Friendships between women
Female friendships are heralded as something very special by those lucky enough to have them. Is the desire to 'tend and befriend' really part of a women's DNA? And can female friendships teach us anything about dementia care? Frances writes about her friendship with Sally.
I met my friend Sally, a nun living with vascular dementia in 2007. Within the space of about a couple of months we had developed a very close friendship which began to give us both an enormous amount of pleasure. During the first year or so we regularly prayed together, and whenever possible, went to church together to share in receiving Holy Communion. In addition, time permitting, we also enjoyed sitting out in the garden, having a discussion about almost anything and everything, including the state of the world and the future of religious orders. She was very ambivalent about the latter! She indicated her appreciation of my friendship with her by, on one occasion, making the sign of the cross on her forehead, and on another, describing me as 'the bone of my bone'. Today, although her physical condition and cognitive capacity have deteriorated, she still knows who I am and greatly enjoys my visits to see her. On my last visit she spent the time caressing my arm and one of the support workers who care for her said that, in her view, Sally looked very happy.
During the time I have known Sally I have learned some very important lessons both about myself and the care of people living with dementia. I know that my presence in Sally's life greatly enhances her quality of life. Having seen her as a resident in three different institutions, I know that it is absolutely not enough for staff to provide good physical care alone. What people living with dementia need are members of staff who have the capacity and willingness to develop good, supportive, caring relationships with them as unique people. Dementia is an illness which profoundly threatens the human identity of people with dementia and they need us to remind them of their humanity through our relationships with them. In one institution in which Sally resided, the relational care that she received was so poor that it had a profoundly negative impact on both her physical and mental health. Her protest was reflected in what, I imagine, the staff regarded as her 'challenging behaviour'. After a move to another institution, her physical and mental health improved and although, in terms of her behaviour, she 'had her moments', she became much more settled. About 18 months, later a new manager was appointed and Sally's cognitive capacity increased significantly. This kind of improvement has been referred to as 'rementing' and the premise is that really good relationships can help to recover some of the apparently 'lost' cognitive capacity of the person with dementia. I had, personally, been sceptical of the concept of rementing until I saw it happen before my very eyes. In my view, the quality of her relationship with the new manager has slowed Sally's decline over a period of the last two and a half years.
The other aspect of caring for people with dementia I have learned about is this - that there are many ways to care. I am very conscious that, for informal carers, there a great deal of focus is on the physical care of people with dementia; it is, of course hugely important, but it is not enough on its own. It would be an absolute disaster both for Sally and I for me to provide the physical care she requires. I can only offer my continued love and friendship because, as her informal carer, because I am not burdened by the day to day tasks required in the provision of physical care. In addition, I absolutely appreciate the importance of 'doing' in relationship to the provision of care. However, once there is 'nothing more to be done' what people with dementia require is our quiet, often unspoken, presence in their lives. I visit Sally regularly once a month. During the three and a half hours I am with her I usually sit in silence next to her holding her hand. Sometimes she will wordlessly ask me to have a walk with her. What she wants and what I offer is my quiet presence and it is in the silence that we most effectively communicate who we are to each other. As we are both women of faith, I am sure that God is present with us during my visits.
|Tags: carers, friendship, relationships, spirituality||Written 2014-07-10|