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Integrating Citizenship, Embodiment, and Relationality: Towards a Reconceptualization of Dance and Dementia in Long-Term Care

Published online by Cambridge University Press:  01 January 2021

Pia Kontos  and
Alisa Grigorovich
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Abstract

Dance, as aesthetic self-expression, is a unique arts-based program that combines the physical benefits of exercise with psychosocial therapeutic benefits. While dance has also been shown to support empowerment, meaningful self-expression, and pleasurable experience, it is rarely adopted to support these aspects of engagement in the context of dementia care. The instrumental reduction of dance to its application as a therapeutic tool can be traced to the contemporary movement towards cognitive science with an emphasis on embodied cognition. This has effectively elided a consideration of how the body itself, separate and apart from cognition, could be a source of intelligibility, inventiveness, and creativity. We argue for the need to broaden the therapeutic model of dance to more fully support embodied and creative self-expression by persons living with dementia. To achieve this, we explore how a relational model of citizenship that recognizes corporeality and relationality as fundamental to human existence brings a new and critical dimension to understanding the importance of dance in the context of dementia. Drawing on this model, we articulate a new kind of ethic characterized by a pre-reflective intercorporeal sensibility that requires the mobilization of public structures and practices to cultivate a relational environment for individuals living with dementia that supports human flourishing.

Type
Symposium 2 Articles
Information
Journal of Law, Medicine & Ethics , Volume 46 , Issue 3: The Medicalization of Poverty; Perspectives of Alzheimer's Disease: Ethical, Legal, and Social Issues , Fall 2018 , pp. 717 - 723
Copyright
Copyright © American Society of Law, Medicine and Ethics 2018

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References

Eddy, M., “A Brief History of Somatic Practices and Dance: Historical Development of the Field of Somatic Education and Its Relationship to Dance,” Journal of Dance & Somatic Practices 1, no. 1 (2009): 5-27; Rouhiainen, L., “Somatic Dance as a Means of Cultivating Ethically Embodied Subjects,” Research in Dance Education 9, no. 3 (2008): 241-256.Google Scholar
Kontos, P., Miller, K. L., and Kontos, A., “Relational Citizenship: Supporting Embodied Selfhood and Relationality in Dementia Care,” Sociology of Health & Illness 39, no. 2 (2017): 182-198; Kontos, P., Grigorovich, A., Kontos, A., and Miller, K. L., “Citizenship, Human Rights, and Dementia: Towards a New Embodied Relational Ethic of Sexuality,” Dementia: The International Journal of Social Research and Practice 15, no. 3 (2016): 315-29; Miller, K. L. and Kontos, P., “The Use of Elder-Clowning to Foster Relational Citizenship in Dementia Care,” in Andreassen, T. A., Gubrium, J. F., and Solvang, P. K., eds., Reimagining the Human Service Relationship (New York, NY: Columbia University Press, 2016): 158-177; Grigorovich, A. and Kontos, P., “Advancing an Ethic of Embodied Relational Sexuality to Guide Decision-Making in Dementia Care,” The Gerontologist (2018): 219-225, available at <https://doi.org/10.1093/geront/gnw137> (last visited August 28, 2018).Google Scholar
Jennings, B., “Agency and Moral Relationship in Dementia,” Metaphilosophy 40, nos. 3-and 4 (2009): 425-437, at 425.Google Scholar
