Whispers and song: a phenomenological inquiry to discover nurses' lived experience of person-centred dementia care
Wareing-Jones, S. (2016) Whispers and song: a phenomenological inquiry to discover nurses' lived experience of person-centred dementia care, no. 414.
Person-centred is now a widely used term to describe much dementia care in the UK and Jersey. This existential hermeneutic phenomenological research seeks to discover the lived experience of person-centred dementia care for nurses in Jersey and through this, the essences and meanings of person-centred care. It is grounded in Merleau-Ponty’s ideas of embodiment for being in the world and Buber’s primacy of relationships and includes complimentary ideas within Lévinas, Gendlin and Vanier’s philosophies. Its methodology is inspired predominantly by van Manen, it is hermeneutic in its interpretive and poetic stance and is existential in its focus on nurse’s lived experiences. Eight nurses, working in care homes and specialist dementia care units, took part in semi-structured interviews which were recorded and transcribed. Deep immersion into these texts followed using the six existentials of corporeality, relationality, temporality, spatiality, materiality and mood, proposed by van Manen and Todres, as lenses to get closer to the participants’ lived experiences, essences and meaning of person-centred dementia care. This research has been amongst the first to use six existentials for data analysis; it demonstrates the accessibility of this methodology for counsellors from its parallels with therapy; it demonstrates the potential of poetry and metaphor images to uncover the essences and meanings of phenomena; and its enhanced focus on the experience of person-centred care reveals considerable rhetoric in the use of the term in mission statements and care philosophies. This research shows that the term, and the models and frameworks associated with it, are not well understood, indicating the need to embrace a new understanding of person-centred care from the macro context to individual practitioners; the need for more effective training, education and practice development together with new support structures for nurses and better communication throughout the services. It also proposes a new vision focussed more on ‘caring’ than ‘care’ and for a uniting Jersey Dementia Strategy to help refine and define systems, policy, practice and care.