musical activities are experienced differently over time, 4) shared musical activities are experienced by me and as we, 5) music is a supportive structure, and 6) the thread of connection (an overarching theme). A GRADE-CERQual assessment found moderate to high confidence in these findings. Findings informed the development of the Contextual Connection Model of Health Musicking. CONCLUSION Shared musical activities foster experiences of connection for people living with dementia and their family care partners. Experiences of connection are supported through professional facilitation and the structural aspects of music, and are influenced by the setting and changes over time. These experiences of connection play a central role in supporting dyadic and individual wellbeing. These findings are largely relevant to a western cultural context; future research should seek to include more diverse cultural experiences.
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Affiliation(s)
- Kate McMahon
- Faculty of Fine Arts & Music University of Melbourne, Melbourne, Victoria, Australia
| | - Imogen N Clark
- Faculty of Fine Arts & Music University of Melbourne, Melbourne, Victoria, Australia
| | - Karette Stensæth
- Centre for Music and Health Norwegian Academy of Music, Oslo, Norway
| | - Thomas Wosch
- Institute for Applied Social Sciences, University of Applied Sciences Würzburg-Schweinfurt, Würzburg, Germany
| | - Helen Odell Miller
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
| | - Anna Bukowska
- Department of Occupational Therapy, University School of Physical Education, Krakow, Poland
| | - Felicity A Baker
- Centre for Research in Music and Health, Norwegian Academy of Music, Oslo, Norway
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Fletcher JR. Cognitivism ageing: The Alzheimer conundrum as switched ontology & the potential for a new materialist dementia. J Aging Stud 2023; 66:101155. [PMID: 37704273 DOI: 10.1016/j.jaging.2023.101155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 04/08/2023] [Accepted: 06/18/2023] [Indexed: 09/15/2023]
Abstract
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.
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Affiliation(s)
- James Rupert Fletcher
- Wellcome Fellow, Department of Sociology, University of Manchester, 3rd Floor, Arthur Lewis Building, Oxford Road, Manchester M13 9PL, UK.
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3
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Villar F, Westerhof GJ. A conversational, small-story approach to narrative care for people with dementia living in care institutions: Strategies and challenges. J Aging Stud 2023; 64:101105. [PMID: 36868619 DOI: 10.1016/j.jaging.2023.101105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 01/11/2023] [Accepted: 01/17/2023] [Indexed: 01/25/2023]
Abstract
The aim of the paper was to define what narrative care is and identify and discuss everyday conversational narrative care strategies regarding people living with dementia in long-term care institutional settings. To do so, we differentiate between two approaches to narrative care: a big-story approach (reflecting on life stories) and a small-story approach (enacting stories in everyday conservations). The paper is focused on the second approach, which appears to be particularly fit to be used with people living with dementia. We identify three main strategies to implement this approach in everyday care: (1) prompting and sustaining narratives; (2) valuing non-verbal and embodied cues; and (3) constructing narrative environments. Finally, we discuss some training, institutional and cultural barriers and challenges for providing conversational, small story-based narrative care for people living with dementia in long-term care institutions.
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Affiliation(s)
- Feliciano Villar
- Departament of Cognition, Development and Educational Psychology, University of Barcelona, Passeig de la Vall d'Hebron 171, 08035 Barcelona, Spain..
| | - Gerben J Westerhof
- Department of Psychology, Health and Technology, University of Twente, Drienerlolaan 5, 7522 NB Enschede, The Netherlands.
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van der Byl Williams M, Zeilig H. Broadening and deepening the understanding of agency in dementia. MEDICAL HUMANITIES 2023; 49:38-47. [PMID: 35817558 DOI: 10.1136/medhum-2022-012387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/10/2022] [Indexed: 06/15/2023]
Abstract
Agency has become an essential component of discussions concerning selfhood, well-being, and care in dementia studies but the concept itself is rarely clearly defined and the use of this term can be confusing and conflicting. This paper outlines some of the key ways in which agency has been conceptualised in relation to dementia, highlighting the complexities surrounding this concept and focusing on agency in a way that is tied to our ideas about citizenship, legal and human rights. Seven key dimensions of agency are examined: embodiment, emotions, sense of agency, intentional conscious action, the social context of agency, decision-making and moral responsibility. Using a critical realist approach, this paper brings together the diverse ways in which agency has been understood into an interdisciplinary, laminated understanding of agency. This model is then used in an applied example demonstrating that this model can be used to identify the ways in which an arts intervention can support the agency of people living with dementia. This paper proposes that agency is layered, multidimensional and exists on a continuum.
