Department of Public Health, Nursing, Aarhus University, Aarhus, Denmark.
VIA University College, Aarhus, Denmark.
Nurs Philos. 2024 Jan;25(1):e12425. doi: 10.1111/nup.12425. Epub 2023 Feb 27.
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.
这是一篇基于故事的随笔,观察了一位患有痴呆症的母亲日常生活中的当下时刻和闪耀时刻。这个故事被用来开始哲学思考,思考“可能的不同方式”。痴呆症带来了残酷的存在体验,如认知恶化、心理功能下降,以及常常带有伤害性的社会评判。患有痴呆症的人经历了自我的转变和改变。认知衰退逐渐破坏了社交联系的基础,常常造成深刻的不安全感。因此,护理人员和医疗保健专业人员的挑战是找到澄清代理概念的方法。值得发展的是,从护理情境的各个角落中敏锐地感知“存在的事物”的能力。理解和实践这一点可以增强存在感和联系感,赋予痴呆症患者力量。找到方法、关系动作,使护理人员和医疗保健专业人员能够将平凡日常情境中出现的创造力嵌入其中,充满意义的过剩,与患有痴呆症的人分享心理景观(和体现的关系理解)——抓住并分享审美时刻(言语和非言语)共同存在,这一点很重要。我们认为,护理人员和医疗保健专业人员可能会发现这种护理理解很有用。这意味着需要从现象学-解释学的角度去思考,发展能力和实践智慧,理解和意识到日常生活中创造性和创新性的可能性(常常是前语言和未被注意到的小事情),我们受到精神分析学家丹尼尔·斯特恩的启发,称之为相遇的闪耀时刻,与他人一起创造当下经历和体验。