Foucault and Dementia

Why did you choose Foucault as a lens?

I chose Foucault as a lens because he addresses the psycho-social and political aspects of illness and medicine. As each generation manages to deal with different threats of illness, both medical advances and political attitudes focus on the next threat to the population. Currently the world is trying to make sense of the threat both socially and economically that dementia presents. Until recently people with dementia were separated and corralled in care homes, cut off from family and society, left to die. In the same way in the past, lepers, the indigent and the insane met similar fates. The rise of the medical model of treatment is not much use for people with dementia as there are limited treatments and no cure. So it is important that people with dementia are accepted by and encouraged to take part in society as best they can. It is a challenge for civilians and politicians to consider their own values: are human beings with a cognitive disability allowed to have a full life?

In particular: the Panopticon where prisoners are kept stable by the threat of an unseen but all seeing guard resembles some arrangements in care homes. Records of care and daily lives are available for family to read. Care Homes are inspected. If a person with dementia is living at home, an official will visit the client and the carer before any help is given. There are different models of care dependent on how much money the client has.

People with dementia are restricted as to what kind of work or social life they are “allowed” to have. They lose their autonomy, needing a carer with them in order to take part in society.

Dementia has yet to benefit from the “medical gaze”. Actual firm diagnosis can only be given after death when the brain is examined, but people with dementia are subjected to a barrage of tests prior to diagnosis. After diagnosis, people with dementia are encouraged only to go home and tidy up loose ends before they die.

Political will is mainly focused on cure and on the cost to society of dementia. Dementia friends create a them and us situation and to think someone can watch a video for fifteen minutes and be considered a Dementia Friend is ridiculously superficial.

Just as in the past, indigents were separated from society, people with dementia are largely separated from society because its situation is too complex for their safety. I fear this will change only slowly: look at how many public spaces and domestic housing still need to be adapted for wheelchair users for example.

I asked at my local branch of the Bank of Scotland if they had had dementia training: “No, oh, well, I think there are some leaflets in the back office…”

It is all very well to make public servants such as bus drivers aware of dementia, but how does a bus driver deal with both an angry queue and a passenger with dementia? The same may go for supermarket cash desks. Perhaps we will see Dementia friendly signs over one of the supermarket cash desks along with “cash only” “hand baskets only” signs.

Many people are doing sterling work towards a better society for people with dementia and they need support of all kinds if people with dementia are to live the lives they could live.

1941 A young woman’s hopes for the future

“Here’s a fairy tale: One day there will be no war. There will be Time and Peace and Leisure. And there will be Two Young People who will be Very Much in Love, who will be looking for a House which will hold their few but Delightful Possessions. And there will be All Kinds of Pleasant Ploys and there will be no more tensions and wonderings and hurtings. And it’ll be a Great Success and everyone will say “That’s nice.”

A Seaman’s view of London in the blitz

Extract from letter G to D travelling back to training via London

We were at Kings’ Cross by ten. Some of us wanted to go straight to Chatham but George and I dug in our heels , and it was decided to see the Union Jack Club, there to get a bed — and a drink. Now the Union Jack Club is opposite Waterloo Station, so we went into a tube station. I had heard of people sheltering in tubes but, dear me, I’d had no idea what it was really like. Along every corridor and platform there were rows of people stretched out on the most horrible blankets and under the tawdriest wraps (?) — you had hardly room to move down the platform. They were miserably poor folk, dreadfully untidy and uncomfortable looking, and they depressed me terribly. Yet they seemed to be quite happy and were certainly very cheerful. Think of it! Trying to sleep there, fully dressed and between a few tattered blankets, on the dirty floor, the trains roaring past, enormous crowds moving up and down and falling over the sleepers.; and everything suffocatingly hot and stuffy. We felt guilty in our good clothes and our independence and freedom — for most of the adults there had half a dozen children crawling round them.
The train took us as far as Piccadilly Circus and no further — Waterloo line out of action. A fatuous ticket collector told us to get a bus, a saner passer-by told us that the buses weren’t running. None of us knew London well but we had some scraps of knowledge: I had piloted the party through the underground somebody else knew the way from the Strand while Fred knew the way from the Strand to Waterloo, so we thought a careful pooling of our knowledge would take us to the Union Jack, black out or no.
We needn’t have worried about the black-out. It was not as light as day outside but there was not so much difference either. The whole sky was bright with the fires the News is talking about just now; enormous clouds of red-orange smoke hung about everywhere, the streets were lit up as brilliantly as if someone had arranged some gigantic multi-coloured spot-lights. We couldn’t actually see the fires, for there were none in Piccadilly and the buildings round about were pretty high but a solitary balloon hung in the smoke and reflected, in a carnival fashion, the glare below it.
There was no sense of impending doom; the streets were quiet and yet rather gay. The one or two passers-by were cheerful and we set off in high spirits.
Presently we came out into a more open place and the first thing we saw was St Pauls’ surrounded by enormous waves of orange-red smoke and big flames. That gave me a turn, but it was such an extraordinarily fine sight that we were much more excited than scared. The dome stood out beautifully, untouched by the flames while the lesser buildings round about crackled and sparked. This was at Waterloo Bridge; and as we crossed over, we saw fire after fire, all (?) and bouncing-but none of them particularly terrifying. You didn’t get the impression of wide spread devastation that photographs of the dock fires gave you.
I don’t know if the conflagrations had anything to do with it, but it was far and away the hottest, windy night I’ve known. We carried our oil-skins and our heavy coats and our (cares?) and parcels and the lack of buses and panted and sweated like a sheep-dog on a hot day. What a broad river the Thames is! We seemed to take hours to cross the bridge, all lit-up as it was with the fires round about and offering an excellent target, we thought to any planes that might still be lurking above the smoke. We were beginning to be haunted by two fears: that the Union Jack would be full; or that it would be bombed or burnt, for there seemed to be more fires to the South. Half-past eleven saw us there, much too tired to take any further interest in fires and there was room and the building was untouched. We drank large cups of tea, arranged to be called at five, and went to bed in the dark.

