Between 1931 and 1972, the French writer Georges Simenon (1903-1989) published 75 novels featuring the celebrated Detective Chief Inspector Maigret. Simenon was incredibly prolific and produced several hundred books, though it is through Maigret that he is best known. There have been numerous films and also two British TV series, starring Michael Gambon and (later) Rowan Atkinson as the master sleuth. The whole Maigret series is available in English in a fairly recent issue from Penguin.
While the nation has been doing various obsessive pastimes during lockdown, like running from Land’s End to John O’Groats without leaving the house, or bingeing on masses of TV boxed sets, I set myself the task of reading the entire Maigret series from 1 to 75. At this moment, I am midway through #74, with a slight sense of sadness that I shall soon reach the end.
I’m sure that the series isn’t intended to be consumed all in one go in less than 6 months. At a conservative estimate, this equates to over 12,000 pages. However, it has been interesting to move through time with the author and his characters in a period of over four decades. Maigret is a large man often seen smoking a pipe. A raincoat and a hat are also part of the image. Simenon was anxious to get away from novels that glorified the criminals, gentlemen thieves and aristocratic murderers, and wanted to portray the decent but difficult role of the police, as they operate between the criminal fraternity on the one hand and the upper class establishment of the judiciary, so Maigret himself comes from rural stock, his father having been an estate manager at a chateau.
In contrast to, say Sherlock Holmes, Maigret relies more on instinct and getting to know his victims and suspects, rather than on brilliant leaps of deduction. As a result, there is a characteristic cycle where at first he is not sure in what direction his enquiries are leading. This makes him appear ill-tempered and taciturn. Later, things start to fall into place, though often he is left weary or saddened by the outcome. He makes it clear that he does not wish to judge the actions of others: that is for the courts.
Although we occasionally encounter Maigret’s first name, Jules, we are not told the given name of his wife, who appears as Madame Maigret throughout. She has extreme patience for all his foibles, cooks devotedly and usually manages to greet him by opening the front door when she hears him on the stairs coming home. I imagine that there has been plenty of feminist analysis of her contributions to Maigret’s life and well-being.
Over the 40 years of action, there are some small changes. There is the occasional mention of technology, like a computer, in the later books. When makes and models of car are mentioned, these probably move with the times. However, most of the collection is in a largely undefined temporal space of mid-twentieth century Paris. Sometimes other parts of France, or even abroad: Belgium (early works – Simenon was born in Belgium), England and the USA. Each book is firmly set in a month of the year and the weather is often described. So too, is the food and drink that Maigret and his colleagues consume at the host of bars and bistros they frequent. In the later books, Maigret is drinking less alcohol, just as well as his levels of consumption are at times alarming.
What’s missing almost entirely from this chronicle of Maigret’s career is World War 2 and the German occupation of much of France. WW2 is hardly mentioned. In one book, the German bombing of a railway station in northern France is a key event, but otherwise you would hardly know. To some extent, this may mirror an awkward period for Simenon himself. Because of his surname, it was thought that he might have Jewish ancestry, but after the war he was in trouble from the other side as he had negotiated some film rights with German studios. He was notionally banned from publishing for five years but seems to have eluded this by moving to North America from 1945-55. He lived mainly in Switzerland after returning to Europe.
To write 75 novels about one character must have required an amazing ability to retain the details from each book. I’m not sure how Simenon remembered all the details about Maigret and his colleagues, so that they maintain a consistent identity through the series. Maybe he had a card index? Maybe just in his head? Nonetheless there are very few inconsistencies that I picked up in reading the series. Occasional details, so that an injury to the right eye later seemed to affect the left, but very little else.
The other element that relates to ageing and cognition is how the output of artists changes over time, and sometimes how this appears to reflect incipient dementia, for example in the case of Iris Murdoch. Simenon was publishing Maigret novels from the age of 28 to almost 70, so you would expect some changes in his writing style and choice of subjects. Some of this appeared to have been reacting to his market. For example, earlier books are more likely to have artisan settings, whereas later ones feature more cases among high society or very rich people. Later books are perhaps more likely to be set in Paris, especially Montmartre, laced with pimps and prostitutes, and one imagines that these were especially popular themes with his readership.
