Yesterday I went to see a play Inside out of Mind. Based on a dementia admissions ward it told the story of staff and patients. It captured the chaos, noise and unpredictability of the ward as well as the emotional and physical demands of caring for people with dementia.
We saw how staff formed close bonds with patients and cared deeply about them but were challenged by some of their behaviour which clearly upset and confused patients. I was upset by one scene where staff and patients sat together wearing witches hast for a ward Halloween party – well-intentioned, but please don’t do it to me if I end up on your ward!
It was evident in the performance that not only patients but staff become institutionalised. In response to a question “Where do you go for help?” one of the characters - a ward sister- says “We keep it all inside”.
But this play is not fictional, it is based on research conducted on dementia wards. Justine Schneider was commissioned by the UK National Institute for Health Research to carry out an overt participant observation study of health care assistants caring for people with dementia.
The researchers worked as supernumerary HCAs in three wards for people with dementia and behavioural problems.
Commissioned to inform policy and workforce planning, I expect the final report could, like countless others, have sat on a shelf gathering dust. Justine tried to organise feedback sessions for staff once the report was completed but the attendance was poor.
She wanted to find a different way to communicate what she had observed to others. So she approached a theatre company to write a play based on the transcripts. Her hope is that Inside Out of Mind “will help people to understand that dementia care is not easy, wherever it is provided, and that the people who do it well deserve our admiration and respect”.
I watched the play with an audience of HCAs from three trusts in Nottinghamshire who were visibly moved by the performance. The trusts had arranged for staff to see the play and attend workshops to discuss the issues that arise.
I am not claiming this one play could change the face of dementia care but as part of a strategy to educate staff across large organisations it appears to be a refreshing and exciting approach.
I am fascinated by the collaboration between researchers, NHS trusts and the arts working together as a way of helping staff to walk in the shoes of people with dementia. It has also helped outsiders like me walk in the shoes of healthcare assistants.
For more information about “Inside Out of Mind” visit www.lakesidearts.org.uk.