See supra note 2.Google Scholar
Id.Google Scholar
Kontos, P. and Grigorovich, A., “Rethinking Musicality in Dementia as Embodied and Relational,” Journal of Aging Studies (“Special Issue: Ageing, Body and Society. Key Themes, Critical Perspectives,” Martin, W. and Twigg, J., eds.), 45 (2018): 39-48.Google Scholar
Bartlett, R. and O'Connor, D., Broadening the Dementia Debate: Towards Social Citizenship (Bristol, UK: The Policy Press, 2010); Kontos, P., Miller, K. L., and Kontos, A., “Relational Citizenship: Supporting Embodied Selfhood and Relationality in Dementia Care,” Sociology of Health & Illness 39, no. 2 (2017): 182-198.Google Scholar
See Kontos et al. (2017), supra note 2; Kontos et al. (2016), supra note 2; Miller and Kontos, supra note 2, at 158-177; Grigorovich and Kontos, supra note 2.Google Scholar
Kontos, P., “Embodied Selfhood: Redefining Agency in Alzheimer's Disease,” in Tulle, E., ed., Old Age and Agency (Hauppauge, NY: Nova Science Publishers, 2004): at 105-121; Kontos, P., “Embodied Selfhood in Alzheimer's Disease: Rethinking Person-Centred Care,” Dementia: The International Journal of Social Research and Practice 4, no. 4 (2005): 553-570; Kontos, P., “Embodied Selfhood: An Ethno-graphic Exploration of Alzheimer's Disease,” in Cohen, L. and Leibing, A., eds., Thinking about Dementia: Culture, Loss, and the Anthropology of Senility (New Brunswick, N.J: Rutgers University Press, 2006): 195-217; Kontos, P., “Alzheimer Expressions or Expressions Despite Alzheimer's? Philosophical Reflections on Selfhood and Embodiment,” Occasion: Interdisciplinary Studies in the Humanities 4 (2012): 1-12, available at <http://arcade.stanford.edu/sites/default/files/article_pdfs/OCCASION_v04_Kontos_053112_0.pdf> (last visited August 8, 2018).Google Scholar
Merleau-Ponty, M., Phenomenology of Perception, trans. by Smith, C. (London, UK: Routledge & K. Paul, 1962): at x.Google Scholar
Bourdieu, P., Outline of a Theory of Practice, trans. by Nice, R. (Cambridge, UK: Cambridge University Press, 1977): at 76-78; Bourdieu, P., The Logic of Practice, trans. by Nice, R. (Cambridge, UK: Polity Press, 1990): at 9.Google Scholar
Kontos, P., “Habitus: An Incomplete Account of Human Agency,” American Journal of Semiotics 22, nos. 1/4 (2006): 67-83.Google Scholar
Id.Google Scholar
See Merleau-Ponty, supra note 10; Merleau-Ponty, M., “An Unpublished Text by Maurice Merleau-Ponty: A Prospectus of His Work,” in Edie, J., ed., The Primacy of Perception (Evanston: Northwestern University Press, 1964): at 3-11.Google Scholar
Diprose, R., Corporeal Generosity: On Giving with Nietzsche, Merleau-Ponty, and Levinas (Albany, NY: Suny Press, 2012).Google Scholar
Käll, L. F., “Intercorporeal Expression and the Subjectivity of Dementia,” in Dolezal, L. and Petherbridge, D., eds., Body/Self/Other: A Phenomenology of Social Encounters (Albany, NY: SUNY Press, 2017): at 368.Google Scholar
Kontos, P., Miller, K. L., and Kontos, A., “Relational Citizenship: Supporting Embodied Selfhood and Relationality in Dementia Care,” Sociology of Health & Illness 39, no. 2 (2017): 182-198; see Kontos et al. (2016), supra note 2; see Miller and Kontos, supra note 2; Grigorovich and Kontos, supra note 2.Google Scholar
Coveney, C., Gabe, J., and Williams, S., “The Sociology of Cognitive Enhancement: Medicalisation and Beyond,” Health Sociology Review 20, no. 4 (2011): 381-393; Abraham, J., “Evolving Sociological Analyses of ‘Pharmaceuticalisation’: A Response to Williams, Martin and Gabe,” Sociology of Health & Illness 33, no. 5 (2011): 726-728.Google Scholar