Simenon did publish a few books after the end of Maigret but at a slower rate. What caused him to stop writing Maigret novels, I don’t know. His later years were blighted by the suicide of his daughter in 1978 and surgery for a brain tumour in 1981. Whether the antecedents of either of these events contributed to the end of Maigret, we cannot really tell.
It was through my experience in a care home that I noticed how people were transformed by music and song. All the residents responded positively to music. If they were not singing along, they were clapping their hands or tapping their feet.
Listening to and enjoying music is a universal experience. Whether it is jazz, rock or country, music has the power to stimulate and bring to mind forgotten memories. So, could it help in dementia?
Musical emotion and memory are preserved in dementia. A study has showed that regular singing or music listening sessions over 10 weeks can improve cognition and attention in people with dementia (1). Listening to music provokes the recall of personal emotional memories and the names of children and friends.
There is a relationship between music and memory. Musical memory is a form of implicit memory. This is information remembered unconsciously or effortlessly. When music evokes this form of memory it lights up many parts of the brain.
Music therapy is beneficial in the setting of dementia. It can improve behaviour, cognition and mood. Music may also delay future cognitive decline (2).
Multiple organisations have recognised the beneficial effect of music for dementia residents in care homes, such as Lost Cord and Singing for the Brain (3, 4). These musicians visit care homes to engage residents in interactive sessions or sing-alongs to enhance vocalisation and mobility.
Music engagement is also appropriate at home; everyone can listen to music at little or no cost, which makes it easy for people with dementia to share the experience with their family and loved ones as a brilliant way of communicating and engaging with them.
Music is an exciting tool for those with dementia; it can bring people with dementia together with their loved ones, improve their self-esteem, as well as triggering memories and boosting cognition as it can reach parts of the brain in ways that other things cannot.
References/further reading:
1. Särkämö T., Tervaniemi M., Laitinen et al. “Cognitive, emotional and social benefits of regular musical activities in early Dementia: randomized control study”. Gerontologist, vol 54, 2014, pp. 634-650. https://pubmed.ncbi.nlm.nih.gov/24009169/
2. Elliott M., and Gardner P. “The role of music in the lives of older adults with dementia ageing in place: A scoping review”. Dementia, vol 17, no. 2, 2018, pp. 199-213. https://pubmed.ncbi.nlm.nih.gov/26993049/
3. https://lost-chord.co.uk/
4. http://alzheimers.org.uk/get-support/your-support-services/singing-for-the-brain?documentID=760
A significant aspect of the work of the charity is in Increasing the general public’s understanding of the experience of what it is like to live with dementia; whether this is from the perspective of the person with the diagnosis, their family carer or health and social care professionals. Achieving a high level of understanding is often crucial to the provision of high-quality dementia care. In the UK, over 200,000 new cases of dementia are reported each year, however, the nature of dementia often makes it difficult for many to understand what it may be like to actually live with dementia.
A real positive in working for a dementia charity is that we are asked to offer our opinions and commentary on a range of literary products on dementia. Now I love a good story and reading novels is one of my greatest pleasures so when the charity is asked to comment on a play script or a novel that explores some aspect of living with dementia I jump at the chance. I have read some good (and bad) scripts and novels, met some amazing authors, illustrators and actors in doing so.
One of the more recent requests was in seeking our recommendations for fiction that explores the dementia experience for National Book Day. Internationally the novel is celebrated in many ways through prizes and awards for authors to days, such as National Book Day, to encourage those of all ages to read more. Another example was World Book Day which was held in March of this year with its theme being to encourage us to ‘share a million stories’ across the UK. I am not sure of how successful the day was, but this set me thinking, how many novels are sold each year? I found a website of a book sales monitor who claim to provide statistics for the print book market in the UK. In total, they claim that over 190 million books were sold in the UK in 2018. It is less clear as to how many of these were fiction and even less clear on the numbers that relate to dementia in any way – very few is probably the answer to that.
