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One of my all-time (and many) bugbears – the term “therapy” being added to normal, everyday activities. Why is it that when people get old, they suddenly stop enjoying music and now have to have “music therapy”? Or art “therapy”? Or pet “therapy”? Why can they not just listen to music, do a bit of drawing or own a pet?

This is a major part of the medicalization of ageing, and the ageist positioning of people when they get old and are in need of support. The word therapy implies that there is something wrong, that you need “professional” help, and that you are indeed sick!

A few years ago I vowed to NEVER attend a “dementia conference” again. In my opinion, it has become a money-making scam, playing on the guilt of families and fears of caregivers, all these “therapies” that are invented for the poor sods living with memory impairment! Some of these are plain demeaning, reducing adults to toddlers, insulting them with colouring books and building blocks, bringing in the clowns and purring electronic pets. These “therapies” have become an industry – hence the term “dementia porn”! Like sex toys for the “demented”…

There is very little research that shows that any of these supposed interventions have lasting positive outcomes from a “therapeutic” perspective. On the other hand – we know the power of music, or artistic expression and the joy derived from the unconditional love of a pet. But why make this into “therapy”?

I think it all stems from power issues. Instead of taking the time to sit and listen with someone to their favourite music, we horde everyone into the same room and do a Vera Lynn sing-along! (All old people like the wartime favourites, you know!). We get someone to bring their docile Labrador to let everyone pet the poor dog. I often think how cruel it is to give someone ve minutes with a beautiful dog, only to take the dog away again. It must feel terrible to someone who really loves dogs!

And then there is “horticultural therapy”…let’s all plant plants in little pots, inside in the lounge, then they are whisked away never to be seen again.

Ok, so now I have yet again stepped on many toes. Why can we not simply create environments where we can encourage people to ENGAGE with life? Have pets that they can feed, can sleep in bed with them, that will bark and run and pee in a corner? (Like my dogs do all the time when it rains?) Why can we not participate in baking bread, and making toast as we do at home? Or go outside in the garden and dead-head the roses or daisies? Or write letters (yes, that is what we all did) to faraway family and friends? Maybe even draw a picture just to add colour to the letter?

Risk. We have become so risk averse that we prevent people from living as if they are sick, and then we throw therapy at them to mostly make US feel good, to show the world how well we uhm….care. I really think that when people withdraw it is because they often cringe so badly that they simply have to disconnect.

If ever someone puts a plastic bin around my neck and gives me lukewarm sugary milky tea in an orange plastic mug and will also close my eyes and hope to die.

Right there, right then.

Remember, “consciousness is never affected” for people living with dementia. They know they feel, they hear, they see. They are aware and conscious. Try and imagine, just for a second, how you WOULD react if you were given a bowl of pureed sloppy porridge-like food for lunch. The sad thing is that the person with dementia most probably wants to react exactly the same as you would, but they have lost the ability to respond. So they stop eating.

We need to start believing that people living with dementia are conscious, adult, sensitive, human beings. They are not patients. They have a right to citizenship, power, autonomy, dignity, participation, and agency. They are not “ours” to treat or care for (I often hear the phrase “my residents”), they are people in their own right whom we have the job of supporting, and enabling.

If we can change our minds about people whose minds have changed, their lived experience (and ultimately clinic outcomes) will be vastly improved.

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