Now I know where I get my indecision from

Sunday January 19th 1941

C/o Miss Graham, 60 Hillhead Street, Glasgow W.2.

Gilbert my dear
I’ve tried and so far I just cannot write oftener — look you, here it’s Sunday night again and Part II of last Sunday’s letter still to be written. As it is I haven’t yet finished my Thank You letters for Christmas presents! And I simply cannot compete with your twenty eight pages per week — Monday, Wednesday, and Saturday. Laddie, you leave me gasping, because you must cook and sleep and eat — how in Heaven’s name you achieve all your correspondence too is more than I can guess. I fear I am one of the weaker brethren. Lack of strong mindedness to stop letters too — I should have written several this afternoon, but wrote twelve pages home instead (because my conscience pricked and warned me I’d been up a fortnight and one postcard on arrival didn’t count!) And of course I’ve been utterly occupied with people and things ever since I came up to town — really haven’t time to teach just now.
Like you, I’ve lots of news but I think I’d better answer your three last letters first and then we’ll be verging on getting up to date. Or won’t we? If I sort these ones out and then there’s another letter from you before you have this…
… Oh. Oh. oh. But mortals can but try.
Darling, you say the nicest things and always fling up a guarded apology in case your’re sounding sentimental. But you needn’t worry. Sentimentality doesn’t flourish beside sincerity like yours — there’s a king of honesty of thought (do you know I believe that’s what integrity is. It’s been only a word for me for so long, but I believe I recognise it now as a quality) in your letters that sweeps away every trace of the artificial.
You say “The fact is, as I’ve always suspected, in your earnest attempt to view the most important things in the Cold Light of Reason, you deceive yourself. I think — you may correct me coldly and soberly if you like! — that you feel one thing and think another” Dear it’s not that. If I were sure of what I feel, I’d come off my guard at once and to hell with thinking — in this matter anyway. But the trouble is I feel too much in two different directions — and that’s not according to the rules and I can’t help feeling it’s not Playing Fair (bless you for your gentle and courteous reassurances) and I’ve thought and thought till I can think no more, and I still don’t know. And I still hate people that dither — here’s my nemesis! Eric’s been very much in attendance this last ten days and he’s such a darling too. You both behave so very gallantly that I’m ashamed of my indecision and truly sorry for it, but I honestly can’t help it. I offered to say “No” to him now (he’s away yesterday, home, on his way to the R.A.F. at Loughborough) rather than have him wait and wonder, and he gave me almost exactly the same answer as you. It’s curious how alike you are — the things I most admire in him are the things I most admire in you — integrity and honesty and simple goodness and kindness and love of the south country and trees and beasts and youngsters and the enjoyment of living and using your mind oh and countless other things. And generosity of mind and, bless you both, seeing the diverting as well as the more serious side of the whole complicated situation. How I do love you both! He said with the ghost of a twinkle, “I see it’s 50-50. But sometimes it’s 45-55; and then again sometimes it’s 55-45?” Which just precisely sums it up, at present. Oh and it makes me so proud and so humble at the same time to be loved so truly. It’s the most enriching experience yet in a life that sometimes I feel couldn’t be richer. I wish I could deserve it better. It isn’t fair that I should have so much — I begin to agree with Miss Barr — almost! — “Of course you must appreciate Miss Goudie, that you are Exceptionally Fortunately Placed in your home and other circumstances…” And all I can say is “I know. I do. Really I do.”
And I must use the war as a kind of buffer until I’m surer of what I do feel, so I’m ignoring your express permission, the rhetorical question “What then?” about being engaged. Your paradox about being hurt and happy isn’t different to penetrate — it’s exactly what I’m feeling too, in a slightly different way — I’m getting absolutely no satisfaction out of the situation, it hurts and yet I’m so honoured and happy and grateful. And, whatever happens, I’ll never forget this wonderful autumn and winter when the future suddenly spread out and life flowered. What’s it Beckett says? (never realised how much I loved that play till my thoughts began to take up it’s language for clearer expression)
“Spring has come in winter. Snow in the branches shall float as sweet as blossoms. Ice along the ditches
Mirror the sunlight…” (Funny. Irrelevant comment, but there’s the opposite of Housman’s
“See the cherry, hung with snow”)
But you mustn’t wring my heart with things like “I doubt my happiness lies very much in your hand” You’re much too brave and self reliant for that to be true, and it would be an insult to you to believe it.
Yes, you shall have a photograph — I have really been meaning to have it taken for weeks but the days go by and it isn’t done.
Like your Poor child-Rich child contrast — shall indeed “bake you a cake as quick as I can” whenever I’m home again. And maybe toffee. Poor darlings. Glad you liked the chocolates — one very nearly has to have influence to get them nowadays, but I was lucky.
No dear, not a new dress. Pyjamas they was. And what do you mean by “again? Hivings!” Hivings, yourself! I haven’t had a new frock for months and months! — not since the early summer and for winter ones not since last October. Bah.
Destroyers are bonny bonny ships — would prefer you to be on one in peacetime all the same. But speaking aesthetically, yes, yes a destroyer. Aren’t sloops lovely? Saw a grey graceful beauty being built, summers ago on the Clyde and loved it.
And your text lesson! Ho and ho. I bet you enjoyed yourselves. But NO BEARDS I implore you. And what did I tell about the electric shaver? “Ten days grim effort,” bless you!
This is so short a letter but I must sleep. And it’s been so difficult and sticky. I expect that’s obvious to the reader! — because I’ve had to stop-an-think so much through it with the result that I’ve only answered one of your letters after all. But courage, mon brave. Oh and I’ve still all my news from the middle of last week, and it keeps piling up. And so many ideas to compare with you — got a whole set of new or rather discovered – old ones the other day.
O world! O life! O TIME!
Darling, I’ll always love you whether I marry you or not.
Doreen

