So – I have read through Julian Hughes’ masterly text: 285 pages in softback, published by Open University Press and one of a series of ‘Dementia Reconsidered’ titles edited by Keith Oliver and Dawn Brooker.
It aims to be: ‘accessible to multiple audiences – from people living with dementia to practitioners’.
The first section, which is headed ‘Theory and everyday life’ provides people like me with a short introduction to the scholarly world of writings about ethics: theories I did not know about – Consequentialism, Deontology, Principlism and Virtue Ethics (Viva la virtudes!). But originating from famous men whose names live with us: Jeremy Bentham, Immanuel Kant, Beaucamp and Childress, and Aristotle. It is good to have these explained, compared in a table and referenced for further discussion. Even better that Julian supports Aristotle’s oldest of all the theories, which maps easily to my own intuition and Christian teaching.
This prepares the reader to go again through areas which are so important and are encountered time and again in living with and caring for people with dementia: stigma, autonomy, paternalism, dignity, quality of life, consent and capacity, best interests and personhood.
There follows thoughtful commentary on matters including driving a motor vehicle, the acceptance of various forms of care, telling the truth, food and drink, antibiotics, resuscitation, dying and death.
Things which are there day by day, but which are so important and potentially difficult, that I will often shelve the thinking for another time – which may never come. Gripping a nettle tightly takes away its sting. These brief chapters offer a way to get a grip - probably one issue at a time.
We see how much dementia strips away, but how much remains and how we can help to maintain the individual, with those who love them and with others who have skills to offer.
Each week we post a blog from David Jolley where he shares his personal views on relevant subjects.