‘Only my family can help’: the lived experience and care aesthetics of being resident on an NHS psychiatric/mental health inpatient dementia assessment ward – a single case study

Abstract

In the United Kingdom, people living with dementia admitted to National Health Service (NHS) psychiatric/mental health inpatient dementia assessment wards (dementia assessment wards) are nearly always compulsorily detained under a section of the Mental Health Act 1983 owing to the risk and complexity of the presenting condition. As such, dementia assessment wards admit some of the most vulnerable patients in society, yet these environments of care are under-researched and under-reported in the literature. Using care aesthetics as an overarching explanatory lens, this article focuses on the care of one patient (Charlotte – not her real name) resident on a dementia assessment ward and uses a range of qualitative methods to illuminate that experience, including ethnographic observations and a care record review. To further develop the reach of the case study, interviews were also conducted with Charlotte's husband as her main family carer and key ward staff involved in Charlotte's care. Data were analysed using a sensory and narrative-based method to provide a sequential, embodied, individually positioned and storied account of Charlotte's care and interpreted experience on the ward. The analysis revealed that Charlotte's presentation of dementia was complex insofar as she resisted any attempt by the ward staff to offer her food or drink or to help with washing and dressing. Charlotte also swore frequently and loudly and spent time actively ‘watching’ and ‘looking’ at people and the environment in which she was now living. The findings contribute to the fields of critical dementia studies, dementia education, health-care practice and policy making, and may be used to highlight the value of sensory and embodied approaches to capturing a caring dynamic.