Dementia care
You’ve recently written a book about relationships in dementia care. In your role as a psychodynamic psychotherapist, how have your experiences shaped your perception on how social workers can build meaningful relationships with adults affected by dementia? Over time, I have seen first-hand how important the relationship between a social worker and person with dementia can be – and also with family members. There has to be an openness and curiosity as a starting point. Making assumptions around best interests for a person with dementia can lead to a shutting down of relationships. Often the work, particularly in my field in palliative care, is about how to support a person’s sense of self when life is feeling increasingly precarious. Sometimes, that might mean that a professional becomes an auxiliary mind for someone with dementia, but this has to be based on an attuned understanding and knowledge of a person; not a sort of imagined construct. It’s also about tapping into pockets of knowledge which may be held in different places within multidisciplinary teams and families. It is about having a sense of life history and becoming as responsive to
Building meaningful relationships in dementia care
emotional need as we are to pragmatic need.
Following the publication of her latest book, ‘Holding Time: Human Need and Relationships in Dementia Care’, Dr Esther Ramsay-Jones talks to us about the importance of relationship-centred care. Using her professional and personal experience, she shares insights into how social workers can make a positive impact on those affected by dementia.
a policy-practice gap that professionals are trying to
Beyond this, I think we often talk about choice and control, at least in UK dementia care policy, but this is often embedded in a relational context; people make choices in conjunction with others who are in their network of support. Sometimes a social worker might the only person in that network, which is why attentive listening can make all the difference. There is also the reality that, when service provision is threadbare in certain areas, choice is invariably limited so there is work with. This may result in letting people down which subsequently makes relating very difficult.
You have first-hand, personal experience of dementia – was it hard writing a book that had such close connotations? It’s often the case that in professional encounters with people we are relating to at a somewhat intimate level, emotions can be stirred up by individuals who may remind us of people who have been part of our lives. In part, this is impossible to avoid since our minds hold memories, histories and textured emotional landscapes. I began working in dementia care partially because my grandmother lived with Alzheimer’s for some time; and of course, some of the people I have worked with have reminded me of her and what she experienced.
Read Dr Esther Ramsay-Jones’ book Holding Time: Human Need and Relationships in Dementia Care by Dr Esther Ramsay-Jones, Free Association Books, £14.99 (September 2019) Buy online at freeassociationpublishing.com
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Working within the field and writing about it has not been easy at times; not simply because of personal experience, but because bearing witness to people’s gradual decline and increasing levels of dependency can be painful. Sometimes we underestimate the impact of being alongside moments like these.
