The past twenty years have seen a move away from a purely assistance-based approach, involving rehab at best, initially towards what Naomi Feil defined as a “validating approach”, and then towards the “gentle care” described by Moyra Jones (The Gentle Care Method). These models share a focus on patients’ residual abilities rather than on the disabilities they have built up, and the goal of “possible welfare” rather than of (impossible) functional recovery. Above all, these approaches (starting with the crucial studies of Kitwood and of the Bradford School) consider the caregiver’s ability to transform and tailor their relationship with the patient to be the primary tool for reducing the damage caused by the condition and for increasing the patient’s quality of life. While these models have not yet been confirmed by any definite scientific evidence, they have become tools of reference in the most recent behavioural approaches to Alzheimer’s and to the degenerative dementia that accompanies the onset of old age.
These are the tools of reference we adopt in our A più voci – With Many Voices programme, which is designed specifically to stimulate patients’ ability to use their powers of speech and conversation, to meet their need to express their deep-seated emotions, to be heard out and respected, and to be recognised as individuals so as to recover their status in society (as Piero Vigorelli argues in his Possible Conversation with an Alzheimer Sufferer).
The loss of function that this illness entails is gradual, affecting certain abilities before others, thus A più voci – With Many Voices focuses on patients’ ability to observe, to experience emotions, and to use their imagination and their fantasy, all skills that last longer than an individual’s logical and cognitive faculties, thus allowing even those who have built up a substantial cognitive deficit to take part. The activity is designed for a fairly broad target audience with an MMSE score of 10 to 20, although in actual fact it is a stimulating and gratifying experience for everyone. The nature of the activity and guidance from the educators allow everyone to take part in accordance with their own level, turning loss of inhibition and of interpretative mental skills into greater freedom of judgment and capacity for imagination.
Other important and explicit goals in the programme target caregivers, whether relatives or professionals, focusing on the development of a new, different and more appropriate way of communicating with the patient. Relatives who have taken part in our activities, together with the people they care for, have confirmed the method’s effectiveness: enjoying a gratifying and moving experience in stimulating and prestigious surroundings, in the course of which patients prove to be perfectly capable of responding to the demands made of them, leads to a recovery of the caregiver’s self-esteem in respect of his or her ability to cope with the situation, and to the fostering of an instant feeling of wellbeing.
The project also aims to prompt a change in the perception of this condition by society as a whole, encouraging encounters with the exhibition’s visitors and thus offering people with Alzheimer’s and their relatives new opportunities for socialising while minimising the stigma attached to the disease.