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Affiliation(s)
- Millie van der Byl Williams
- London College of Fashion, University of the Arts London, London, UK
- Dementia Research Centre, University College London, London, UK
| | - Hannah Zeilig
- London College of Fashion, University of the Arts London, London, UK
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5
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Choral singing and dementia: Exploring musicality as embodied and relational accomplishment. J Aging Stud 2022; 63:101077. [DOI: 10.1016/j.jaging.2022.101077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/30/2022] [Accepted: 10/06/2022] [Indexed: 12/05/2022]
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Just and inclusive end-of-life decision-making for long-term care home residents with dementia: a qualitative study protocol. BMC Palliat Care 2022; 21:202. [PMID: 36419147 PMCID: PMC9684772 DOI: 10.1186/s12904-022-01097-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 11/04/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Many people living with dementia eventually require care services and spend the remainder of their lives in long-term care (LTC) homes. Yet, many residents with dementia do not receive coordinated, quality palliative care. The stigma associated with dementia leads to an assumption that people living in the advanced stages of dementia are unable to express their end-of-life needs. As a result, people with dementia have fewer choices and limited access to palliative care. The purpose of this paper is to describe the protocol for a qualitative study that explores end-of-life decision-making processes for LTC home residents with dementia. METHODS/DESIGN This study is informed by two theoretical concepts. First, it draws on a relational model of citizenship. The model recognizes the pre-reflective dimensions of agency as fundamental to being human (irrespective of cognitive impairment) and thereby necessitates that we cultivate an environment that supports these dimensions. This study also draws from Smith's critical feminist lens to foreground the influence of gender relations in decision-making processes towards palliative care goals for people with dementia and reveal the discursive mediums of power that legitimize and sanction social relations. This study employs a critical ethnographic methodology. Through data collection strategies of interview, observation, and document review, this study examines decision-making for LTC home residents with dementia and their paid (LTC home workers) and unpaid (family members) care partners. DISCUSSION This research will expose the embedded structures and organizational factors that shape relationships and interactions in decision-making. This study may reveal new ways to promote equitable decision-making towards palliative care goals for LTC home residents with dementia and their care partners and help to improve their access to palliative care.
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Abstract
Although friendship is vital in later life, particularly amongst people who are living with dementia, little is known about how friendships are sustained following a diagnosis. Some research suggests that, because of dementia-related stigma, friendships dissolve following diagnosis; however, other researchers have shown that friendships can persist in dementia. The purpose of this article is to explore strategies that people with dementia and their friends (i.e., those who have been friends for at least 2 years) utilize to sustain their friendships. Following a constructivist approach, we interviewed people living with dementia, friends, and family members to better understand how friendships are maintained after a diagnosis of dementia. Data were analyzed using thematic analysis. An overarching theme, adapting to change, was generated. Participants adapted in several ways, including: (1) prioritizing friendship, (2) shifting ways of thinking about our friend/ship, and (3) addressing changes through practical strategies. These strategies helped maintain mutually beneficial, reciprocal friendships that were able to withstand changes that accompany a diagnosis of dementia.
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Affiliation(s)
- M Rebecca Genoe
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, Saskatchewan
| | - Darla Fortune
- Department of Applied Human Sciences, Faculty of Arts and Sciences, Concordia University, Montreal, Quebec
| | - Colleen Whyte
- Department of Recreation and Leisure Studies, Brock University, Saint Catharines, Ontario
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O'Connor D, Sakamoto M, Seetharaman K, Chaudhury H, Phinney A. Conceptualizing citizenship in dementia: A scoping review of the literature. DEMENTIA 2022; 21:2310-2350. [PMID: 35768395 PMCID: PMC9483710 DOI: 10.1177/14713012221111014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Citizenship has provided an important conceptual framework in dementia research
and practice over the past fifteen years. To date, there has been no attempt to
synthesize the multiple perspectives that have arisen in this literature. The
purpose of this paper is to explore, reflect on, and contrast, the key concepts
and trends in the citizenship discourse as it relates to people with dementia.
