Innovation
We arranged for a theatre company, Az2b, to perform their play, ‘Grandma, remember me’ which deals with the effects of dementia on three generations of the same family, for our student nurses (all branches) midwives and operating department practitioners, as well as for members of the public, paid and unpaid carers and health care professionals. After the play the theatre company held a question and answer session that covered their experiences with dementia (the play’s author and other members of the cast have personal experiences of dementia) so students and other members of the audience could ask about dementia and its portrayal in the play. We persuaded our local education funding body (Yorkshire and Humber) to meet the costs of the students attending, whilst non-students paid a nominal charge to cover costs.
What prompted innovation?
Dementia is likely to be one of the biggest threats to health and social care provision over the next ten years. By 2021 there will be a million people in the UK living with dementia and currently two thirds of people with dementia live in the community. One in three people over the age of 65 can expect to develop dementia (http://www.alzheimers.org.uk/infographic). This has prompted the excellent and timely ‘Dementia Friends’ initiative run by the Alzheimer’s Society, and funded by the Cabinet Office and the Department of Health with the high profile backing of Prime Minister David Cameron. This has particular local resonance for us in the City of Hull where one in three people live alone, one of the highest rates in the country (http://www.ons.gov.uk/ons/guide-method/census/2011/census-data/index.html). In light of this we realised that we did not have enough educational provision on dementia for our students in the pre-registration curriculum and, because an organised and streamlined curriculum is of necessity a premium, that we needed a learning activity that would engage the students in a different way without impacting on their time in the classroom or in clinical practice. We also felt that the medium of a play might stimulate learning in a way that more traditional methods might not.
What makes innovation different?
We have taken health care students out of their usual learning environments – the lecture theatre, the clinical skills suite, the clinical practice arena – and provided a learning experience that is realistic, moving and yet humorous. They will all in their professional careers encounter many people affected by dementia and the play helps them to see the effects of this on the person with dementia and her family and friends. The intimacy of the atmosphere of the theatre draws in the audience so that the content impacts on them in a very personal and immediate way. In addition we have entertained the students as they have learned, as we firmly believe that learning should be enjoyable and emotionally fulfilling
There is also value in students watching this with other health care professionals as well as carers of people with dementia and on occasion with people who themselves live with dementia. This came out in the question and answer session afterwards, which prompted some questions from students to other audience members. A further ancillary benefit was in holding this play in a local sixth form college so we were able to make some free tickets available to their drama and health studies students and foster links for future working.
Changes in practice
The feedback we have received from this innovation (see below for details) has encouraged us in our work to further embed learning about dementia in our pre-registration curriculum. We have had follow up discussions with the theatre company about organising a rolling programme of performances annually, and the possibility of making a screenplay version of the play that could be easier to access and could be used in different ways, illustrating different elements of dementia care for different programmes of study. This will have an impact on other educational provision as we are keen to look further into the effects that the arts (written and graphic, as well as dramatic) can be used to support and foster learning for health care students.
Impact
We evaluated audience members, including students, after the two performances we have held so far. The response was overwhelmingly positive. The purpose of the evaluation was principally to obtain qualitative information but some of the numerical information was interesting too; of the people who responded, 27% said that prior to seeing the play they had not thought it was possible to live well with dementia. After seeing the play, this had fallen to 9%. This is noteworthy as “It is possible to live well with dementia” is a key theme of the Dementia Friends initiative. 61% of responders said the play had changed their view about dementia. Direct quotes from students included:
“The sudden change in the Grandma was an eyeopener to me and how fast disease can set in,”
“I love the way it was shown that dementia can be visually recognised (vacant stare/chattering) Awareness of dementia and early recognition was portrayed really well”
And, in answer to the question “if your views [on dementia] have changed, please tell us in your own words what has changed” one student simply responded:
“Have patience with people.”
Dissemination
- The Journal of Dementia Care has asked us to co-author a piece with the playwright on the potential value of the dramatic arts in informing and educating about dementia.
- In addition we are writing a paper on the wider use of drama to influence learning in this area, based in part on the evaluations of the play.
- We are also considering a paper with colleagues interested in written and graphic arts on the role of the arts in general in teaching and informing about health issues for people being educated to be health care professionals.