Resilience and Ageing

Creativity, Culture and Community

Goulding, Anna, Davenport, Bruce

• Publisher: Policy Press
• Year: 2018
• ISBN:
  9781447340959
• Topic: Sozialwissenschaften
• Subtopic: Gerontologie

Understanding how creative interventions can help develop social connectivity and resilience for older people is vital in developing a holistic cross-sector approach towards ageing well. Academics with a wide range of expertise critically reflect on how the built environment, community living, cultural participation, lifelong learning, and artist-led interventions encourage older people to thrive and overcome both challenging life events and the everyday changes associated with ageing. The book uses a range of approaches, including participatory research methods, to bring the voices of older people themselves to the foreground. It looks at how taking part in creative interventions develops different types of social relationships and fosters resilience.

FOUR

Narrative identity and resilience for people in later life with dementia living in care homes: the role of visual arts enrichment activities

Andrew Newman, Bruce Davenport and Teri Howson-Griffiths

Editorial introduction

This chapter is based on data from a large-scale, mixed methods project wherein groups of people with dementia were invited to take part in visual arts activities. The project generated a wide range of data, but this chapter takes a fine-grained approach to analysing the qualitative data from the project. Through this the authors explore the narrative processes and identity work that were evoked through the activities. These are considered from the perspective of resilience to explore how such activities might contribute to the resilience of people with dementia.

Introduction

This chapter explores how visual arts enrichment activities might play a role in the resilience of people in later life living with dementia in care homes, through the development or preservation of narrative identities. This complements previous work on the role of arts enrichment activities in the resilience of older people with dementia (Newman et al, 2018) that originated from the results of the same research project, entitled Dementia and Imagination.1 That paper concluded that arts enrichment activities support resilience in the domains of creative expression, communication and self-esteem and through their effects on carers and family members. This chapter differs in that it explores the role that the arts enrichment activities might have in supporting narrative agency and expression, and how that might facilitate resilience in older people living with dementia (Randall, 2013). This is viewed as a way through which the personhood of a person living with dementia might be supported or enhanced (Kitwood and Bredin, 1992; Kitwood, 1997). The wider contribution is that the work provides an understanding of the potential of narrative care, where ‘people make sense of their experiences, and indeed their identity, through the creation and sharing of stories’ (Villar and Serrat, 2017, p 44) to improve the lives of people in later life with dementia.

The Dementia and Imagination project examined how arts enrichment activities2 might improve the lives of people in later life living with dementia in different settings. The research was funded by the UK Arts and Humanities Research Council’s Connected Communities Programme3 and the UK Economic and Social Research Council4 (reference AH/J011029/1) and was undertaken between 2013 and 2017.

This chapter begins with the proposition that ‘the biographical side of human life is as intricate and dynamic and as critical to consider as, say, the biological side. […] We are continually constructing stories about our lives, stories that reflect a combination of genetic predisposition, past experience and personal choice’ (Kenyon and Randall, 2015, p 143). However, it might be expected that the nature of dementia, with its associated memory problems and sometimes language difficulties, would mean that constructing a narrative using textual language would be challenging. In response to this, visual arts enrichment activities have the potential to encourage the use of embodied forms of communication, such as those that involve ‘primordial and sociocultural characteristics of the body that reside below the threshold of cognition’ (Kontos, 2005, p 559). While not explicitly concerned with ‘illness narratives’ (Bolaki, 2017), the examples discussed in this chapter do, at times, suggest a ‘changing sense of self and identity’ (Woods, 2011, p 73) that may or may not be recognised by the individual (in particular see the discussion of participant ND34, later in the chapter). Nevertheless, the approach ‘valu[es] the individual as the empowered author-narrator of her own story’ (Woods, 2011, p 73), despite some of the difficulties that, by the nature of their dementia, exist.

This chapter aims to examine how, and the extent to which, resilience in older people with dementia may be facilitated through narrative identities, and the extent to which visual arts enrichment activities may support this. We present the theoretical framework used to support the analysis, followed by a description of the methodology, analysis, results, discussion and conclusion.

Theoretical framework

Narrative and narrative inquiry

The lack of precision about how the terms narrative and narrative inquiry are used means that it is difficult to produce a categorical definition. As is noted by Phoenix et al (2010, p 2), ‘it is difficult to give a single definition of narrative, or draw a precise boundary around its meaning. In part, this is because it means different things to different people and is used in a variety of ways by different disciplines’. Riessman (2008, p 11) defines it as ‘a family of methods for interpreting texts that have in common a storied form’ and these texts can be oral, written or visual. None the less, Mishler (1995) suggests that narrative inquiry can be divided into a number of areas for consideration. Those relevant for this study are:

• representation – temporal sequence of events;

• linguistic and narrative strategies;

• cultural, social and psychological contexts and functions of stories; and

• narrative and culture, myths, rituals and performance.

