With a few lines on a piece of paper Hans Holbein created pictures which, 500 years later, still convey the characters of living people. I wouldn’t have dreamed that it was possible to achieve that with a sewing machine. But Georgie Meadows can do it. The inspiration for her Stitched Drawings comes from her work as an OT with elderly people with dementia. She says she doesn’t feel she has total control over a picture. It’s a bit like dementia: a sewn line shows a forlorn old man’s sagging shoulders; loose threads illustrate the disordered hair of an old lady; another elderly lady struggles to get a pair of trousers up her husband’s spindly legs.
Most of us fear dementia, for our families and friends, and for ourselves. As doctors, many of us find patients with dementia difficult – they are hard to communicate with, hard to warm to, hard to help. But even if we escape the shadow of dementia in our personal lives, it is our job and will be an increasing burden to our ageing society.
It is difficult enough to remember that people with dementia still have something to offer us, the able-brained, let alone to know how to reach it. So much of modern everyday life calls for the capabilities which dementia takes away, and most of us are better at helping people with worn-out knees than worn-out brains.
Georgie Meadows’ drawings evoke our compassionate instincts. And she has found a way to harness the urge to help. Go to Monmouth on Thursday afternoons and join her weekly Tea Dance: many people there have dementia, but far from all. Elderly people who are lonely, housewives looking for social exercise, teenagers, children, anyone is welcome. As the short film, ‘Thursday Afternoons’, which accompanies her exhibition, shows, everyone is enjoying themselves. People whose brains fail them when asked about what they had for breakfast remember the dances they learned when they were young. Some can even pick up new steps.
And dancing means physical contact. If you haven’t had a hug for years, what could be nicer than to foxtrot round the floor in someone’s arms – which offer support so the tottery don’t fall. And even in a wheelchair you can still dance with your arms.
Visiting a dementing relative in a care home can be grim. How much better to accompany granny to the tea dance and see her come alive again, for youngsters to find she isn’t so frightening, for middle-aged sons and daughters to realise that they and their frail parent can still share pleasures.
Singing, like dancing, is a rewarding social activity which calls on patterns of behaviour laid down in our deep memory banks. Play the Hallelujah Chorus in a care home and a surprising number of residents will be roused from their twilight world to join in. Or try them with ‘The White Cliffs of Dover’. Or ‘Yellow Submarine’. ‘Singing for the Brain’ is an Alzheimer’s Society initiative which does with singing what Georgie Meadows does with dancing. And drawing can unlock memories, too. Should we be concerned that schools don’t demand rote learning these days? Will we have fewer memories to draw on when we need them?
Dementia cafes, another venture to provide normal, social activities for people with dementia and for their carers, and a source of advice, help and support for all, started in UK in Farnborough in 2000. Now there is probably one near you.
Physical activity, music, shared experiences, make us all feel calmer, less anxious, more in control. They relieve boredom and give us a place in the community. So it seems common sense that people with dementia should benefit (though no studies have yet been done to prove it). But activities need to be the intellectual equivalent of tai chi: looking for what the person can still do rather than demoralizing them by exposing what they can’t. As Georgie Meadows points out, routine and continuity are important. People and events which come and go just make confusion worse. The Monmouth Tea Dances have been a regular fixture since 2006.
No-one pretends that these ventures are the whole answer to the increasing burden of dementia. But they may mitigate, at least somewhat, the pitiful wailing and the awful restlessness of the old lady in the corner of the care home lounge. A different model is a purpose-built village for people with dementia, with staff playing the role of shopkeepers, publicans, hairdressers. There are dementia villages in Holland and Switzerland. You may object to the deceit, but people who live in ‘Dementiaville’ seem a lot happier than those confined to the average EMI home.
Can a million people be trained into friendship? Last month, the government and Alzheimer’s Society launched a campaign to recruit that number of Dementia Friends. My first reaction was to shrink from the idea of manufacturing emotion. Is mass awareness really going to make a difference? It won’t help the severely affected; they need professional care. But Dementia Friends has worked in Japan. An elderly man at Tesco’s checkout is searching helplessly for – he doesn’t remember what. If the cashier can recognise that he probably has early dementia, and knows how to help him, and how to deal with impatient customers in the queue, she will be helping everyone.
If dementia gets you down, look at the stitched drawings. They will restore your compassion.
‘Stitched Drawings’ and ‘Thursday Afternoons’ can be seen on line at the Wellcome Collection, and at the Royal United Hospital, Bath, from 17th January to 28th March 2013. For further venues contact the Wellcome Collection. ‘Thursday Afternoons’ is also available on the website of Cromwell Films.
Judith Harvey was a research scientist, ran the VSO programme in Papua New Guinea and taught in a Liverpool comprehensive school before going to medical school. She has been a partner, a salaried GP and a locum and an LMC chair. She started a charity which for nine years enabled medical students to go to Cuba for their electives.
Judith is a long-time supporter of NASGP and has been providing regular articles for The Sessional GP for over 12 years, her reflections ranging widely on practical, ethical and cultural aspects of health and medicine.
Judith has now published all her articles from the NASGP website as a new book Perspectives: A GP reflects on medical practice and, well, just about everything…