Using Signs and Symbols to Label Hospital Patients with a Dementia Diagnosis: Help or Hindrance to Care?

Philosophical and biomedical perspectives both agree that the ways in which someone is seen is critical to their wellbeing. Empirical work confirms the philosophical claims that attention is an active process, a relationship between the subject and the observer, which changes both of them. How one is seen affects how one sees oneself and studies suggest that this impacts on physical functioning and independence, clinical outcomes, recovery from disability, longevity, and the ‘will to live’. This may be particularly important for older people and people living with dementia, who are a large population within acute wards. We draw on the empirical findings of our 18 month ethnography within 5 hospitals across England and Wales (NIHR HS&DR researcher led funding) to explore the ways in which everyday technologies are enrolled to drive attention to the existence, diagnosis, and needs of people living with dementia at the bedside. Within the acute setting, seeing ‘dementia’ and the person living with dementia and their essential bedside care has been transformed into technical products and routinized task focussed approaches to delivery. We explore the ways in which these everyday technologies both produce and maintain the invisibilities of people living with dementia and bring about particular understandings of the condition. We show the ways in which the use and reliance on technical approaches to perceived problems of attention and ‘seeing’ people living with dementia, instead, narrows attention on particular tasks and ‘symptoms’, which can compete with a wider appreciation of people’s individual care needs and restrict the expertise of ward staff.