There is a growing recognition that the arts can complement healthcare, and that creative arts initiatives can help people connect with their fellow human beings as an effective way of supporting mental health and wellbeing. Novels can challenge our perspectives on the human experience of dementia in ways unmatched by other media. In a world dominated by technology, reading a novel encourages us to silence the noise and enter another world. Reading fiction (or non-fiction), can be a great way to increase our understanding and empathy of the human condition in its many forms. Novels can be used to evidence the experience of dementia and discusses several well-known novels to illustrate the power of storytelling, such as, ‘Still Alice’ and ‘Elizabeth is missing’.
In general, novels that afford some focus on the lived experience of dementia often do so as witnessed by the relatives and friends of the person with the diagnosis, whether that be from observing and suspecting something is ‘not quite right’ to an exploration of how relationships can alter as a result of dementia. Very few are narrated in the first person. What is of greater interest to me is that, despite extensive searches I have found no novels that explore the experience of dementia that also involves another species, for example, in the form of a family pet. However, if we look to the literature on psychosocial interventions Animal Assisted Therapy (AAT) is a recognised intervention in dementia care based on the interaction between patients and animals. AAT and Dog Assisted Therapy in particular, has been proposed to help adults with dementia in the management of their distress behaviours. Perhaps not surprisingly researchers in this field have found that people with dementia, exposed to an AAT intervention, experienced significantly longer and more frequent periods of pleasure and positive social interaction. Is this really surprising? Many people, before they develop dementia, have long and satisfying relationships with animals. It is often the advent of dementia that affects their continued enjoyment of these relationships. For example, if it is deemed the person with dementia requires institutional care their beloved pet may not be allowed to make that transition with them. This is often seen as a transitory sadness (or sometimes an inconvenience in respect of finding a home for the animal) on the part of health and social care providers but for the person with dementia this may be akin to losing a child, a loved one.
So where am I going with this? I recently read a book that was translated into English from an Italian author. Whilst short term memory was a factor in the presentation of the protagonist, this was not a picture of dementia but of mental ill health and solitude. However, the strand that ran through the novel was the relationship the main character built with a stray dog and the dialogue (yes, a two-way dialogue!) that passed between them (Morandini 2015). If the care and research world the loving relationship with an animal is reduced to ‘an intervention’, then perhaps this is a topic that could be better explored in the world of literature? If literature is a means of enhancing the readers understanding and empathy of the experiences of others, then could this work by telling the story of a person with dementia and their pet?
Dr Karen Harrison Dening
Head of Research & Publications, Dementia UK
Morandini, C. (2015) (Translated by Ockenden, J. 2019) Snow, Dog, Foot. London: Peirene.
Dementia specialist Admiral Nurses are being asked more and more to support production teams of theatre, film and TV programmes on how best to portray dementia. The profile of dementia in the arts has risen sharply over the last decade; there is a growing number of fictional novels that give us a glimpse into what it might be like to have dementia. We have seen some favourite soap characters develop dementia for instance and there have been film portrayals of people with dementia. I have had the privilege of reading drafts of novels and film scripts and advising actors on the nuances of presenting an accurate yet sensitive portrayal of characters.
The most recent and most rewarding of these opportunities was in advising the lead actor and production crew of the making of the BBC’s new drama ‘Elizabeth is Missing.’ The request to support the production came as a result of Dementia UK’s growing national presence. Having already read ‘Elizabeth is Missing’ [1], this request sparked my interest, even more so when I learnt that the main character to play the person with dementia (Maud) was to be Oscar winning actor and former Labour MP, Glenda Jackson. I arranged to read the script and a meeting with Glenda and the production team was arranged. We discussed how and why Maud might have reacted to certain situations. I was amazed to find out that this film project had been the nugget of an idea and in the making before even the novel was published. From this point on though the team forged ahead and I was then invited to the films premiere in Mayfair on 27th November (an STV Productions, BBC One and BAFTA event).