Using a scoping review methodology, forty-nine articles were identified for
review. Despite the use of different descriptors, thematic analysis revealed
four core themes underpinning citizenship discourse: 1) the relationality of
citizenship; 2) facilitated agency and autonomy; 3) attention to stigma,
discrimination and exclusion; and 4) recognition of the possibilities of
identity and growth. Overall, this scoping review found a major emphasis on
expanding definitions of agency and autonomy to render citizenship unconditional
and inclusive of the diverse life experiences of people living with dementia.
Notably, there is recognition that a more intersectional lens for embedding the
subjective experience within a broader socio-political context is needed. Whilst
the adoption of a citizenship lens in dementia research and practice has had
real-world implications for policy and research, its exploration and use
continue to be led by academics, highlighting the importance that future
research involve input form people with dementia.
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Affiliation(s)
- Deborah O'Connor
- School of Social Work, 8166University of British Columbia, Vancouver, BC, Canada
| | - Mariko Sakamoto
- Centre for Research on Personhood in Dementia, 8166University of British Columbia, Vancouver, BC, Canada
| | - Kishore Seetharaman
- Department of Gerontology, 1763Simon Fraser University, Vancouver, BC, Canada
| | - Habib Chaudhury
- Department of Gerontology, 1763Simon Fraser University, Vancouver, BC, Canada
| | - Alison Phinney
- School of Nursing, 8166University of British Columbia, Vancouver, BC, Canada
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Hackett K, Sabat SR, Giovannetti T. A person-centered framework for designing music-based therapeutic studies in dementia: current barriers and a path forward. Aging Ment Health 2022; 26:940-949. [PMID: 34139133 PMCID: PMC8678363 DOI: 10.1080/13607863.2021.1931029] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objectives: Music-based interventions have received growing attention to improve quality of life for people diagnosed with dementia. Results of randomized controlled trials and meta-analytic reviews to date, however, reveal a lack of conclusive evidence for or against the effectiveness of such interventions. Herein, we critically review the basic assumptions and methodological issues ingrained in the cultures of research and care as they relate to evaluating music-based treatments for people with dementia, and propose a shift in the methodology by which music interventions are empirically evaluated.Method: We begin by reviewing existing barriers to achieving clarity on the effectiveness of music interventions, and we highlight methodological and sociocultural constraints that have limited our ability to reach concrete conclusions in research studies to-date. We then consider several key factors that have demonstrated relevance in matching people to specific music-based interventions. Based on these key factors, we developed a person-centered framework integrating elements from precision-medicine methodology to guide intervention studies.Results: Our organizing framework systematically integrates the following factors to inform the design of intervention studies: 1) person-centered goals and desired outcomes; 2) differences among individuals in clinical, cognitive, and historical attributes; and 3) the context of intervention and access to resources.Conclusion: Integration of the proposed framework into empirical investigations of music interventions for people living with dementia will inform precise and tailored interventions that will bring clarity to this growing body of research. Another aim of this framework is to foster a more humane, person-centered approach to our culture of care.
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Affiliation(s)
| | - Steven R. Sabat
- Department of Psychology, Georgetown University, Washington, DC, USA
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10
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Gray J, Donnelly H, Gibson BE. Seriously Foolish and Foolishly Serious: The Art and Practice of Clowning in Children's Rehabilitation. THE JOURNAL OF MEDICAL HUMANITIES 2021; 42:453-469. [PMID: 31332591 DOI: 10.1007/s10912-019-09570-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
This paper interrogates and reclaims clown practices in children's rehabilitation as 'foolish.' Attempts to legitimize and 'take seriously' clown practices in the health sciences frame the work of clowns as secondary to the 'real' work of medical professionals and diminish the ways clowns support emotional vulnerability and bravery with a willingness to fail and be ridiculous as fundamental to their work. Narrow conceptualizations of clown practices in hospitals as only happy and funny overlook the ways clowns also routinely engage with sadness, despair, discomfort and many other ways of being and doing. Our exploration of clown practices as foolish exposes the ways children's rehabilitation upholds particular neoliberal models of success and invites a re-centring of rehabilitation and health care research and practice towards relationship building, supporting meaningful projects and a continued nurturing of aesthetic and pleasurable ways of being-in-the-world in the present moment as valuable unto themselves.
