For some time, I’ve wanted to visit Nova Scotia on the east coast of Canada; partly influenced by the beautiful short stories of Alastair Macleod, living on Cape Breton Island. Last year, I met his son, Alexander, also a fine writer, at a writer’s workshop where we compared the history and geography of Northumberland, where I live, and Nova Scotia where he grew up. Due to the complex economic changes, both areas have seen a decline in traditional industries of fishing, coal mining and farming and increase in tourism and property development. Both on the East Coast.
It seemed an important place to experience as part of my study visit where I wanted to explore older people’s sense of place and belonging in a rural setting. I wanted to investigate the sense of identity which I have found in my work with older people in Newcastle and Northumberland, where place is often central to identity, and personal histories are written in the scrubbed doorsteps or the rope factory or the ship building or the mines. Those structures may be gone but they live on in many older people, not as fond memoirs, but as a real sense of identity. For those living with dementia, it may be one aspect of identity which is more easily evidenced in creative activities.
It was such a relief to find, via the internet, the Eldertree Project, part of Antigonish Health and Arts (AHA!), based in a small university town two hours from the main city Halifax. As I drove there, across wide expanse of forest and field, I kept thinking ‘This is Scotland in Canada!’ Early migrants from Scotland (Nova Scotia=New Scotland) and Ireland established European settlements with their traditions of music, farming and fishing. Now their cultural legacies are maintained in local communities, alongside references to First Nations Canadians.
I had been invited to a community event at a residential care facility and arrived to a sunny garden, full of people listening to a local band playing country music. Two members of staff were dancing with residents, glasses of juice passed around. Before dinner, everyone was called in to watch a film made by AHA! with music and song created with older people, local children and local musicians. The film reflected the local culture in the present, not just reminiscing about the past.
This was a celebration with a special tea where residents could invite guests to share a meal. I was lucky to be guest of Paul who had dressed for the occasion with blazer, white shirt and tie. As a new resident, he told me of his recent fall and diagnosis of dementia; significant changes since his lifelong career as an engineer building trails through the forest for trucks carrying timber. His descriptions were very vivid as he talked about ice skating on the estuary in winter, living at the edge of the water, walking the old trails he had helped to develop. His story and those of other older people are being collected to create a performance piece to celebrate and acknowledge the elders in the community.
Paul had arrived at a point in his life when we was aware of diminishing memory, distressed about having to live separately from his wife who was in a different facility because of her own health difficulties, For him, the minutiae of each day seeming to stretch into an unclear future. I was struck by the way he dealt with those changes in his life with such dignity and calm, how the celebration event allowed him to be a host again, to enjoy the live music outside.
Estuary near Antigonish
Whilst in Antigonish, I had been asked to facilitate a workshop and discussion with the AHA! Group about our shared experiences of using creative writing, collecting words, opinions and memories from older people especially those with dementia. The workshop included health and art professionals and volunteers working on the project, as well as my host, Anne Simpson (local poet, novelist and essayist) who had a key role in mentoring emerging writers on the project. Discussion ranged across the challenging subject of ethics, the extent to which we censor or select from other peoples stories, what support do we get from arts and health networks nationally or regionally, what is the most appropriate artwork to illuminate the writing, what is truth, whose truth are we representing, what values do we as writers and artists bring to the process.
This discussion reinforced for me that it is important to approach writing with older people with dementia in the same way that I might prepare for any community based workshop with people who have not written before, aiming to make it participative, that people learn from the activities or the readings, that everyone has equal opportunity to be involved and contribute to the cultural life of the community, regardless of memory loss. The main difference is that I am usually the one holding the pen and doing the actual writing whilst collecting words directly from participants in the dementia workshops.
We talked about dealing with difficult stories where confidentiality around violence or abuse needs to be maintained but the impact can be captured in other details- the wedding ring flung in the drawer, the financial struggle of a single parent. These are universal themes that cut across age groups, dementia diagnosis and individual histories. This gave us opportunity to reflect on the ageist attitudes which reinforce the cognitive difficulties associated with dementia. No wonder we often hear older people say ‘I don’t want to be a burden.’
This discussion was held in a residential care home working along the principles of the Eden Alternative approach, where creative expression and arts activities are part of the daily programme. This was evident with the art work on the walls and atmosphere of inspiration and vitality throughout the building; so different to some silent facilities where residents spend hours dozing in plastic covered chairs. I was reminded again that science now demonstrates that creative expression is as effective as psychotropic drugs in maintaining calm and communication; there is no excuse for this vital approach to be ignored.
How do we capture those times of change, allowing people to express their emotions about major life challenges, moving from independent living to residential care- which eventually becomes end of life care? A programme of creative activities can become central to care, central to honest communication and freedom of expression.
As I left Antigonish, close to the water and en route to Cape Breton Island, I thought about Paul and his future, the opportunities he might have for returning to the forest, quoting Latin names for plants, smelling the pine, listening to the water moving. I was reminded again and again, that the sense of ‘place’ is so central to our sense of identity, crucial for Paul in celebrating his past as well as his future.
Paul: social host, nature lover, engineer, husband, environmentalist, ice skater, Nova Scotian.