Comments from participant Hannah Lefeuvre

These thoughts about the conference from Hannah at given in full here, and have also been appended to the abstracts of each item on the abstracts page as appropriate.

Over two days, Bishaka Sarker provided a rich and full programme of workshops, speakers, debates, performances and provocations around the specific area of dance practice, of working with dementia. Rather than comment on each item of the conference programme, I have written about elements that offered a fresh perspective or an important reminder of the scope for work with the ageing dancer. The full conference was recorded and extracts are available on the Chatarunghan website: (http://www.chezfred.org.uk/Chat/20101210MemoryConference/index.html).
Thank you to Dance South West for providing funds to help me travel to Liverpool!

Friday 10th December 2010
National Dementia Strategy – Teresa Jankowska, Liverpool PCT
Teresa spoke of Liverpool’s approach of moving away from the medical model of the Doctor being the expert, of acknowledging the individual, who know their own stories best, and listening to these stories.
She talked about Liverpool’s commitment to workforce development and training (including consultants and therapists) and gaining an increased understanding of Dementia. She cited examples of identified quality outcomes, such as ‘a person has the right to contribute to society, even in later, demented years’. She recognised the ‘bringing into contact’ that occurs as we come closer to death.
Richard Coaten was a memorable speaker, who’s paper was rooted in the idea that whilst cognitive function is diminished, emotional intelligence is not. He talked about the importance of being in the moment and being emotionally open. Holding a “high quality, free-floating attention”, supporting identity and personhood. Dementia strips us away to our essence, it is an expression of humanity. We are building bridges of understanding, through the lived body. For example, we are building bridges between:
Physco – Soma
Sense – non-sense
Known – not yet known
Thinking – feeling
Meaningless – meaningful

The meeting place is about relationships.

Richard highlighted the Dance Movement Therapy skills that come into play in this work, including:

• Locating triggers – ways in
• Mirroring – reciprocity – same height / can you accept difference in otherness?
• Rhythm – neuroscience gives us evidence that rhythm helps organise principles in our brains
• Music, song and percussion
• Importance of repetition
• Re-membering
• Working through metaphor and symbolism

He also stressed the important of working in pairs, rather than solo and the need to plan, debrief and prepare well.

Richard referred to the conference image, of two hands, to provoke an improvisation, by delegates, of one hand dementing, the other supporting. He linked this to Yung’s theory on compensatory function, ie, that when one element of the body dements, another compensates. He talked about our role as supporters / enablers within these two hands.

Richard spoke of a subjective embodied experience and how through dance, participants can go from a place of low well-being, anxiety and depression, to a lovely sense of positive wellbeing and the brain being at rest.

He spoke of “creative alertness”, “poetic awareness” and called the work “embodied, phenomenological and psychological” He saw the work as remedial rather than curatorial and drew a parallel between the improvisatory nature of dance and that of a person’s response to their condition.
John Killick – read several poems that had been written by people with dementia and emphasised the creative urges and talents of those he had worked with. As he read these poems, including one about “floating in the sky, high up above the clouds” and “young people don’t see true beauty” I felt as though the voices were those of people that had drifted into a profound place, where the mind starts to shut down on the day-to-day practicalities and stresses of life and move into a spiritual awareness. I wondered if there was any research that might correlate the level of stress / creative outlets against the likelihood of getting dementia. For example, if a person experiences less stress, is creatively and spiritually fulfilled in childhood and adulthood, are they less likely to ‘dement’ and is dementia a degenerative condition or a regenerative condition? A moving back to what is important, coming full circle – more in touch with one’s spirituality and a profound thinking, in preparation for death / another life? Experiencing rich South Asian dance in Liverpool, I was reminded of what this culture and philosophy can offer to our perspective on dance in later years.
“It’s a licence to be free to be me...I think when I got the diagnosis...I wanted to find out if I was artistic. Being able to think outside of the box. It’s a nice feeling.”
“I’d rather be a creature of the air than the earth.”
“Why cry when you can laugh? It doesn’t cost anything”
Killick spoke of his dream – a work with dementia to include contributions and collaborations from all art forms.
References:
• “I’m still here” (Book) – the gifts of alzeimers
• www.dementiapositive.com (John Killick and Kate Allen)
• John referred to Tom Kitwood and Faith Gibson, who talks about how dementia strips people down. Frees them to be creative. Communicate with greater authenticity.

Diane Amans (notes)
• What is important? What is likely to lead to a positive experience?
• Playfulness – Liberman (Educationalist) says that a truly playful person has a rich resource of coping strategies and that playful encounters are important in all aspects of life.
• Wellbeing and dementia is about being able to engage with people. Our own inner child is open and free. Confident and at ease. Spontaneous and immediate.
• Lures to invite people to respond: a giant balloon – clocking reactions, Occupational Therapist played the violin and they moved together, Rock and roll music
• Partner dancing is ideal
• Non-verbal communication works well – verbal directions can cause anxiety.
• Author Oliver James talks about feeling good and not knowing why
Fergus Early – observations
• One to one work is ideal - picking up on signals
• Multi-sensory input - touch, words, putting elements together
• Cultural appropriateness – research people’s backgrounds – triggers
• Sometimes the work can bypass the diagnosis
• Greater attention span in dance
Azucena Guzman
Azucena talked about her research in Psychomotor dance, using Dazon music and dance. Her research is interested in non-pharmological interventions (such as dance) before pharmological. Although this was an incredibly engaging presentation, grounded in sound academic research, I took few notes. I have requested a copy of her slides (azucena.guzman@newcastle.ac.uk). I will forward these on when I receive them.