The film and book have two main thrusts; it is essentially a ‘murder mystery’ but played out through the eyes of a person with dementia. It skilfully weaves us through the altered reality of a person with dementia as they grapple with the present day and the effects of living with dementia with the memories and emotions that call from their past. The character of Maud was probably one of the most honest and accurate portrayals of a person with dementia that I have seen. There was humour laced in at times which gave the character and context authenticity. There was no Hollywood glitz but a sense of ‘everydayness’ and a tangibility to her character that many families affected by dementia will be able to recognise and relate to.
Parts that stood out for me included the close bond that Maud had with her granddaughter. Often we consider the relationship between the person with dementia and their most direct carer, often a spouse or adult child. What we witnessed in this grandmother-granddaughter relationship was an unconditional acceptance and love with an empathy that was very moving. The second most memorable part was when Maud, sat at the bus stop, was approached by her daughter, Helen, but did not recognise her as such and the resulting conversation was one you would have expected her to have had with a stranger. Helen was aware that her mother had failed to recognise her and was very visibly distressed. Indeed, as Admiral Nurses we counsel many family members on this very upsetting loss of recognition. As Helen turned back to face her mother, Maud became immediately aware that it was in fact her daughter and became distraught that she had failed to recognise her. This was an incredibly touching and poignant part of the film.
I feel very proud and yet humbled at the same time to have played a part in this outstanding and sensitive portrayal of what it might be like to live with dementia. ‘Elizabeth is Missing’ is to be screened on BBC One on Sunday 8th December at 9pm. I hope that it is as well received by the viewing public and offers a valuable insight into the reality of a person living with dementia.
1. Healey, E (2014) Elizabeth is Missing. New York: Harper Collins.
Nicci Gerrard is a well-known journalist, author and campaigner. Her book about dementia is an elegy for late father, who had dementia in the last years of his life. She has researched it thoroughly, speaking to many people living with dementia and their families as well as to a range of clinicians and dementia researchers. As well as this, she draws on literature and art.
John Gerrard developed dementia gradually so that it was impossible to say when its onset was, especially as he was somewhat absent minded to start with (though well connected with and knowledgeable about nature). His state declined rapidly following a hospital admission which for various reasons was extended to five weeks. He was discharged a shadow of the person who had been admitted. The shock of this change led his daughter to launch John’s Campaign, which advocates for family carers to have the right to be with their loved ones in hospital and not to be restricted to brief visiting hours.
The book follows the journey of dementia through its chapters, especially once the author starts to discuss the process and impact of diagnosis. Thus we move from the general business of ageing through such matters as adapting to the diagnosis, how dementia affects carers, the importance of home, hospitals and the end of life. There are many insights both from Nicci Gerrard’s own experience and from the people she speaks to. One chapter, for instance, is about the issue of shame – how people, both those with the condition and those around them, often have a period of heightened and potentially painful self-consciousness, a feeling of being at risk of being exposed. There is a lot of embarrassment in the early stage of dementia, it appears.
Nicci Gerrard takes a stance between undue pessimism about the unrelenting course of dementia on the one hand and facile acceptance of living well with dementia on the other. She describes the experiences that she meets head on. This is fairly uncompromising material and challenges the reader to think about what dementia is about and how it challenges the integrity of a person’s nature.
By the time of death, however, matters are more peaceful. Following death, there are a variety of ghosts of the departed person that one can call to mind, seeing them at different stages in their life. This ability to move about in time gives a longer perspective of the person’s life that acts to promote restitution and to put the years of dementia into context, in a way that was perhaps impossible during the heat and dust of caring for them. So what does dementia teach us about love? I think that the book maybe leaves this question open, though it addresses well what bereavement teaches us.
What Dementia Teaches Us about Love by Nicci Gerrard, published by Allen Lane, 2019.
The somebody is Wendy Mitchell as she was before she was diagnosed with Alzheimer’s disease at the age of 58. She was a highly active, well-organised NHS manager with a responsible job, able to deal with nursing rotas for a hospital in her head. The dementia first declared itself with a stroke-like episode that came out of nowhere. Over time after this, she became aware of fluctuations in her ability and a sense of fog in her mind. Remaining at work required being super-organised to stay in front of her tasks though, in the end, even she was unable to keep up.