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Affiliation(s)
- Julia Gray
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON, M4G 1R8, Canada.
| | - Helen Donnelly
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON, M4G 1R8, Canada
| | - Barbara E Gibson
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON, M4G 1R8, Canada
- Department of Physical Therapy, University of Toronto, Toronto, Canada
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11
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Motta-Ochoa R, Incio Serra N, Frantz A, Blain-Moraes S. Enacting agency: movement, dementia, and interaction. Arts Health 2021; 14:133-148. [PMID: 33651673 DOI: 10.1080/17533015.2021.1894464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background: Arts-based programs can counter the dominant narrative of loss associated with dementia, in part through fostering expressions of agency. This study uses social science theories of interaction between structure and agency to examine how an arts-based movement program, entitled Mouvement de passage, supports agency among individuals with dementia. Methods: Ethnographic methods were used to trace how participants enact agency within the structure of the movement program. The program's sessions were video recorded and iteratively analyzed. Results: Participants expressed their agency in three ways: 1) transforming the exercise's structure according to individual interests and desires; 2) resisting the exercise's structure; and 3) improvising movements collectively. Conclusions: The movements of individuals with dementia were shaped by both program structure and individual/collective expressions of agency. The design of Mouvement de passage, based on open-ended structures and voluntary participation, provides a template for developing interventions that foster agency among these persons.
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Affiliation(s)
- Rossio Motta-Ochoa
- School of Physical & Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Quebec.,Biosignal Interaction and Personhood Technology (BIAPT) Lab, Montreal General Hospital, Montreal, Quebec
| | - Natalia Incio Serra
- School of Physical & Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Quebec.,Biosignal Interaction and Personhood Technology (BIAPT) Lab, Montreal General Hospital, Montreal, Quebec
| | - Allison Frantz
- Biosignal Interaction and Personhood Technology (BIAPT) Lab, Montreal General Hospital, Montreal, Quebec.,Biosignal Interaction and Personhood Technology (BIAPT) Lab, Montreal General Hospital Integrated Program in Neuroscience, McGill University, Montreal, Quebec
| | - Stefanie Blain-Moraes
- School of Physical & Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Quebec.,Biosignal Interaction and Personhood Technology (BIAPT) Lab, Montreal General Hospital, Montreal, Quebec
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12
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Jeong JM. Co-creative Affordance: Rethinking "Beyond Loss" in Dementia through Co-dwelling. Med Anthropol 2020; 40:35-49. [PMID: 32568563 DOI: 10.1080/01459740.2020.1768252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Based on a decade of voluntary work and a year of intensive ethnographic fieldwork in an orthodox Jewish care home in London, I demonstrate the ways in which an individual's loss of cognition, language and memory is challenged, rethought and facilitated in everyday life. Drawing on Ingold's idea of dwelling, I examine how loss is constantly negotiated and distributed in ways of becoming that are radically contingent, profoundly relational and potentially generative during an art activity in the context of co-dwelling. I refer to this as dementia-becoming. I suggest a more inclusive understanding of loss as a way of life, constitutive of life, and appreciated as a potential co-creative affordance.
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Affiliation(s)
- Jong-Min Jeong
- Department of Social Anthropology, University of Manchester, Manchester, UK
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13
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Dassa A, Harel D. People with dementia as ‘spect-actors’ in a musical theatre group with performing arts students from the community. ARTS IN PSYCHOTHERAPY 2019. [DOI: 10.1016/j.aip.2019.101592] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Andrews G, Duff C. Understanding the vital emergence and expression of aging: How matter comes to matter in gerontology's posthumanist turn. J Aging Stud 2019; 49:46-55. [DOI: 10.1016/j.jaging.2019.04.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 04/11/2019] [Accepted: 04/18/2019] [Indexed: 11/24/2022]
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Grigorovich A, Kontos P, Kontos AP. The "Violent Resident": A Critical Exploration of the Ethics of Resident-to-Resident Aggression. JOURNAL OF BIOETHICAL INQUIRY 2019; 16:173-183. [PMID: 30741393 DOI: 10.1007/s11673-019-09898-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 01/14/2019] [Indexed: 06/09/2023]
Abstract
Resident-to-resident aggression is quite prevalent in long-term care settings. Within popular and empirical accounts, this form of aggression is most commonly attributed to the actions of an aberrant individual living with dementia characterized as the "violent resident." It is often a medical diagnosis of dementia that is highlighted as the ultimate cause of aggression. This neglects the fact that acts of aggression are influenced by broader structural conditions. This has ethical implications in that the emphasis on individual aberration informs public policy strategies for prevention with a focus on restricting the freedom of individuals using behavioural modification, drugs, or other restraints with the intent to protect others from harm. A more ethical approach requires attention to the structural conditions of long-term care that both foster aggression and constrain prevention efforts. To this end, we turn to a model of relational citizenship that offers a theory of embodied selfhood and relationality as essential to human dignity, thus entailing human rights protections. The application of an ethic based on this model offers a more holistic prevention strategy for resident-to-resident aggression by drawing attention to the critical need and obligation to promote human flourishing through system level efforts.
