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3.5.3 An exploration of wandering in older persons with a dementia through radical reflection and participation (96)

Jan Dewing, Independent Consultant Nurse, Honorary Research Fellow, University of Ulster, Northern Ireland and Visiting Fellow, Northumbria University, Engalnd, United Kingdom

Abstract:

Aim:

This presentation will provide an overview of the completed research and will also suggest what the key implications for practice, research and policy might be (Dewing 2007). In this study Merleau-Ponty’s philosophy of phenomenology was used as the philosophical and theoretical framework (Merleau-Ponty 1962).

Background:

Two overarching principles guided the research; radical reflection (a way of organizing phenomenological reduction) and meaningful participation by older persons with dementia. A person-centred methodology was generated which comprised of principles from human science research (van Manen 1990, an ethic of care and process consent. The essence of the phenomenon of wandering was accessed through encounters with the lived experience of wandering in ten older persons with dementia living in a nursing home in England; using three observation styles supported by video recording and conversational interviews.

Methods:

Using principles from human science research woven with creative expression (i.e. poetry), data was holistically analysed keeping it embedded in the participant’s lived experience. Through evocative phenomenological portraits of the lived experience of wandering, the lived experience of wandering was found to be active, dynamic and imbued with numerous meanings and purpose connected with being-in-the-world. In particular it is an embodied manifestation by which a person living with an advancing dementia actively creates integrated meanings in their world. Meanings encompass four existential dimensions: relationality with an embodied self, relationality with others and objects, space and place and finally, lived time.

Results:

The findings point to the phenomenon of wandering having a number of elements within its essence, which had not been previously captured in the literature:

  • Movement of an embodied self within lived space and time
  • The feeling of being at home or not being at home
  • A desire or longing for freedom
  • Living with a sense of a hopeful-hopeless future

Recommended reading list:

  • Merleau-Ponty M (1962) The Phenomenology of Perception (Translated by C Smith). London. Routledge and Kegan Paul
  • van Manen M (1990) Researching Lived Experience: Human Science for an Action Sensitive Pedagogy. Toronto, Ontario, The Althouse Press University of Western Ontario
  • Dewing J (2007) An Exploration of Wandering in Older Persons with a Dementia through Radical Reflection and Participation. Unpublished Dotoral Thesis. Manchester, RCNI/University of Manchester

Source of Funding: N/A

Level of funding: N/A

Biography:

I work as an Independent Consultant Nurse. I am also an Associate Lecturer at the University of Ulster Northern Ireland and a Visiting Fellow at the University of Northumbria England. I worked for many years in practice and had a variety of leadership and management posts. I have also worked as a Lecturer/Practitioner in joint posts with a University. During my years in practice I was involved in the nursing development unit movement in the UK. I found myself working with older people and came to develop a passion for gerontological practice and in particular ‘person-centred’ dementia care and with systematic/emancipatory practice development. After leaving the NHS I worked as a Senior Fellow for Dementia Care at The Royal College of Nursing before returning to the NHS as a Consultant Nurse for Older Peoples Rehabilitation and Intermediate Care. I then branched out and became a self –employed Consultant Nurse. This seemed a good idea (at the time) as it was meant to give me time to complete my doctoral research. My consultancy work involves me working with several academic organisations or directly with provider organisations. I mainly undertake systematic practice development with nurses and other professionals working with older people; facilitation and coaching; service review and development work and carry out research. I have recently completed my thesis and continue to write and present on the care of older persons and practice development.