By the time she received a diagnosis, Wendy Mitchell was not surprised though even so it had a big impact. She documents various things that she had enjoyed that came to an end – running, baking and driving, for instance. However, her organisational talents have helped her to remain independent. This may appear effortless ('you haven’t changed’, people frequently say to her) but actually it is at the cost of a big effort. For example, to go on a train journey requires attention to every detail of the route, including obtaining pictures of landmarks that she will pass between arriving at the station and her eventual destination. She needs to set alarms on her iPad so she doesn’t leave her suitcase on the train. She also talks eloquently about how she is prone to paralysing anxiety, which of course makes her cognition worse, and how she has learned to deal with it. Mainly this is a matter of letting it pass, but also of seizing the moment when she is feeling capable.
It behoves us as health professionals to bear in mind what a small part we play in the course of someone’s life with dementia. Most of it is spent doing ordinary things, time with family and friends, adjusting to small changes as they happen. This book reflects that – there is not too much mention of contact with the NHS. And what there is salutary. There is little on offer beyond the diagnosis, and the NHS as her employers were a great disappointment as the only option on offer appeared to be health retirement with no discussion of adaptations that could have been made to supprt her at work.
The Wendy Mitchell she used to know had been quite a private person. She would listen to others’ troubles but rarely venture her own. After dementia, this changed as she made the decision to go for everything that was offered. This included participating in research, speaking at conferences, and in the end writing a best-selling book. She reflects on how dementia made this possible.
Finally, the book is a declaration of love for her two daughters. She is determined that they will not be her carers. She has been attentive to them all their lives and she continues to be so, though she also has to accept that she needs their support too. The front cover shows them as little girls on Blackpool beach. One can imagine Wendy insisting on the picture being included.
Somebody I Used to Know by Wendy Mitchell. Published by Bloomsbury, 2018.
Throughout this past academic year, I have had the opportunity of visiting an East Midlands care home alongside another student as part of the Reading Aloud placement scheme, which involved reading poetry to residents there who are living with dementia. Initially, we got through the poems we had selected very quickly: while the audience listened politely, they often did not outwardly respond to the poems or actively engage with conversations we made following each one. However, that’s not to say the reading wasn’t having any effect, or wasn’t being enjoyed; over the following sessions, the residents became more relaxed in our presence, more talkative, and visibly happy when we started to read a poem they recognised.
Beyond the poetry, I got the impression it was also really refreshing for people to just talk to us – for some, we may have been the only younger people they saw week in, week out, and as such the chance to share their experiences and stories was really interesting for both generations. I observed how eager some residents were to tell us about their jobs and their families, holidays they’d had and how they’d met their spouses, because recounting these memories clearly made them happy. I had conversations about the Scottish Highlands, A's career as a teacher and how B was locally born and bred.
The most moving transformation we saw was in a resident whom I'll call Alice, who spent most of the time we were there walking around. We always asked her if she wanted to sit down and listen to some poetry, and although she refused, there was nevertheless a sense that she wanted to be involved somehow as she kept hovering on the edge of our group. Then, during our last session, she finally agreed to listen and sat right next to us. As we started a Wordsworth poem, she began to recite it along with us word for word, getting visibly more excited. For months, she’d been adamant that she didn’t know any poetry, so for her to put herself outside her comfort zone and join in – reminding her that she actually knew some very well – made her (and us) very proud.
Other popular poems were the ones people remembered from their childhood: B's favourite ‘If’, by Rudyard Kipling, which we always started with; John Masefield’s ‘Sea Fever’, which one listener said had a lovely ‘swishy’ rhythm to it; and Edward Lear’s ‘The Owl and the Pussycat’, which I chose because I vividly remember my Grandad reading it to me as a child. These residents are of the generation who learned poetry by rote at school, and it became clear over the course of the placement that many took great pleasure in the reading aloud group – it gave them an opportunity to just relax, listen, and experience whatever feelings or memories the poems brought up.