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Affiliation(s)
- Alisa Grigorovich
- Toronto Rehabilitation Institute-University Health Network, 550 University Ave, Toronto, ON, M5G 2A2, Canada.
| | - Pia Kontos
- Toronto Rehabilitation Institute-University Health Network, 550 University Ave, Toronto, ON, M5G 2A2, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Alexis P Kontos
- Department of Justice Canada, 284 Wellington Street, Ottawa, ON, K1A 0H8, Canada
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Andrews GJ, Duff C. Matter beginning to matter: On posthumanist understandings of the vital emergence of health. Soc Sci Med 2019; 226:123-134. [DOI: 10.1016/j.socscimed.2019.02.045] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 02/03/2019] [Accepted: 02/25/2019] [Indexed: 11/29/2022]
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Abstract
AbstractThis paper seeks to understand the engagement of people with dementia in creative and arts-based activities by applying a relational model of citizenship and incorporating concepts of contextual and embodied learning from adult learning theory. A theoretically driven secondary analysis of observational and interview data focuses on the engagement of staff, volunteers and people with dementia during an arts-based intervention in a day centre and care home. The processes through which learning is co-constructed between the person with dementia, staff/volunteer facilitators and peers in the group to co-produce a creative engaged experience involves: increasing confidence for learning, facilitating social and physical connections, and affirming creative self-expression. The role of facilitator is central to the process of creative engagement to reinforce a sense of agency amongst participants and recognise people's prior experiences of learning and engagement in creative activities. People with dementia continue to learn and grow through engagement in creative activities to produce positive outcomes for the individual participants and for the care staff who observe and participate in this creativity. Facilitating creativity requires attention to lifelong experiences of learning in addition to the immediate interactional context to integrate arts-based interventions in dementia care successfully.
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18
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Skinner MW, Herron RV, Bar RJ, Kontos P, Menec V. Improving social inclusion for people with dementia and carers through sharing dance: a qualitative sequential continuum of care pilot study protocol. BMJ Open 2018; 8:e026912. [PMID: 30498050 PMCID: PMC6278785 DOI: 10.1136/bmjopen-2018-026912] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION This study examines the potential of dance to improve social inclusion for people living with dementia and carers. Research suggests that arts-based programmes can improve the health of people living with dementia and carers; however, little is known about how these programmes might address barriers to social inclusion. Addressing barriers requires the development and evaluation of accessible, non-stigmatising and affordable programmes that facilitate social inclusion across the continuum of institutional, community and household care settings. METHODS AND ANALYSIS The study involves a qualitative sequential pilot study of the innovative Baycrest NBS Sharing Dance Seniors programme underway in non-metropolitan regions of two Canadian provinces. It focuses on the remotely instructed delivery of the programme in care facilities, community centres and households. The study involves five phases of observations, diaries, focus groups and interviews with programme participants (people living with dementia), carers, coordinators, instructors and volunteers as well as critical reflections among research investigators and knowledge users. NVivo-based thematic and narrative analyses of the qualitative data will produce new knowledge about the experiences, effectiveness and challenges of the dance programme that will inform understanding of whether and in what ways it increases social inclusion and quality of life for older people living with dementia and carers. The findings will identify opportunities for programme expansion and support the further development of arts-based approaches. ETHICS AND DISSEMINATION The study is approved by the Research Ethics Boards at Trent University and Brandon University, and by participating organisations according to their governance procedures. The perspectives of people living with dementia and carers are incorporated throughout the study (from design to dissemination) and the study adheres to the ethical considerations when including people with dementia. A series of publicly available reports, seminars and symposia will be undertaken in collaboration with knowledge user and collaborating organisation partners.
