Behind the stiff upper lip: war narratives of older men with dementia.

The concept of the stiff upper lip stands as a cultural metaphor for the repression and figurative ¿biting back¿ of traumatic experience, particularly in military contexts. For men born in the first half of the 20th century, maintaining a stiff upper lip involved the ability to exert high levels of cognitive control over the subjective, visceral and emotional domains of experience. In the most common forms of dementia, which affect at least one in five men now in their 80s and 90s, this cognitive control is increasingly lost. One result is that, with the onset of dementia, men who have in the intervening years maintained a relative silence about their wartime experiences begin to disclose detailed memories of such events, in some cases for the first time. This article draws on narrative biographical data from three men with late-onset dementia who make extensive reference to their experience of war. The narratives of Sid, Leonard and Nelson are used to explore aspects of collective memory of the two World Wars, and the socially constructed masculinities imposed on men who grew up and came of age during those decades. The findings show that in spite of their difficulties with short term memory, people with dementia can contribute rich data to cultural studies research. Some aspects of the narratives discussed here may also be considered to work along the line of the counter-hegemonic, offering insights into lived experiences of war that have been elided in popular culture in the post-War years

StoryCorps Memory Loss Initiative: Enhancing Personhood for Storytellers with Memory Loss

StoryCorps’ Memory Loss Initiative was designed to gather oral histories of people with memory loss. This study investigated the StoryCorps interview experience for storytellers who self identify with early stage memory loss and the persons who interviewed them. StoryCorps interviews took place in Milwaukee, Chicago, and New York. Follow-up interviews were conducted with 42 persons with memory loss, along with 27 family members who participated in the StoryCorps interviews. Results revealed that the StoryCorps experience was a meaningful activity that allowed participants to acknowledge the beauty of the present moment, to reflect and engage in meaningful conversations, to re-affirm both the selfhood of individuals with memory loss and their relationships with family members, and to and be a part of national history while leaving a legacy for future generations within families. The findings are discussed within the context of personhood enhancing strategies for persons with memory loss

Personhood and dementia: revisiting Tom Kitwood's ideas

Person-centred care is often cited as an aim of gerontological nursing and promotion of personhood is said to be the basis for person-centred care. As such, it forms a cornerstone value for many gerontological nurses, particularly those working in dementia care. Tom Kitwood's ideas and definition of personhood are widely referred to in the literature and used in the dementia care field. More recently, there is a move to critique and partially reject Kitwood's ideas on personhood. This paper has three aims: (i) to explore some central ideas around key theories of personhood (ii) to critique Kitwood's work on personhood. (iii) To summarize current critiques of Kitwood's ideas and provide a response that outlines why Kitwoods' ideas are still relevant. It is suggested many critiques ignore Kitwoods' ultimate purpose; that of moral concern for 'others'. However, the main criticism put forward in this paper is that, rather than completely rejecting personhood theories, Kitwood locates his work on what it means to be a person within a traditional Cartesian personhood framework, albeit from a revised or pragmatic viewpoint. Finally, it is suggested that definitions of persons and personhood need to take account of the body and time (corporeality and temporality) and gerontological nursing may want to reassess how much allegiance is given to basing nursing frameworks on the concept of personhood.sch_nur3pub4161pub

Staff-resident interactions in long-term care for people with dementia: the role of meeting psychological needs in achieving residents' well-being.

noObjectives: The aim of this study is to explore the extent to which staff–resident interactions address or undermine residents’ psychological needs and how such interactions are associated with residents’ well-being. Method: Data on staff–resident interactions and residents’ well-being were collected for 51 residents from nine long-term care settings using dementia care mapping (DCM). DCM yields a count and detailed description of staff–resident interactions that either address (personal enhancers – PEs) or undermine (personal detractions – PDs) residents’ psychological needs, and every 5-minute scores for each resident's mood and engagement (ME-value). The relationship between PEs and PDs and well-being was analysed by studying residents’ ME-values before and three time frames after a PE or PD occurred. Results: A total of 76 PEs and 33 PDs were observed. The most common PEs were those addressing psychological needs for comfort and occupation. However residents’ well-being increased most often after PEs that addressed residents’ need for identity, attachment and inclusion. The most common PDs were those which undermined the need for comfort, inclusion and occupation. Residents’ well-being decreased most often after PDs that undermined the need for comfort. Conclusion: Increasing interactions which address residents’ need for attachment, identity and inclusion and eliminating interactions which undermine residents’ need for comfort may be particularly important in achieving residents’ well-being. In the long run, residents’ well-being could be achieved by staff availing of the opportunities to empower and facilitate residents, thus meeting their needs for occupation. These findings provide directions for training in person-centred care