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1 - Introduction: Placing dementia

Published online by Cambridge University Press:  13 May 2022

Richard Ward
Affiliation:
University of Stirling
Andrew Clark
Affiliation:
University of Salford
Lyn Phillipson
Affiliation:
University of Wollongong, Australia
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Summary

Is there somewhere that dementia belongs? If we had asked this question 20 years ago doubtless the weight of responses would have emphasised institutionalised settings: hospitals, clinics and care homes. Such places would likely be secured, perhaps bounded by fences – places of containment and segregation (Steele et al, 2019), of care, but also control (Ward et al, 2008; Kelly and Innes, 2013). They may even be places where the occupants desired to be elsewhere, congregating at the doors or at the edges of the building (Chalfont, 2008), perhaps even making a bid to escape (Chatterji, 1998; Bartlett, 2007). It is far less likely those responses would have foregrounded outdoor or public spaces. Indeed, commentators writing at the turn of the new century were keen to highlight that public spaces were rarely considered appropriate for people with dementia (Blackman et al, 2003). On the whole, biomedically informed research on dementia considered independent movement beyond the home to be fraught with risk, often focusing on the prevalence and frequency of people with dementia becoming lost, but without considering what role the environment itself might have played in these situations (for example, McShane et al, 1998). Silverstein and colleagues (2002) captured the caring but paternalistic and risk-averse mood of the time: ‘If someone with dementia can walk, that person can wander and become lost. If someone with dementia is missing, that person is lost. And if someone with a dementia is lost, that person is at risk of harm’ (p 7).

Fast-forward to the end of the first quarter of the 21st century and much has changed. Arguably, if we posed our question now a more diverse set of responses would ensue. Hopefully a more diverse range of people would feel entitled and enabled to offer their perspective, revealing that ways of engaging and eliciting the direct views of people living with dementia have in themselves evolved a great deal (for example Keady et al, 2017). Yet, arguably the legacy of efforts to ‘place dementia’ still inhabit approaches to the condition. Consider, for example, the everyday language of dementia care practice, talk of ‘admission and discharge’, of being ‘allocated a bed’, ‘awarded a place in day care’ or deemed ‘eligible for respite’.

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Chapter
Information
Dementia and Place
Practices, Experiences and Connections
, pp. 1 - 22
Publisher: Bristol University Press
Print publication year: 2021

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