Behaving as a person: professionals’ arts of doing when dealing with dementia in nursing homes

Abstract

Dementia affects memory, language and motor functions, engenders behavioural and psychological disorders, and progressively weakens the ability of older people to communicate and interact. Simultaneously, maintaining residents in social exchanges and enabling them to behave as a ‘person’, a status to be understood in moral terms, is a main objective of care work in nursing homes. Based on an ethnographic study conducted in a long-term Swiss care facility and by focusing on professionals’ inquiries, this article uncovers two ‘arts of doing’ used by professionals to make contact with residents and maintain them in the fabric of relationships. First, ‘sensitive arts of doing’ are in play when professionals seek to interpret a situation from a resident’s gestures and emotions in order to (re)establish the fine-tuning necessary for continued interaction. Second, ‘hermeneutic arts of doing’ are employed when professionals try to determine how residents perceive their environment and elucidate how to make sense of what they are doing together. Highlighting these two ‘arts of doing’ gives depth and substance to the relational activities undertaken by professionals and proposes concrete methods that can support care, interaction and value-based practice with older people with dementia.