Including the Person with Dementia in Designing and Delivering Care

By Elizabeth Barnett.

Jessica Kingsley Publishers

Price £14.95

ISBN 1 85302 740 5

Everyone tends to see the world from the point on which they

In Including the Person with Dementia… the work of
painter Frans Hals is used to demonstrate this. The book begins
with an analysis of two paintings by the great Dutch artist
(1580-1666) of the male and female regents of a workhouse painted
when Hals was himself a destitute resident. Analysing these
pictures Barnett writes: “Hals has shown us with depressing clarity
the stiff, unbending emotional deformity which the ‘care’
relationship he experienced created in the givers.”

Browsing through a junk shop in the 1980s – geriatricians often
find diamonds in dustbins – I found Robert Witt’s 1902 book How
To Look At Pictures
. Witt says that when looking at paintings
one should ask who painted it, when was it painted, which school of
painters did the artist belong to, is it a new style, or further
development of an established style?

He says that you should also ask why did the artist paint it,
who paid for it, what space did they have to fill, what materials
did they use, how did they express their views through their
painting. One should ask similar questions when looking at

Elizabeth Barnett entered dementia research through a circuitous
path. This meant that no one told her that people with dementia
could not express their own thoughts. As a health service
administrator, commissioned to research key issues in the design of
dementia facilities, she felt a strong ethical and intellectual
need to find out what the staff and clients thought. From that
beginning her easy-to-read and challenging book arrived.

Institutionalised patients do not share our world. The
institution, 24 hours a day, seven days a week, is the reality of
their lives. Relatives, friends, care staff, even researchers,
spend time in their world, and then escape to the reality of their
own world. The message is clear. Only if we respect the views of
the people we care for will we be able to plan, to provide for, and
to care for the most vulnerable adult members of our society with a
correct mix of love and compassion.

Peter Millard is professor emeritus of geriatrics, St
George’s Hospital Medical School, London

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