Japan is a ‘super ageing society’, in which a currently reported 4.6 million people live with dementia. This figure is expected to nearly double over the next 10 years. While Japan has much to teach the world about being a society living with dementia – the UK’s Dementia Friends movement originates there, for example – its arts and dementia field is still very young.
When I was offered the opportunity to speak at an event in Tokyo, I jumped at the chance to combine this with further research visits and conversations. The Arts, Memory and Aging symposium at Tokyo’s National Arts Centre on 8 October 2018 was jointly planned and delivered by Arts Alive, an organisation which offers MoMA-inspired art discussion sessions, and Aoyama-Gaukuin University.
In the keynote, leading US neurologist Professor Peter Whitehouse talked about the imperative for society to experiment with new ways of caring, including those informed by intergenerativity, internationalism and interdisciplinarity.
Yoko Hayashi introduced Arts Alive’s art discussion programme, Artrip and two participants affected by dementia spoke about their experience. Adriane Boag described her work as co-ordinator of the arts and dementia programme at the National Gallery of Australia. Herb Fondevilla, Associate Professor at Aoyama-Gaukuin University presented thoughts on how arts and dementia might be introduced into Japan.
My own presentation, based around my PhD research within the TAnDem Doctoral Training Centre, focused on how arts and dementia practice and commissioning requires a combination of academic research including attention to theorisation and context, along with appropriate evaluation, and sensitivity to narrative and stories. During a panel discussion and questions we touched on issues including conceptions of ‘disability’, citizenship and human rights in relation to dementia as well as how arts activities might be evaluated and researched.
In 2004 the Saitama Arts Theater established its very active Saitama Gold Theater. This is a company specifically for those over the age of 55. I visited during the first World Gold Theater Festival. This included a full programme of events, including a Japanese version of ‘Bed’, co-created with David Slater, artistic director of the UK’s participatory arts company, Entelechy Arts. I saw a wonderful musical version of Moliere’s Malade Imaginaire, performed by a cast of 400 older people. Performers were orchestrated by the director from the back of the auditorium. Stage hands enabled, prompted and supported on stage throughout, making these actions a natural and integral part of the show. The enthusiasm and pleasure of participants was obvious.
Outside of Tokyo, and with Noriyo Washizu, an Alzheimer’s Association of Japan board member, I visited the SAIIN day-care centre in Kyoto, observing an art therapy session. A group of people living with dementia sang about and paid attention to the colour, taste and material nature of a perfect apple, and used fine tissue paper to represent it. Each beautiful resulting picture was then discussed by the group over tea and cake. Concentration throughout the two-hour session was impressive.
We also visited a non-profit organisation called Tanpopo. I was interested to understand its ‘arts and care’ social enterprise model, connecting people with disabilities to business, enabling them to use their creative capacities, and to be paid for their work as a group. This is facilitated because of a requirement for Japanese companies to, by law, employ a percentage of disabled workers. I met talented, happy and engaged individuals, proud of their work and their contribution to the group and society.
Back in Tokyo I observed an Artrip session in another day-care centre. Participants with dementia demonstrated their sensitivity to the nuances of a set of pictures, Western and Japanese, bringing their own knowledge and histories to the discussion with humour and intelligence.
I also had interesting conversations with Yasuko Murato, President of the Japanese Society for Person-Centred Dementia Care, and Michiko Nakagawa who is currently translating the second edition of Dawn Brooker’s Person-Centred Dementia Care.
The funding system for the arts is very different in Japan, as are provisions for health and social care. There is little state funding for culture or the arts, a tax system that does not incentivise private philanthropy, and few charitable organisations working in the field. Few cultural organisations have outreach or education departments. The nascent arts for health movement has no existing national networks to support practitioners.
A comprehensive private insurance system pays for individuals’ health and social care. While person-centred care principles may be well understood in some areas and there is wide-spread social awareness of dementia, I suspect there are opportunities for arts practitioners and organisations to develop a miore in depth understanding of both. Similarly, members of the hierarchical and highly-respected health professions may need persuading of the range of outcomes that can result from arts participation. There is also significant scope to increase the involvement of people living with dementia in both arts and dementia research and practice.