Behuniak, S. M., “The Living Dead? The Construction of People with Alzheimer's Disease as Zombies,” Ageing & Society 31, no. 1 (2011): 70-92; Cuijpers, Y. and van Lente, H., “Early Diagnostics and Alzheimer's Disease: Beyond ‘Cure’ and ‘Care,’” Technological Forecasting and Social Change 93 (2015): 54-67.Google Scholar
Twigg, J., “Carework as a Form of Bodywork,” Ageing and Society 20 (2000): 389-411; Daly, T. and Szebehely, M., “Unheard Voices, Unmapped Terrain: Care Work in Long-Term Residential Care for Older People in Canada and Sweden,” International Journal of Social Welfare 21, no. 2 (2012): 139-148.Google Scholar
Maust, D. T., Kim, H. M., Seyfried, L. S., Chiang, C., Kavanagh, J., Schneider, L. S., and Kales, H. C., “Antipsychotics, Other Psychotropics, and the Risk of Death in Patients with Dementia: Number Needed to Harm,” JAMA Psychiatry 72, no. 5 (2015): 438-445.CrossRefGoogle Scholar
Dannefer, D., Stein, P., Siders, R. A., and Patterson, R. S., “Is That All There Is? The Concept of Care and the Dialectic of Critique,” Journal of Aging Studies 22, no. 2 (2008): 101-108; McWilliam, C. L., Coleman, S., Melito, C., Sweetland, D., Saidak, J., Smit, J., Thompson, T., and Milak, G., “Building Empowering Partnerships for Interprofessional Care,” Journal of Interprofessional Care 17, no. 4 (2003): 363-376.Google Scholar
Dupuis, S. L., McAiney, C. A., Fortune, D., Ploeg, J., and Witt, L. D, “Theoretical Foundations Guiding Culture Change: The Work of the Partnerships in Dementia Care Alliance,” Dementia: The International Journal of Social Research and Practice 15, no. 1 (2016): 85-105; Sterin, G. J., “Essay on a Word: A Lived Experience of Alzheimer's Disease,” Dementia: The International Journal of Social Research and Practice 1, no. 1 (2002): 7-10.Google Scholar
Zeilig, H., “Dementia as a Cultural Metaphor,” The Gerontolo-gist 54, no. 2 (2014): 258-267; Volicer, L. and Hurley, A. C., “Review Article: Management of Behavioral Symptoms in Progressive Degenerative Dementias,” The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 58, no. 9 (2003): M837-845.CrossRefGoogle Scholar
Schaller, S., Mauskopf, J., Kriza, C., Wahlster, P., and Kolo-minsky-Rabas, P. L., “The Main Cost Drivers in Dementia: A Systematic Review,” International Journal of Geriatric Psychiatry 30, no. 2 (2015): 111-129.CrossRefGoogle Scholar
Lucas, J. A., Chakravarty, S., Bowblis, J. R., Gerhard, T., Kalay, E., Paek, E. K., and Crystal, S., “Antipsychotic Medication Use in Nursing Homes: A Proposed Measure of Quality,” International Journal of Geriatric Psychiatry 29, no. 10 (2014): 1049-1061.Google Scholar
Schneider, L. S., Dagerman, K. S., and Insel, P. S., “Efficacy and Adverse Effects of Atypical Antipsychotics for Dementia: Meta-Analysis of Randomized, Placebo-Controlled Trials,” American Journal of Geriatric Psychiatry 14, no. 3 (2006): 191-210; Simoni-Wastila, L., Ryder, P. T., Qian, J., Zuckerman, I. H., Shaffer, T., and Zhao, L., “Association of Antipsychotic Use with Hospital Events and Mortality among Medicare Beneficiaries Residing in Long-Term Care Facilities,” American Journal of Geriatric Psychiatry 17, no. 5 (2009): 417-427.CrossRefGoogle Scholar
Cohen-Mansfield, J., “Nonpharmacologic Interventions for Inappropriate Behaviors in Dementia,” American Journal of Geriatric Psychiatry 9, no. 4 (2001): 361-381.Google Scholar
