Telling and Re-Telling Stories: Staff Witnessing Narratives from People Diagnosed with Dementia

People navigate an array of emotive and competing narratives which construct the landscape of dementia in the UK. Dominant narratives include biomedical explanations of behaviour and the economic burden of old age. Narratives of person-centred care are equally inflated with emphasis on staff ability and ambivalent definitions of good care. These dynamics risk undermining the heterogeneity of alternative stories from people associated with the label as well as for the people around them. In the current study, the narrative approach of outsider witnessing practice (OWP) was utilised to explore the social location it offered in hearing subjugate narratives of identity from people with a diagnosis of dementia (PDwD) and the narratives of the impact of hearing these from staff. Two PDwD and two staff members were recruited from a dementia day centre, seven stories were produced and analysed. The methodology of narrative analysis was employed to specifically focus on the presence of the wider dominant narratives, experiential stories and interactions in the storytelling constructions of identity. Analysis revealed the significance of social interaction in the constructions of identities for PDwD within OWP, verbal biographical stories weighed significantly in producing shared values and cultural norms, however the interactional elements co-constructed and validated identities of humour, privacy, empathy, determination and many more. Individual staff interviews revealed the pressures faced in providing good support, however OWP offered validation in staff’s more relationship focused approaches in working with PDwD. Implications of the current study include the role of OWP in clinical practice as a space to elicit counter narratives in dementia and health settings as well as raising awareness of professional’s contributions to identity constructions of the people who use services. Moving pressures off of individual staff to provide person centred care and hear staff’s personal and relational narratives of care which can help expand understanding of how best to support each person most meaningfully. Finally, targeting the wider political and societal assumptions by bringing spaces for alternative narratives to be heard more readily in the public realm can diversify the narratives of dementia.