A further difference in the Japanese context is its well-advanced model of corporate social responsibility, leading to involvement of business in the provision of public services and goods. This sits alongside recent growth of what has been termed ‘venture philanthropy’.
All of this means that the environment in which arts and dementia work will be implemented, commissioned and delivered is quite different to that in the UK. My sense is that new and contextually appropriate stakeholder relationships between arts, health and commercial or business partners will need to evolve if arts and dementia projects are to succeed in Japan. In addition, attention will need to be paid to very particular ways in which ‘value’ is conceived and captured in relation to the involvement of people with dementia in the arts in these contexts.
Some links
Arts Alive – www.artsalivejp.org
Meet me at MoMA – https://www.moma.org/visit/accessibility/meetme/
Whitehouse, P. (2017). From Intergenerational to Intergenerative: Towards the futures of intergenerational learning and health. Journal of Intergenerational Relationships - https://www.tandfonline.com/doi/abs/10.1080/15350770.2018.1404862
TAnDem Doctoral Training Centre - https://www.worcester.ac.uk/discover/tandem-phd-studentship.html
Saitama Gold Theater - http://www.saf.or.jp/en/about/
On funding for the arts in Japan:
Potts, J. (2015). The way of the mécénat: corporate arts funding in Japan. The Conversation - https://theconversation.com/the-way-of-the-mecenat-corporate-arts-funding-in-japan-38662
Kawashima, N. (2014). The development of art projects in Japan: Policy and economic perspectives. Field: A Journal of Socially-Engaged Art Criticism - http://field-journal.com/issue-8/the-development-of-art-projects-in-japan-policy-and-economic-perspectives
Appearing in photo from left to righ are: Zena Aldridge (Admiral Nurse Research Fellow); Karen Harrison Dening (Head of Research & Publications, Dementia UK); Sue Lister, MBE, (AWOC) and Ann Murray (AWOC).
Childlessness is the state of people – men and women – not having children. Childlessness may have personal, social or political significance; some people make the decision not to have children; it is estimated that the majority of lesbian, gay, bisexual and transgender people do not have children. Naturally there are researchers and theorists that are inquisitive about this human phenomenon. The researcher Thomas Baudin and his colleagues (in 2015 study) took a sterile and practical view in stating there to be several ‘categories of childlessness’:
- Natural sterility which randomly affects an individual(s).
- Social sterility, which can include poverty driven childlessness, or an endogenous sterility where fertility has been affected by poor living conditions.
- People who are childless by circumstance and/or choice; this could include people who are childless because they have not met a partner with whom they would like to have children, decided too late to have children so affected by advanced maternal age, or because they suffer from certain medical issues, such as endometriosis that make it difficult for them to conceive.
- People who are childless by choice; deciding not to have children is a process that takes place in the context of other life events, particularly partnerships.
Further, they go on to say that the first three categories can be seen as "involuntary childlessness". With the fourth often called "voluntary childlessness". Now I am sure many would argue that this is perhaps a simplistic view and that there may be many more reasons and rationales for childlessness. However, that is not the purpose of this blog but rather to consider some of the long-term issues following a decision not to have children.
Now I can wax lyrical about statistics of an ageing population, likewise too the numbers of people living into old age and now ‘old, old age’ or the ‘oldest old’ (as the original term does not factor in that many people are now living beyond what was originally perceived as old age). However, my nursing practice has taken me into the field of dementia for over 35 years, and latterly into researching issues of palliative and end of life care for families affected by dementia. Gloomy you might say but I have met some wonderful people along the way; heard some joyous stories (and some very sad stories) but it is these stories of people’s lives that are incredibly rewarding to me.
From the instant we are born we are all ageing and will all die at some point – this is inevitable and something all human beings have in common. However, as we delve deeper into the similarities and differences of human circumstance, the amazing variation of individuals and their circle of families, networks, interests, as well as cultures and ethnicities, become apparent.
