‘The body does not forget- DMP in dementia care’

‘The body does not forget- DMP in dementia care’ Setting a new pattern of possibilities while building bridges of understanding in and through the ‘lived’ body… ‘Hands’ by Rodin

The Territory Living to the full Independently and Interdependently De Kooning, Untitled

The Problem ? Dementia Syndrome (Main) Alzheimer’s Type Vascular Type Lewy-Body  Essentially about living with disability e.g. Memory loss, Communication difficulties, Behaviour problems, Social isolation, impaired cognition +

“I am living with dementia, I am not dying of dementia’Peter AshleyAlzheimer’s Society Ambassador

My main message The body does not forget (except perhaps in end stage) therefore go by way of the body if cognition is impaired  What does that mean?

Focusing on embodied practices including movement and dance because  We are working with remaining potential  Dementia closely associated with stasis “Being Slow” “Being Lost” “Being a Blank” A Phinney (2003) ‘The Lived body in dementia’

Movement and the experience of the body moving are at the core of our life’s experience of being ‘in’ and ‘connected to’ our world

Building Bridges between… Soma Psyche Sense Non-sense Not-yet-known Known Feeling Thinking ‘Bridge of Sighs’ Venice Meaningless Meaningful

Respect & Trust & Fun Finding “ways in” The triggers  Helping release that which remains (ADL) Examples ‘Embodied Selfhood’ Kontos Body (person) in Relationship   Working with Metaphor & Symbolism Life-Story (POAL)    Movement Music Dance Song Reminiscence ‘Sense of adventure’ Understanding ‘difference’ & otherness’

‘Hybrid of art of dance & science of psychology adapted to human service’ (Goodill, 2005) Embodied / phenomenological / bio-psychosocial Used as treatment in remedial rather than curative sense Focus on residual capacity rather than disability Supports improvisatory nature of person’s response to condition Offers important skills & techniques for supporting ‘Personhood’ & new possibilities for caring Dance Movement Psychotherapy

‘In psychotherapy old wounds are healed, hidden conflicts resolved, and unfulfilled potential brought out. Hence life becomes more satisfying, secure and productive.’ (Kitwood, 1990:43)

DMP Skills & Techniques • Helping locate the triggers – ‘ways in to furthering relationship’ (Therapeutic Movement Relationship) • Body action • Using Reciprocity (Mirroring) • Rhythmic group activity • Repetition & Validation • Re-membering (‘Personhood’) • Working with Metaphor & Symbolism

Identifying ways to connect • ‘Creatively Alert’ (Coaten) • ‘Poetic Awareness’ (Kitwood) • ‘High Quality Free Floating Attention’ (Kitwood) • ‘Selfhood as…embodied dimension of human existence’ (Kontos) therefore go by way of the body where cognition is impaired • Working with embodied/non-verbal + cognitive • Accepting ‘Otherness’ & ‘Difference’ as unique to person rather than exception

Benefits of the work • Person with dementia helped to come to terms with the condition • Same for carer & family & circle • Movement relationship means continual adaptation to changing needs, behaviours, communications as condition progresses • ‘Movement as life’ (‘embodied selfhood’) is well supported • Help with developing coping strategies

Warm-up / Beginning • Welcoming participants (music) • Checking hands (temperature) • Hand-washing • Reaching/tapping/stretching/stroking • Opening up the body - all senses • Names & shapes • Moving together in a circle

Development Ideas / Middle • Follow-my-Leader Dance • Passing shapes/movements around circle • Elastic circle • Use a theme • Rhythmic movement & dance • Movement/dance improvisation/movt. conversations • Use of objects supporting recovery of memories • Work towards a sharing / celebration

Closure Ideas / End • Passing a hand-squeeze around circle • Shoulder massage (given by staff) • Singing a song to close • Hand-massage (hand-cream?) • Asking what people enjoyed the most? • Identifying music/ideas for next time • Thanking everyone for coming

Props / Resources • CD player / Laptop • CDs or I tunes selection (wide variety) • 1940s Big Band/ World Music/Dance Music • Wide selection of props (scarves/elastic/hats/musical Instruments/cloths/chinese ribbon sticks) • A bag to store the props in Slide 9 Slide 9

Reminders: • GIVE PRAISE • IMPORTANCE OF REPETITION • SUPPORT INDIVIDUAL CONTRIBUTIONS • DEVELOP A FLOW BETWEEN ACTIVITIES • HAVE FUN / PLAYFUL / CHILDLIKE • WORK IN PAIRS NOT SOLO • USE LIFE-STORY TO INFORM WORK • PLAN, PREPARE & DE-BRIEF / REVIEW WELL

Finally… The fragility of life and living processes are intimately bound up with the beauty of the body in movement. The dance helps bring us back from ‘Being lost’, ‘Being a blank’ and ‘Being slow’, celebrating life to the full; appreciating the riches of our deep and abiding humanity, in spite of great loss and great fragility. How to encourage ‘Rementing’ is therefore the real challenge that the dementing condition presents us with.

‘The body does not forget- DMP in dementia care’