Saturday 11th December 2010
Francois Matarraso opened day two with his reflections on the conference so far, drawing parallels between his impression of the work on day one and his interaction with his son in his early, pre-verbal years. Francois acknowledged Community Dancers’ sensitivity and their ability to say the unsaid. Whilst Art is always about relationships, he felt that it was more than that in this context – about a communion – a shared commitment and values. He referred to Richard Coaten’s term, re-membering, of being a member of a community again: that’s what remembering is. He talked about being present in the moment, and a present being a gift that the practice brings.

Music, Rhythm, Dance and Neuroscience – Julia Clark

A highlight of the conference. Julia gave neuroscientific evidence of the value of dance and music for dementia. It was a very dense presentation. Notes from her presentation are listed below, kept in note form, for clarity.

• Everyone is different - we each have a different genetic cross-wiring in the brain, therefore each dementia is different. This gives justification for the single case-study approach. The arts can tap into this
• Julia’s case study had Locked-in Syndrome* at 22 yrs old. She was intellectually intact, but couldn’t move, except her eyes. The person is there. Can happen after a trauma or stroke. A 1 year into the condition, the patient could swallow and breath independently. As the years went by, Julia observed the patient degenerate rapidly.

* A journalist had Locked-in syndrome recently and documented it. If we go back to medical routes, we can trace it to 1907. Sub-cortal dementias affect parts of the brain controlling movement, e.g. Parkinsons, Huntingtons, Motor Neurones. Facial and emotional expression decreased. The cause of damage is not important, it’s where it is. Starter motor in brain initiates movement. Loss of brain’s piper rhythm in Locked-in – unable to initiate movement.

Evolution and use of music

Music therapy can be used to enhance mood. People may forget what you say, but not how you make them feel. Many types of memory. Examples of rhythm in nature / everyday lives include:

• Migration, eco-location – e.g. bees, swallows, bats, pod of whales
• Military cadence – override emotion through rhythm and song. Energises, motivates, improves posture.
• Rocking child, courtship, ecstasy, anger, battle chant
• Rugby Haka

Music and movement share pathways. Isabel Curran 2006 – A regular musical beat can be used to replace the piper rhythm – internal rhythms synchronise and muscles respond to the beat of the music. For example, clapping – possibly heart beat.

Mozart effect
• Causes dophamine and serotonin to be secreted – diminished in movement disorders
• Improves space-time reasoning
• The heart is a muscle, therefore it can respond to the music
• Calm music- increases the production of hormone Oxytocin – the love hormone and reverses the effect of stress hormones
• If Mozart is played during surgery, has been found to resulted in a better recovery

General notes
• Classical Indian music slows breathing and heart rate.
• Music preference is less effective than pace.
• Repetitive sound meditation – repetitive ohm and keeping very still has been found to be beneficial. FMRI scan of meditation shows up a focused attention, increased attention to frontal lobe
• Props – extend your movement and sense of life and self (amputated self)
• Brain feedback loops – moving, facial muscle – smile. Milliseconds to change mood – when hear happy music – changed facial expression
• Non-parametric and parametric tests – I need to look this one up, as I got a bit confused.

On Fortuitous Novelties – Clive Parkinson
Clive, a designer, spoke about Art, design and sentience and his work with an artist Darren Browett, creating objects to take into homes. He spoke of how the objects had provoked conversations, which were beyond just reminiscence work. These carefully crafted objects were loaded with meaning. He talked of his own experience with his grandmother and her requests to constantly come home and his own observations of increased disinhibition, giving powerful opportunity for creativity.

I loved the tidiness of his work. So much was encompassed in these smooth, clean, wonderfully crafted objects. Giving opportunity to sit and wonder, stare, touch and share.

Cohen “arts is like chocolate for the brain. Focuses on assets and the person. Art allows us to explore taboo ideas e.g. decay and death, sexuality and mistakes.”

http://darrenbrowett.wordpress.com
http://moma.org/meetme

General thoughts

I gained a lot from conversations in breaks and over dinner, meeting people with a range of reasons for becoming interested in this work. Overall, there was a very high standard of speakers and a varied programme. It was good to focus on such a specific area and practical workshops are essential.
As a lot of my work is currently with Early Years children, I found masses of links between the work with young children and people in later years. I wonder why it is endearing when a child cries, gets upset, thinks laterally or confuses their words, yet in later years it is seen as a degeneration, a loss of pride and dignity?
Hannah Lefeuvre, January 2011