The role of imagination in dementia care

Happy Elderly WomanImagination is often defined as an ability to envision something that is not present in reality – a fundamental part of creative processes that subsequently may lead to innovation. Author J.K. Rowling proposes that imagination could be understood in a broader sense, as a power to empathize with humans whose experiences we have never shared. Uniquely, imagination can allow us to learn and understand without having experienced. How can we employ this information resource in the best way?

It is important to choose to identify not only with the powerful, but with the powerless, in order to understand the world in its full spectrum of colours. My mind cross-referenced this thought with a quote from F.S. Fitzgerald’s famous novel The Great Gatsby that I often try to recall when facing a challenging behaviour of any sort:

“Whenever you feel like criticizing any one,” he told me, “just remember that all the people in this world haven’t had the advantages that you’ve had.”

In the world of dementia care, which is the application domain of my PhD research in creativity and play – one who cares for a person with impaired memory is often faced with strange and bizarre situations classified as challenging. I believe the key to resolutions in these situations is to reveal its causes with empathy, and I am building games to enable this kind of creative, imaginative understanding. The idea is to enable carer’s imagination to act like a detective, pick up the clues to gradually uncover the reasons that lie behind behaviours and emotions of an individual with dementia.

What could be the impact of such an application of imagination? Another quote from J.K. Rowling, I believe, reflects very well the issue of importance of understanding (not only in dementia care) that I am trying to address with my research:

Many people prefer never to exercise their imagination at all and never wonder how it would have been to be other than how they are. They can close their minds and hearts to any sufferings that do not touch them personally. They can refuse to know. Choosing to live in such narrow spaces leads to a form of mental agoraphobia… Willfully unimaginative see more monsters, they are often more afraid.

We are therefore going to play hard-to-forget at my talk at ICLCity 2012, organised by Centre for Creativity in Professional Practice, taking place at City in June. Looking forward to seeing you there.

Also, I would like to encourage you to put your imagination into action today. Many who suffer from dementia live in care homes. Join the Big Care Home Conversation brainstorming campaign, that is tackling the question: What makes life good in care homes now, what could make them better – and how might we get there?

Play It Again, Sam

Woody Allen’s Play It Again, Sam (1972) is one of my favourite films. Have you seen it? Only recently I realized its story features an insightful creativity technique application that relates to my current PhD research at the Centre.

By day, he is Woody Allen. But when night falls and the moon rises, Humphrey Bogart strikes again. Bogart’s Casablanca persona is appropriated as the fantasy mentor for Allen’s troubled character in the film, named Allan; throughout the plot, Allan is encouraged to take advice extracted from a familiar, but distant parallel world to solve his issues with dames in real life. Looking from the semiotics point of view, as Umberto Eco notes: Thus Casablanca is not just one film. It is many films, an anthology. […] When all the archetypes burst in shamelessly, we reach Homeric depths. Two clichés make us laugh. A hundred clichés move us. For we sense dimly that the clichés are talking among themselves, and celebrating a reunion.

I will be relying on that power of stereotypes to evoke emotions in order to create a good game. My PhD work, supported by MIRROR project and supervised by Prof Neil Maiden (School of Informatics) and Prof Julienne Meyer (School for Health Sciences), aims to inform relationships between creativity and games, with application in dementia care domain.

Last month, thanks to Registered Nursing Home Association (RNHA), I took part in an induction for carers in Ipswich. During the role-play exercises, I noticed that carer should at some point act as a sort of detective, understanding residents’ actions and emotions, in the context of its causes and implications. Namely, reasoning in such a deductive way aims to help carer predict and resolve challenging behaviours occurring daily in a care home for people with dementia, which is a fast-paced, flexible and non-deterministic environment due to the nature of the residents’ condition. This approach empowers person-centred care, which is a priority for good carer practice. Furthermore, reconstructing events requires managing information from both personal and other people’s reflections, and therefore supports reflective learning, which has been the main topic of the MIRROR project. Parallel world is being chosen to correspond with its mechanisms to the original challenge.

Ideas found their shape during my last week’s visit to Imaginary, a game development company from Milan, another partner of ours in the MIRROR project. Using direct analogy as implicit creativity support, we are about to create a parallel-world game environment to support carers in discovering their inner detective skills. To spice up things in addition with some tricks of the trade, there will be explicit creativity support injected as well. These are just the initial clues I am giving you – keep in touch to find out more.

After you try my game, I hope you’d wish to play it again. Until, as time goes by

Bogart: That was great. You’ve, uh, you’ve really developed yourself a little style.
Allan: Yeah, I do have a certain amount of style, don’t I?
Bogart: Well, I guess you won’t be needing me any more. There’s nothing I can tell you now that you don’t already know.
Allan: I guess that’s so. I guess the secret’s not being you, it’s being me. True, you’re – you’re not too tall and kind of ugly, but – what the hell, I’m short enough and ugly enough to succeed on my own.
Bogart: Hmmph. Here’s looking at you, kid.

Creativity to Design and Support Care for People with Dementia

Can we design creativity tools to support residential care staff?

On the 31st January 2012 – Professor Neil Maiden gave a talk on the mobile apps we have developed as part of the MIRROR project. His slides have been made available here (through Slideshare).

Creativity techniques and software support tools have the potential to be applied successfully to a wide range of problems. In the EU-funded FP7 MIRROR project we are working with the UK Registered Nursing Home Association to apply creativity to the design and delivery of new tools to improve the care for people with dementia. Our focus has been to support the care staff in residential homes.

Neil talked about two uses of creativity in this domain. The first was the use of creativity techniques such as improvisation and role play to engage and empower care staff in the design of new mobile technologies and apps that can improve their care of residents. The second was the design and implementation of a new mobile app intended to support care staff to think creatively to overcome challenging situations. Care staff can use the app to generate more novel, person-centred resolutions to these situations based on different creativity techniques that it supports. Neil also described how this creativity support app can be used along side other tools also under development, such as a life history app and digital rummage box running on portable tablets.

We’re interested in hearing from anyone working with similar solutions or with technology & care. Do get in touch.

Author: Kristine Pitts