Kovach, C. R., Kelber, S. T., Simpson, M., and Wells, T., “Behaviors of Nursing Home Residents with Dementia: Examining Nurse Responses,” Journal of Gerontological Nursing 32, no. 6 (2006): 13-21.Google Scholar
Rader, J., Barrick, A. L., Hoeffer, B., Sloane, P. D., McKenzie, D., Talerico, K. A., and Glover, J. U., “The Bathing of Older Adults with Dementia,” American Journal of Nursing 106, no. 4 (2006): 40-48.Google Scholar
Swaffer, K., “Dementia and Prescribed Disengagement™,” Dementia: The International Journal of Social Research and Practice 14, no. 1 (2015): 3-6.CrossRefGoogle Scholar
See Cohen-Mansfield, supra note 28.Google Scholar
Kitwood, T., Dementia Reconsidered: The Person Comes First (Buckingham: Open University Press, 1997): at 46.Google Scholar
Fossey, J., Ballard, C., Juszczak, E., James, I., Alder, N., Jacoby, R., and Howard, R., “Effect of Enhanced Psychosocial Care on Antipsychotic Use in Nursing Home Residents with Severe Dementia: Cluster Randomised Trial,” British Medical Journal 332, no. 7544 (2006): 756-761; Moniz-Cook, E., Woods, R.T., and Richards, K., “Functional Analysis of Challenging Behaviour in Dementia: The Role of Superstition,” International Journal of Geriatric Psychiatry 16 (2001): 45-56.Google Scholar
Douglas, S., James, I., and Ballard, C., “Non-Pharmacological Interventions in Dementia,” Advances in Psychiatric Treatment 10 (2004): 171-179.Google Scholar
Cohen-Mansfield, J. and Mintzer, J. E., “Time for Change: The Role of Nonpharmacological Interventions in Treating Behavior Problems in Nursing Home Residents with Dementia,” Alzheimer Disease and Associated Disorders 19, no. 1 (2005): 37-40; Emerson, E., “Working with People with Challenging Behaviour,” in Emerson, E., Hatton, C., Bromley, J., and Caine, A., eds., Clinical Psychology and People with Intellectual Disabilities (Chichester: John Wiley & Sons, 1998): at 127-153.CrossRefGoogle Scholar
Rader, J., Barrick, A.L., Hoeffer, B., Sloane, P.D., McKenzie, D., Talerico, K. A., and Glover, J. U., “The Bathing of Older Adults with Dementia,” American Journal of Nursing 106, no. 4 (2006): 40-48.CrossRefGoogle Scholar
Gitlin, L. N., Kales, H. C., and Lyketsos, C. G., “Nonpharmacologic Management of Behavioral Symptoms in Dementia,” JAMA 308, no. 19 (2012): 2020-2029.Google Scholar
Beard, R. L., “Art Therapies and Dementia Care: A Systematic Review,” Dementia: The International Journal of Social Research and Practice 11, no. 5 (2011): 633-656.CrossRefGoogle Scholar
Genoe, R. M. and Whyte, C., “Confronting Ageism through Therapeutic Recreation Practice,” Leisure/Loisir 39, no. 2 (2015): 235-252, at 239.CrossRefGoogle Scholar
Staricoff, R. L., “Arts in Health: The Value of Evaluation,” Journal of the Royal Society for the Promotion of Health 126, no. 3 (2006): 116-120.Google Scholar
Beard, R. L., “Art Therapies and Dementia Care: A Systematic Review,” Dementia: The International Journal of Social Research and Practice 11, no. 5 (2011): 633-656; Chancellor, B., Duncan, A., and Chatterjee, A., “Art Therapy for Alzheimer's Disease and Other Dementias,” Journal of Alzheimer's Disease 39, no. 1 (2014): 1-11.Google Scholar
Id.Google Scholar
Guzmán-García, A., Hughes, J. C., James, I. A., and Rochester, L., “Dancing as a Psychosocial Intervention in Care Homes: A Systematic Review of the Literature,” International Journal of Geriatric Psychiatry 28, no. 9 (2013): 914-24.Google Scholar
Id.; Ho, R. T. H., Cheung, J. K. K., Chan, W. C., Cheung, I. K. M., and Lam, L. C. W., “A 3-Arm Randomized Controlled Trial on the Effects of Dance Movement Intervention and Exercises on Elderly with Early Dementia,” BMC Geriatrics 15 (2015), available at <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4615324/> (last visited August 8, 2018).Google Scholar
