Social scientists at The University of Nottingham have come up with a novel way of publicising new research into the role of unqualified healthcare assistants in the hospital care of people with dementia.
They have commissioned a new play by Nottingham-based theatre company ‘Meeting Ground’ as a way of making their findings more accessible to a wide range of people, within the healthcare sector and beyond.
The researchers hope that the play’s messages could help inform future policy towards the training of hospital and care home staff involved in looking after those with dementia. The play has been workshopped this week, and an excerpt will be performed at the Nottingham Playhouse on Friday 22 July to an invited audience from the worlds of theatre, health and academia.
One person in four over the age of 80 is likely to develop dementia which is seen as the greatest single challenge for the health and social care sector. The condition has a major impact on how health services across the world prioritise their budgets, especially with an increasing aging population. In the UK, the number of people with dementia will double to 1.4 million by 2040.
The play commissioned by the researchers is called ‘Inside Out of Mind’. It has been written by actor/playwright Tanya Myers and is directed by Stephen Lowe using a cast of professional actors including the leading film and television actor Maurice Roeves. It focuses on seven patients and their carers and in it, Tanya Myers draws on her personal experiences of dementia, which affected her mother-in-law. She has also used the highly detailed and extensive field notes made by the team of social scientists from the University, led by Professor of mental health and social care, Justine Schneider.
Professor Schneider said: “We wanted Tanya to use our research and its extensive field notes taken in dementia wards as a ‘seed’ to inspire a play about dementia and the caring environment. Our academic study set out to examine the role and function of healthcare assistants (HCAs) who are traditionally low-paid with little or no formal training. The aim was to understand their job, what motivates them and what makes a good carer in relation to the modern ‘ideal’ of ‘person-centred’ dementia care. I think Tanya has managed to create a remarkable and original piece of theatre with genuine echoes of our observations in every character and scene.”
Tanya Myers said: “When my mother-in-law was losing her cognitive self, this ignited profound curiosity: What is memory, what is identity? Layers upon layers of her memories, like an onion, peeled away revealing intact moments. She became increasingly preoccupied with these emotionally-charged moments. Was this an effect of trauma? She was driven by a need to keep retelling these stories. I think the birth of character - in terms of writing, is not only a cerebral process; it comes from the heart, finds meaning through relationships; the essence of drama. My aspiration is that this play will raise awareness and help to dispel fear in regards to dementia.”
Artistic Director of Meeting Ground Theatre and playwright, Dr. Stephen Lowe added: “Tanya’s work on this extraordinary play was inspired by her close contact and support for my own mother in her final days. She has brought the same compassion and insight to her writing as she shared with Minnie- to whom the play is dedicated. I am proud to be part of the team realising her vision. When I was presented with the original work research it seemed to be the perfect inspiration to begin to look at a world of people, staff and patients, who are locked away 'inside/out of mind'.
The University research was originally funded by the National Institute for Health Research Service Delivery and Organisation programme. It took the form of ‘participant observation’ by three researchers who worked for four months as part-time, supernumerary HCAs in three dementia care wards within one mental health Trust. Regular staff were aware of the research being carried out and many spoke directly about their role to the researchers, who also conducted individual interviews with staff and focus groups with family carers of people with dementia, as well as ‘mapping’ techniques which analysed the logistics of dementia care on the ward.
The research found that health care assistants are in reality skilled workers who make a distinctive contribution to the care experienced by patients with dementia and whose capabilities directly affect the quality of that care. This has implications for acute, as well as specialist, hospital provision and may also be applicable to residential and nursing home settings where health care assistants make up the vast majority of staff.
The research also identified nine areas which it recommends should be examined by the NHS in re-evaluating the role of health care assistants in dementia care in the UK. The issues raised have important implications for managers of HCAs for the planning and development of the workforce, and for the implementation of the NHS Constitution staff pledges.
‘Inside Out of Mind’ by Tanya Myers will be the focus of a new Managed Innovation Network in the University’s Institute of Mental Health. The Network aims to promote the play’s future production as part of the dissemination of the research. The theatre workshop has been funded by the Institute as well as the Nottinghamshire Healthcare NHS Trust and Collaboration for Leadership in Applied Health Research and Care - Nottinghamshire, Derbyshire and Lincolnshire (CLAHRC-NDL).
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