More of Al Power’s interview on his new book, Dementia Beyond Drugs: Changing the Culture of Care
Q: How has our society’s view of aging created the institutional model of care and what can we do to change it?
A: Society views aging as decline because we are overly preoccupied with what adults can and cannot “do.” We fail to recognize that elderhood is a separate developmental stage, in which the assimilation of experience and perspective into wisdom replaces the busy workday world of younger adults.
As a result of our skewed perspective, we have created institutions that merely try to mitigate decline by medicalizing the aging process and creating a stifling environment that we label “protective.” We do not see the rich tapestry that elders continue to weave, despite illness or frailty. By seeing elders with “new eyes,” we can begin to celebrate and cultivate their gifts rather than simply disempower, isolate, and overmedicate them.
Q: How can we provide care that is more “humanistic” and “enlightened”?
A: There are many examples, as I apply the framework of my model to a variety of care scenarios. But a central humanistic tenet follows Tom Kitwood’s charge that we acknowledge the personhood of each individual and their capacity for growth and engagement through all stages of life, and all stages of dementia.
Here’s an example of how we can be more enlightened: When people in the nursing home “wander,” we used to restrain them, but now we use wander alerts, create circular pathways, use signs on doors and better lighting to create a safer place. We think we have become more enlightened. We haven’t.
I encourage care partners to replace the term “wandering” (suggesting purposeless activity) with “searching,” and then ask, “What are they searching for?” Often it’s some connection, some relationship, something that has personal meaning in an environment that offers none. So by providing the stop signs, circular paths, fenced-in courtyards and alarmed doors, we have merely created a safe place for the person to be lost and searching for the rest of their lives. We’ve missed the larger need.