P.S. Did you ever get the Missing Skegness Letter? After two letters and two weeks I made a great effort and wrote to John Durkan — only to get a third letter — this time from Invergordon instead of Norfolk. Oh me.

At War with Myself

According to an 8 question quiz in Psychologies Magazine, I am at war with myself. The UN don’t seem particularly interested in this civil war so I suppose I will have to initiate peacetalks with myself by myself. How will I persuade myself to have a ceasefire?

If I were at peace with myself, my day would go something like this: Get up, do yoga or meditation, have shower, get dressed, eat boiled egg and toast and drink real coffee.

Sit at desk and: Finish amendments to my novel and send to my patient copyeditor

Take rubbish out

Elevenses

Research primary texts for my Mum and Dad epistolary whatever it might turn out to be

Lunch

Walk

Read text books on writing and teaching writing, plan one of three lessons for the next week

Tea

Socialise

In fact my days go like this:

Wake up, batlle with headache and exhaustion, fight about real coffee v instant. Instant wins. Glare at yoga DVD as though it were my worst enemy. Watch the news, Lorraine, that snarky discussion programme on Channel Five. Think about moving my laptop from my desk to the sofa. Lose that battle and the will to live. Peer at myself in mirror, noting dustiness of mirror and ugliness of very comfortable pink fleecy dressing gown. Wish I was allowed to go outside in it. `Knocked senseless by unpleasant stink from rubbish bin. Glare at six shoeboxes of letters from M and D. Check the TV Guide for evening programmes. Cancel socialising in favour of soaps and thrillers that send me to sleep. Glare at Stair Accounts jobs. Read through Twitter, wondering why most of the posts are irrelevant to my life. Try to think of something witty to say on Twitter or Facebook and end up retweeting stuff I hope will make me appear supportive of the Common Weal. Realise I have only shaky understanding of what the Common Weal is.

Struggle with napping urge and lose battle to sleep. Wake up just in time for The One Show. Turn sound off and read interesting articles on internet. Remeber to check what battles are being waged on earth by watching Al Jazeera. Miss beginning of soap and stay up too late watching it on catch up.

Next day, wake up, battle with headache…

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