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Animated Edition - Spring 2009
Perfect partners?
Leonie Haines, Community Dance Artist on her developing practice with older people

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Image: Old and Young. Photo: Tepic

When first asked if l might like to write for Animated, it was suggested l talk about my "developing practice". I was interested, flattered and daunted but most of all l was not entirely sure what I was being asking for. When offered the clarification "write about what excites you about what you do", l knew l would have plenty to say.

I have always loved dancing and have always felt particularly excited by, and committed to the power and value of community dance. I have worked as a community dance artist/practitioner, in a variety of guises, for the majority of the last twenty years. A detour into the world of Occupational Therapy, (l trained in the late 1990's and have worked in mental health services for older people for the past three years), has brought me to a point of career convergence. I now find myself fascinated and very excited about the contribution that dance has to make to the health and wellbeing of older people who find themselves in the health and/or social care system, in particular older people with dementia.

Whilst not wishing to start sounding like an academic text book, l would like to describe briefly some of the wider issues that impact on older people in health care settings because they have influenced my thoughts about this area of work and have served as an impetus and motivator for the development of my practice.

Despite much progress and greater awareness, older people who find themselves within the health  service remain vulnerable to experiencing discriminatory systems and practices that diminish and disempower. Mental illness adds additional stigma and prejudice and the condition of dementia itself, (which often comes under the remit of mental health services), sprinkles on top of this mix, unhelpful assumptions of hopelessness and despair.

There is no question that dementia is a devastating condition that leaves a person struggling to make sense of the world around them, having to work ever harder to continue to feel connected to it and part of it. However the day-to-day experience of dementia is much more negative than it needs to be, thanks to this web of negative assumptions and expectations weaving together, and unintentionally creating unsupportive environments that do little to help a person with dementia flourish and make the best of the situation they find themselves in.

However, it is not all doom and gloom. There is a slow revolution taking place within dementia care. One that recognises that incurable does not mean untreatable. One that is re-focusing on the person rather than the illness and acknowledges that attention to the emotional and social life of a person with dementia can have a significantly positive impact on their overall wellbeing and this is where my career convergence began. As an Occupational Therapist I see the negative effects that current established cultures and environments can have on the spirit, confidence and self-belief. As a dancer l have come to believe that dance has a role to play in this revolution with regard to the recovery and restoration of wellbeing and it is this that motivates me to explore and develop this area of my practice.

Dance is an excellent partner for a person with dementia. It plays to their strengths and does not dwell on their weaknesses. It negates the need for complex thinking or verbal dexterity and instead goes to work through the senses - tactile, kinesthetic, visual, and aural. It gives a new language, offering opportunities for expression and communication that go beyond words, and can help draw a person out from their inner world, to re-connect with themselves and with the world around them - even if only for short while, it offers a balance against many hours of isolation and under-stimulation. An Alzheimer's Society study in 2007 found that a resident in a care home on average receives two minutes of social interaction every 6 hours.

A dance session within a dementia care setting is rarely predictable. Sometimes a playful and celebratory, shared group experience and other times a quieter series of individual moments of connection through movement, interspersed with sleep or distraction. Each individual will bring something different. Some days they may be able to share with the group and other days you might have to go further into their individual world to find a connection.

Music is integral. It often works as the initial stimulus, bridging the gap between hours of solitary chair sitting and coming to a place where movement can be explored and enjoyed as part of a group or individually. Dance and music in combination can trigger memories and stories that help the label of dementia fall away and instead reveal a person in the context of a lifetime of experience. Triggered memories can also help to connect the past with the present and create tangible evidence of achievement and legacy.

The fact that dance can meet emotional and social needs as well as the more obvious physical ones redresses the heavily physical focus of many health care/residential settings, allowing a person with dementia to feel more integrated, more balanced and more complete as a person. Exploring the potential of dance and people with dementia is a journey of discovery for me. It is a new and developing part of the work that l do. It is often challenging. People with dementia can be difficult to engage.

Problems with understanding and verbal communication; the daily, if not hourly variability of the condition made it hard to know quite where, or how to start in the beginning. Sometimes l lose my way, not sure if the session has been a 'success' or not, not really sure how to define success, in this context, but with every diversion comes reflection and l learn a little more! Other sessions bring magic moments of connection, of expression, of absorption in moving, a smile and laughter and l am re-motivated all over again.

I wonder what my Occupational Therapy experience has brought to the party? Would l have this interest and conviction without that perspective? It has given me more depth to my practice and probably given me more confidence to explore this area. Does it also give me credibility in the eyes of others? I enjoy having a foot in both camps as it were, and remain excited and increasingly convinced that dance within dementia care has the potential to do, for this most marginalised of groups, what dance does best; enable, empower, include, validate and celebrate.

Anna Karpf, recently wrote a piece in The Guardian, (Dec 2008), about the care of people with dementia which she entitled "People who are losing their past still deserve a future". I think dance has a big contribution to make to the quality of that future.

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Animated: Spring 2009