Pulled through a hedge backwards : improving the quality of life of people with dementia through dramatherapy

Abstract

This thesis links my interest in the area of dramatherapy with existing and new research in the fields of dramatherapy and dementia. It has been written as a result of invitations by individuals and organisations interested in Kitwood's (1997) person-centred approach, to work with and write about people with dementia and the effects of dramatherapy upon them. In the light of public awareness of the ageing of our population and since, in the area of dramatherapy for people with dementia, the body of published research is small, I wanted to use a mixed method approach to find out if a small study of sessional work would improve their quality of life (QoL). Qualitatively, the ontological concepts of being-in-the-world put forward by the phenomenologists, held in tension with Steiner's understanding of consciousness, underpin this study. It was important to hear the stories of people with dementia, help them connect consciously with end of life issues, and to respond to existential difficulties with dementia which might impede their QoL. A literature search was conducted for neuropsychological scales and measures which would effectively assess certain areas of QoL: namely, mood, cognition, language and QoL itself. These measures were selected to access levels of potential improvement in these four areas. In order that research findings could be compared, a two-arm study was set up. Volunteers with dementia diagnoses were invited to participate in sixteen sessions of dramatherapy in Sydney, Australia or film-watching as a diversional activity in Newcastle, New South Wales. The two venues for the research were located at branches of Alzheimer's Australia, NSW. The main qualitative epistemological method of inquiry chosen was a phenomenological approach, including an investigation of embodiment phenomena. Qualitative methods also applied to the investigation were narrative, metaphor and ethnographic procedures. Rather than looking for a "neat solution", a meta-analysis of reflexive inquiry was conducted and findings of the mixed methods of exploration were triangulated using pragmatic abductive means. Statistical change score data for individuals were also examined, triangulating findings with the heuristic research. Narrative descriptions of dramatherapy sessions were completed in the form of a playscript. Individual narratives of four of the dramatherapy participants were written for the thesis. An ethnographic drama dealing with tensions in the mixed method approach I had taken was also prepared. Results of the quantitative research were not found to be statistically significant, possibly because of low numbers or the lack of ability to match variables of gender, diagnosis, educational level and age between the two groups at baseline. Bearing this in mind however, the QoL-AD measure (Logsdon, Gibbons, McCurry & Teri, 1996) did show an improvement in the dramatherapy group. The qualitative research demonstrated a robust ability on the part of participants to engage with group activities, psychotherapeutic intervention and reflective practices. QoL levels were observed to improve substantially and higher levels of body awareness and interaction were indicated. The enquiry suggests that dramatherapy is indeed a promising modality for people with dementia and can and does improve their QoL. It indicates that dramatherapy, with its person-centred approach and engagement of creativity can reveal consciousness and inspiring soul qualities that are often missed by the biomedical model. It has shown that personal issues from childhood can be healed through drama psychotherapy. Recommendations for its cost-effective introduction into facilities for the elderly are identified in the thesis, as well as further research in this important area.

Date of Award	2013
Original language	English