I met two amazing women last week who are ageing without children (their description, not mine) who campaign and support individuals that are ageing (including those that have dementia) who do not have offspring or the support of children. AWOC York is an inclusive group and welcomes all those older individuals who do not have the support of nearby offspring. For example, their children may be disabled or have died, or moved away, or they may be estranged from them, and also those who chose not to have children or don’t want to be a burden on their children.
Sue and Ann told me the startling statistic that one in five people over the age of 65 are registered as childless. However, as an Admiral Nurse I often see families affected by dementia accessing the lion’s share of support with families expected to ‘fill the gaps’ that are not provided by health and social care. So where does that leave the older person with no children to rely on? Ageing Without Children (AWOC) founded by Kirsty Woodard has Sue and Ann to thank for their York branch. This group is just one of the couple’s activities: Sue established the York 50+ Festival that, on an annual basis, celebrates old age and gathers over 100 events on many related and pertinent issues, “No Kidding” by their Real People Theatre on the theme of ageing without children being just one of many. Their women’s theatre company has also toured with “Dementia & Me” for the past 6 years – it acts as a springboard for audience discussion and the sharing of experiences. I was blown away by their tireless efforts and the wide range of activities which bring attention to ageing and dementia. Why not take a look at their websites and perhaps even attend one of their many events?
Ageing Without Children: https://awoc.org/
The Real People Theatre Company: https://www.realpeopletheatre.co.uk
York 50+ Festival: https://www.eventbrite.co.uk/e/york-50-festival-dozens-of-events-all-around-york-over-a-two-week-period-tickets-34768505536
Dr Karen Harrison Dening / Zena Aldridge July 2018
This year I had the opportunity to take part in the Reading Aloud scheme at the University of Nottingham (for details, please see: https://www.nottingham.ac.uk/english/public-engagement/shared-reading-groups.aspx#DementiaGroup), which involved reading to people with dementia at the Queens Medical Centre. Over the weeks I met many interesting people and found that the poems I read to them were often warmly welcomed not just because it was a new activity, but because the poems evoked memories of hearing and learning them in their childhood. Wordsworth's ‘I wondered lonely as a cloud’ was recognised at the first line or by the famous daffodils, and many people recited this poem along with me.
Funny poems were always popular, and everyone was amused to hear of the impossible (and often relatable!) relative in ‘Tea with Aunty Mabel’ (http://www.ourdailyread.com/2014/10/tony-mittons-top-10-poems-to-remember-and-recite/) and of Albert’s escapades in ‘The Lion and Albert’ (https://www.poemhunter.com/poem/the-lion-and-albert/).
As I introduced this latter poem on one occasion, one of the men present was able to recite all 18 verses word for word, and then mentioned other poems by Marriott Edgar which I brought along on other occasions. It was also interesting to find how the poems held significance to different people for many different reasons. One woman I met even used to write comic poetry herself, and many people had favourites because they were written by poets from their home town. Seeing the laughter and interaction sparked by poetry was a real joy of the experience.
There was one reading session that had a particular impact on me because of the effect the poetry had on the woman I was reading to. She was one of the more ill people I read to, and when I arrived at the ward she was quite confused and distressed. However, when me and one of the nurses went to sit with her, her attention turned to the poetry and offered a new focus. The light-hearted poems I read seemed to sooth her almost instantly, which I think was helped by the regular rhythm of the verses. When I then started reading a nursery rhyme, she joined in and could say it with me. I stuck with the nursery rhyme theme, which reminded her of her youth. These particular verses appeared to much lift her mood: she was a lot more relaxed and told me about her life and her job - even showing me a picture of herself taken some years ago. Within an hour’s time, she was more comfortable, aware, and happily talking with us, which was a lovely thing to witness. This particular moment stuck with me because the poetry had obviously had a profound effect and had reminded her of experiences which she could then share with us. It was evidence of the power of words and in particular poetry, and really demonstrated the positive effect that reading aloud can have.