Narrative and resilience

The approach to resilience adopted in this chapter follows Windle (2011, p 152), who defines it as ‘the process of effectively negotiating, adapting to, or managing significant sources of stress or trauma. Assets and resources within the individual, their life and environment facilitate this capacity for adaptation and “bouncing back” in the face of adversity. Across the life course, the experience of resilience will vary’. Links between narrative and resilience are traced through the narrative construction of identity. ‘[Identity] is a life story. A life story is a personal myth that an individual begins working on in late adolescence and young adulthood in order to provide his or her life with a purpose’ (McAdams, 1993, p 5). This is supported by Singer (2004, p 445), who states that ‘individuals’ ongoing sense of self in contemporary Western society coheres around a narrative structure, which casts the individual as a protagonist in a lifelong journey’. Randall (2013, p 9) then makes links with resilience, stating, ‘resilience itself has a narrative dimension. It’s a function of narrative openness, I propose. It’s a function of a good strong story, a story of oneself and one’s world.’ A strong story might be described as one that has complexity and the resources that allow the person to respond to the narrative challenges they encounter. In a similar vein, Staudinger, Marsiske and Baltes (1995, p 818) suggested that ‘having access to a larger set of well-developed possible selves may be a protective factor as we confront and manage growing old’, acting as a resource for resilience. These authors also emphasise the importance of hobbies and activities, described as identity projects, as important in the construction of self and, so, resilience. Also of importance is autobiographical reasoning, which is described by Pasupathi and Mansour (2006, p 798) as how people construct a ‘sense of unity across their lives by creating connections between their experiences and self-views’; they also report that the tendency to undertake this increases with age.

The suggestion that resilient older adults will story their lives in particular ways, being ‘more detailed and complex in nature – so to speak stronger overall’, is explored by Randall et al (2015, p 155). These authors used the Connor Davidson Resilience Scale (Connor and Davidson, 2003) to score resilience in 116 community-dwelling older adults. The results showed that the highest scorers had interests and hobbies or ‘identity projects’, a ‘sense of narrative agency’ and a degree of ‘narrative openness’ (Connor and Davidson, 2003, p 157). The lowest scorers demonstrated ‘negative or unresolved memories of their childhood’ and were ‘generally less optimistic’ and they appeared to have ‘low self-esteem’ (Connor and Davidson, 2003, p 159). Randall et al (2015, p 156) suggested that ‘narrative identity continues all life long, ageing being no exception’ and that the challenges that older people face can ‘constitute challenges to our very sense of self’.

A possible threat to the resilience of people in later life is ‘narrative foreclosure’, where narrative identity development may falter (Freeman, 2011), implying ‘that one already knows the ending of one’s life. No other alternative endings are considered as realistic’ (Bohlmeijer et al, 2011, p 365). This situation also shapes the ways that a life narrative is constructed as it becomes static, with a future predestined (Bohlmeijer et al, 2011).

Dubovska et al (2016, p 10) identified a number of thematic lines used by a group of older people in their narrative construction of resilience. These were:

• interest in life;

• ability to take pleasure from life;

• enjoyment of small pleasures;

• liking to learn new things;

• liking contact with young people;

• emphasis on importance of movement;

• love of life, and;

• good social relations.

These are used later in the chapter as a way of understanding the autobiographical narrative that resident respondents provided during the interviews.

Narrative identity and dementia

Caddell and Claire (2010, p 121) found that ‘most people in the moderate and severe stages of dementia were able, at least to some degree, to construct a narrative which consisted of autobiographical memories’ and that this process enabled them to preserve aspects of their self, and so identity. However, Hyden and Orulv (2009, p 206) ‘found that persons with this diagnosis have problems telling stories on the topics suggested, and that they needed much interactional support in order to produce a narrative which was less chronologically organised’. These authors also identify that there has been little analysis of spontaneously produced narratives around a self-selected topic, and this is viewed as problematic, as stories are produced in direct relation to their audience. People do not tell their stories in isolation, and ‘if a dementia sufferer is to sustain his or her part in the social world other people, with their corresponding expectations and performances are required’ (Kitwood, 1993, p 53). The role of others in the co-production of life stories might be seen as a potentially important contributory factor in the preservation of personhood of persons with dementia (Baldwin, 2008).

This study utilises Baldwin’s (2008, p 225) approach to the form and content of stories, which states that ‘stories can be articulated, for example, as much through dance, movement and artistic expression as they can though language – if we as readers are sensitive enough to the narrative features of such media’. In focusing on arts enrichment activities for those with dementia, this study assumes that narratives can be construct...

Table of contents

• Cover
• Title Page
• Copyright
• Contents
• List of figures, tables and boxes
• Notes on contributors
• Series editors’ foreword
• Introduction
• ONE: Setting the scene: older people’s conceptualisation of resilience and its relationship to cultural engagement
• TWO: Ages and Stages: creative participatory research with older people
• THREE: Social connectivity and creative approaches to dementia care: the case of a poetry intervention
• FOUR: Narrative identity and resilience for people in later life with dementia living in care homes: the role of visual arts enrichment activities
• FIVE: After the earthquake: narratives of resilience, re-signification of fear and revitalisation of local identities in rural communities of Paredones, Chile
• SIX: Integrating sense of place within new housing developments: a community-based participatory research approach
• SEVEN: Ageing in place: creativity and resilience in neighbourhoods
• EIGHT: Crafting resilience for later life
• NINE: Oral histories and lacemaking as strategies for resilience in women’s craft groups
• TEN: Objects of loss: resilience, continuity and learning in material culture relationships
• ELEVEN: Later-life gardening in a retirement community: sites of identity, resilience and creativity