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Affiliation(s)
- Mark W Skinner
- Trent School of the Environment, Trent University, Peterborough, Ontario, Canada
| | - Rachel V Herron
- Department of Geography, Brandon University, Brandon, Manitoba, Canada
| | - Rachel J Bar
- Canada's National Ballet School and Department of Psychology, Ryerson University, Toronto, Ontario, Canada
| | - Pia Kontos
- Toronto Rehabilitation Institute - University Health Network, Toronto, Ontario, Canada
| | - Verena Menec
- Community Health Sciences, University of Manitoba, Winnipeg, Winnipeg, Canada
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Kontos P, Grigorovich A. Integrating Citizenship, Embodiment, and Relationality: Towards a Reconceptualization of Dance and Dementia in Long-Term Care. THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2018; 46:717-723. [PMID: 30336101 DOI: 10.1177/1073110518804233] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Dance, as aesthetic self-expression, is a unique arts-based program that combines the physical benefits of exercise with psychosocial therapeutic benefits. While dance has also been shown to support empowerment, meaningful self-expression, and pleasurable experience, it is rarely adopted to support these aspects of engagement in the context of dementia care. The instrumental reduction of dance to its application as a therapeutic tool can be traced to the contemporary movement towards cognitive science with an emphasis on embodied cognition. This has effectively elided a consideration of how the body itself, separate and apart from cognition, could be a source of intelligibility, inventiveness, and creativity. We argue for the need to broaden the therapeutic model of dance to more fully support embodied and creative self-expression by persons living with dementia. To achieve this, we explore how a relational model of citizenship that recognizes corporeality and relationality as fundamental to human existence brings a new and critical dimension to understanding the importance of dance in the context of dementia. Drawing on this model, we articulate a new kind of ethic characterized by a pre-reflective intercorporeal sensibility that requires the mobilization of public structures and practices to cultivate a relational environment for individuals living with dementia that supports human flourishing.
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Affiliation(s)
- Pia Kontos
- Pia Kontos has a Ph.D. in Public Health Sciences (University of Toronto, Toronto, Ontario, Canada), and is a Senior Scientist at the Toronto Rehabilitation Institute - University Health Network and Associate Professor in the Dalla Lana School of Public Health, University of Toronto. She is a critical scholar committed to the transformation of long-term dementia care so it is more humanistic and socially just. She draws on the arts (e.g., music, dance, improvisational play) to enrich the lives of people living with dementia. She also creates research-based dramas to effect personal and organizational change. She has published across multiple disciplines on embodiment, relationality, ethics, and dementia. Alisa Grigorovich has a Ph.D. in Gender, Feminist & Women's Studies (York University, Toronto, Ontario, Canada) and is a postdoctoral fellow in the Dalla Lana School of Public Health at the University of Toronto. Her research focuses on the organization of care, health equity and ethics, with a focus on sexuality and dementia. In her postdoctoral research she is exploring the management of sexuality in long-term residential care
| | - Alisa Grigorovich
- Pia Kontos has a Ph.D. in Public Health Sciences (University of Toronto, Toronto, Ontario, Canada), and is a Senior Scientist at the Toronto Rehabilitation Institute - University Health Network and Associate Professor in the Dalla Lana School of Public Health, University of Toronto. She is a critical scholar committed to the transformation of long-term dementia care so it is more humanistic and socially just. She draws on the arts (e.g., music, dance, improvisational play) to enrich the lives of people living with dementia. She also creates research-based dramas to effect personal and organizational change. She has published across multiple disciplines on embodiment, relationality, ethics, and dementia. Alisa Grigorovich has a Ph.D. in Gender, Feminist & Women's Studies (York University, Toronto, Ontario, Canada) and is a postdoctoral fellow in the Dalla Lana School of Public Health at the University of Toronto. Her research focuses on the organization of care, health equity and ethics, with a focus on sexuality and dementia. In her postdoctoral research she is exploring the management of sexuality in long-term residential care
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Kontos P, Grigorovich A, Dupuis S, Jonas-Simpson C, Mitchell G, Gray J. Raising the curtain on stigma associated with dementia: fostering a new cultural imaginary for a more inclusive society. CRITICAL PUBLIC HEALTH 2018. [DOI: 10.1080/09581596.2018.1508822] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Pia Kontos
- Toronto Rehabilitation Institute - University Health Network, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Alisa Grigorovich
- Toronto Rehabilitation Institute - University Health Network, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Sherry Dupuis
- Department of Recreation & Leisure Studies, University of Waterloo, Waterloo, Canada
- Partnerships in Dementia Care Alliance, University of Waterloo, Waterloo, Canada
| | - Christine Jonas-Simpson
- School of Nursing, York University, Toronto, Canada
- Dotsa Bitove Wellness Academy, Toronto, Canada
| | | | - Julia Gray
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
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