Karkou, V. and Meekums, B., “Dance Movement Therapy for Dementia,” Cochrane Database of Systematic Reviews 2017, no. 2 (2017): 1-29, available at <http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD011022.pub2/full> (last visited August 8, 2018).Google Scholar
Payne, H., Warnecke, T., Karkou, V., and Westland, G., “A Comparative Analysis of Body Psychotherapy and Dance Movement Psychotherapy from a European Perspective,” Body, Movement and Dance in Psychotherapy 11, no. 2-3 (2016): 144-66; see Karkou and Meekums, supra note 46.Google Scholar
See Guzmán-García et al., supra note 44; Abreu, M. and Hartley, G., “The Effects of Salsa Dance on Balance, Gait, and Fall Risk in a Sedentary Patient with Alzheimer's Dementia, Multiple Comorbidities, and Recurrent Falls,” Journal of Geriatric Physical Therapy 36, no. 2 (2013): 100-108; Hamill, M., Smith, L., and Röhricht, F., “‘Dancing Down Memory Lane’: Circle Dancing as a Psychotherapeutic Intervention in Dementia — a Pilot Study,” Dementia 11, no. 6 (2012): 709-724.CrossRefGoogle Scholar
Guzmán, A., Robinson, L., Rochester, L., James, I., and Hughes, J. C., “A Process Evaluation of a Psychomotor Dance Therapy Intervention (Dancing) for Behavior Change in Dementia: Attitudes and Beliefs of Participating Residents and Staff,” International Psychogeriatrics 29, no. 2 (2017): 313-22, at 319.Google Scholar
Id.; Palo-Bengtsson, L. and Ekman, S., “Emotional Response to Social Dancing and Walks in Persons with Dementia,” Journal of Alzheimer's Disease and Other Dementias 17, no. 3 (2002): 149-153; Nyström, K. and Lauritzen, S. O., “Expressive Bodies: Demented Persons' Communication in a Dance Therapy Context,” Health 9, no. 3 (2005): 297-317; Hill, H., “Dancing with Hope: Dance Therapy with People with Dementia,” in Chaiklin, S. and Wengrower, H., eds., The Art and Science of Dance/Movement Therapy: Life Is Dance (New York: Routledge, 2016): at 219-232.Google Scholar
Hill, H., “Dancing with Hope: Dance Therapy with People with Dementia,” in Chaiklin, S. and Wengrower, H., eds., The Art and Science of Dance/Movement Therapy: Life Is Dance (New York: Routledge, 2016): at 219-232.Google Scholar
Id.Google Scholar
Batson, G., Quin, E., and Wilson, M., “Integrating Somatics and Science,” Journal of Dance & Somatic Practices 3, no. 1-2 (2012): 183-193; Payne, H., Warnecke, T., Karkou, V., and Westland, G., “A Comparative Analysis of Body Psychotherapy and Dance Movement Psychotherapy from a European Perspective,” Body, Movement and Dance in Psychotherapy 11, no. 2-3 (2016): 144-166; Warburton, E. C., “Of Meanings and Movements: Re-Languaging Embodiment in Dance Phenomenology and Cognition,” Dance Research Journal 43, no. 2 (2011): 65-84.CrossRefGoogle Scholar
Rosch, E., Varela, F., and Thompson, E., The Embodied Mind: Cognitive Science and Human Experience (Cambridge, MA: MIT Press, 1991): at 147-184.Google Scholar
Batson, G., Quin, E., and Wilson, M., “Integrating Somatics and Science,” Journal of Dance & Somatic Practices 3, no. 1-2 (2012): 183-193.Google Scholar
