Beyond loss: An essay about presence and sparkling moments based on observations from life coexisting with a person living with dementia.

IF 2.6 3区 医学 Q1 NURSING
Nursing Philosophy Pub Date : 2024-01-01 Epub Date: 2023-02-27 DOI:10.1111/nup.12425
Janne B Damsgaard, Jette Lauritzen, Charlotte Delmar, Monica E Kvande
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Abstract

This is an essay based on a story with observations, about present and sparkling moments from everyday life coexisting with a mother living with dementia. The story is used to begin philosophical underpinnings reflecting on 'how it could be otherwise'. Dementia deploys brutal existential experiences such as cognitive deterioration, decline in mental functioning and often hurtful social judgements. The person living with dementia goes through transformation and changes of self. Cognitive decline progressively disrupts the foundations upon which social connectedness is built, often creating a profound sense of insecurity. The challenge for carers and healthcare professionals is therefore to find ways of clarifying a concept of agency. It will be worthwhile developing the ability of attuning into 'what is there' arising from every corner of the care situation. Understanding and practicing this can strengthen existence and the experience of connectedness and meaning, empowering the person with dementia. It is important to find ways, relational moves, in which carers and healthcare professionals can embed the creativity appearing in mundane everyday situations filled with surplus of meaning, sharing mental landscapes (and embodied relational understanding) with the person living with dementia - seizing and sharing aesthetic moments (verbal and nonverbal) being present together. We argue that carers and healthcare professionals may find this understanding of care useful. This implies looking into a phenomenological-hermeneutic perspective developing competences as well as practical wisdom understanding and being aware of the creative and innovative possibilities (often preverbal and unnoticed small things) in everyday life of what we, inspired by psychoanalyst Daniel Stern, call sparkling moments of meeting, creating experience with the other that is personally undergone and lived through in the present.

超越失落:根据与痴呆症患者共处的生活观察,写一篇关于存在和闪光时刻的文章。
这篇文章以一个观察故事为基础,讲述了与患有痴呆症的母亲共处的日常生活中的点点滴滴。文章以这个故事为哲学基础,反思 "怎么可能不是这样"。痴呆症会带来残酷的生存体验,如认知能力退化、精神功能衰退以及经常受到伤害的社会评价。痴呆症患者会经历自我的转变和变化。认知能力的衰退会逐渐破坏建立社会联系的基础,往往会产生极度的不安全感。因此,照护者和医疗保健专业人员面临的挑战是找到澄清代理概念的方法。值得培养的是,在护理工作的每一个角落都能敏锐地捕捉到 "存在的东西"。理解并实践这一点,可以加强存在感以及对联系和意义的体验,增强痴呆症患者的能力。重要的是,护理人员和医疗保健专业人员要找到方法,通过关系行动,将创造力融入到充满过剩意义的日常琐事中,与痴呆症患者分享精神景观(和体现性关系理解)--抓住并分享共同存在的审美时刻(语言和非语言)。我们认为,照护者和医疗保健专业人员可能会发现这种对照护的理解是有用的。这意味着我们要从现象学-神学的视角出发,培养能力和实践智慧,了解并意识到日常生活中的创造性和创新性可能性(通常是言语前的和未被注意到的小事),我们受精神分析学家丹尼尔-斯特恩(Daniel Stern)的启发,将这些可能性称为闪亮的相遇时刻,创造与他人在当下共同经历和生活的体验。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.80
自引率
9.10%
发文量
39
审稿时长
>12 weeks
期刊介绍: Nursing Philosophy provides a forum for discussion of philosophical issues in nursing. These focus on questions relating to the nature of nursing and to the phenomena of key relevance to it. For example, any understanding of what nursing is presupposes some conception of just what nurses are trying to do when they nurse. But what are the ends of nursing? Are they to promote health, prevent disease, promote well-being, enhance autonomy, relieve suffering, or some combination of these? How are these ends are to be met? What kind of knowledge is needed in order to nurse? Practical, theoretical, aesthetic, moral, political, ''intuitive'' or some other? Papers that explore other aspects of philosophical enquiry and analysis of relevance to nursing (and any other healthcare or social care activity) are also welcome and might include, but not be limited to, critical discussions of the work of nurse theorists who have advanced philosophical claims (e.g., Benner, Benner and Wrubel, Carper, Schrok, Watson, Parse and so on) as well as critical engagement with philosophers (e.g., Heidegger, Husserl, Kuhn, Polanyi, Taylor, MacIntyre and so on) whose work informs health care in general and nursing in particular.
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