Payne, H., Warnecke, T., Karkou, V., and Westland, G., “A Comparative Analysis of Body Psychotherapy and Dance Movement Psychotherapy from a European Perspective,” Body, Movement and Dance in Psychotherapy 11, nos. 2-3 (2016): 144-166; Karkou, V. and Meekums, B., “Dance Movement Therapy for Dementia,” Cochrane Database of Systematic Reviews 2017, no. 2 (2017): 1-29, available at <http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD011022.pub2/full> (last visited August 8, 2018); Fischman, D., “Therapeutic Relationships and Kinesthetic Empathy,” in Chaiklin, S. and Wengrower, H., eds., The Art and Science of Dance/Movement Therapy: Life Is Dance (New York: Routledge, 2016): at 33-52.CrossRefGoogle Scholar
Coaten, R. and Newman-Bluestein, D., “Embodiment and Dementia — Dance Movement Psychotherapists Respond,” Dementia 12, no. 6 (2013): 677-681, at 678.Google Scholar
See Fischman, supra note 56.Google Scholar
See Kontos, supra note 12.Google Scholar
Kontos, P. and Naglie, G., “Tacit Knowledge of Caring and Embodied Selfhood,” Sociology of Health & Illness 31, no. 5 (2009): 688-704.Google Scholar
See Merleau-Ponty, supra note 10, at 233.Google Scholar
Id., at 116.Google Scholar
Kontos, P., “Rethinking Sociability in Long-Term Care: An Embodied Dimension of Selfhood,” Dementia: The International Journal of Social Research and Practice 11, no. 3 (2012): 329-346; Kontos, P., “Alzheimer Expressions or Expressions Despite Alzheimer's? Philosophical Reflections on Selfhood and Embodiment,” Occasion: Interdisciplinary Studies in the Humanities 4, no. May 31 (2012): 1-12, available at <http://arcade.stanford.edu/sites/default/files/article_pdfs/OCCASION_v04_Kontos_053112_0.pdf> (last visited August 8, 2018).Google Scholar
Jennings, B., “Agency and Moral Relationship in Dementia,” Metaphilosophy 40, nos. 3-and 4 (2009): 425-437; Carlson, L., “Music, Intellectual Disability, and Human Flourishing,” in Howe, B., Jensen-Moulton, S., Lerner, N., and Straus, J., eds., The Oxford Handbook of Music and Disability Studies (New York: Oxford University Press, 2015): at 37-53.Google Scholar
Id. (Jennings); Nussbaum, M. C., Frontiers of Justice: Disability, Nationality, Species Membership (Cambridge, MA: Harvard University Press, 2009); Carlson, L., “Rethinking Normalcy, Normalization, and Cognitive Disability,” in Figueroa, R. and Harding, S., eds., Science and Other Cultures: Issues in Philosophies of Science and Technology (New York: Routledge, 2003): at 154–171.Google Scholar
Macpherson, H., “Guiding Visually Impaired Walking Groups: Intercorporeal Experience and Ethical Sensibilities,” in Dodge, M., ed., Touching Space, Placing Touch (New York, NY: Routledge, 2016): 131-150, at 132.Google Scholar
“Movement to Music at Baycrest,” Canada's National Ballet School, available at <http://www.nbs-enb.ca/Sharing-Dance/Sharing-Dance-Programs/Movement-to-Music-at-Baycrest> (last visited August 8, 2018). (last visited August 8, 2018).' href=https://scholar.google.com/scholar?q=“Movement+to+Music+at+Baycrest,”+Canada's+National+Ballet+School,+available+at++(last+visited+August+8,+2018).>Google Scholar
Genoe, M. R. and Dupuis, S. L., “The Role of Leisure within the Dementia Context,” Dementia 13, no. 1 (2014): 33-58; Moss, H. and O'Neill, D., “Aesthetic Deprivation in Clinical Settings,” The Lancet 383, no. 9922 (2014): 1032-1033.Google Scholar
Robinson, S. K., “Do Schools Kill Creativity?” TED Talk, available at <http://www.ted.com/talks/ken_robinson_says_schools_kill_creativity/transcript?language=en> (last visited August 8, 2018).+(last+visited+August+8,+2018).>Google Scholar
Anita Sivers quoted in Carlson, L., “Music, Intellectual Disability, and Human Flourishing,” in Howe, B., Jensen-Moulton, S., Lerner, N., and Straus, J., eds., The Oxford Handbook of Music and Disability Studies (New York: Oxford University Press, 2015): 37-53, at 46.Google Scholar