Week 6 summary: Ageing and dementia

Week 6: Ageing and Dementia

Each week, we’ll be reading through your comments and reflections to collate them into a summary, giving an overview of some of the conversations that have been taking place on the course. You can read the summary for week six below. We know that lots of you have taken part in Jonathan’s other University of Warwick FutureLearn course Shakespeare and His World, and we’re delighted that you’ve decided to join us again! If you’ve taken part in Shakespeare and His World, you’ll be used to watching video round-ups at the end of each week. These round-ups provide an excellent opportunity for us to reflect on the week’s content and comments, but they are time-consuming to produce, and we felt that, for this course, it was more important to spend that time getting involved in the conversations on the discussion feeds. For this reason, we’ll be writing text summaries, based on our collective experiences over the week.

Fourscore and upward

Pray, do not mock me.
I am a very foolish fond old man,
Fourscore and upward, not an hour more nor less;
And, to deal plainly,
I fear I am not in my perfect mind.

Lear in King Lear, Act 4 Scene 7, l. 2978-2982

The first of our two central texts this week was Shakespeare’s great tragedy of ageing King Lear. Together, we’ve thought about the play’s exploration of some of the challenges associated with retirement, and we’ve reflected on what we might be able to learn from King Lear about the importance of treating the elderly with kindness and respect.

Sir Ian McKellen’s interpretation of the play has stimulated some interesting conversations among learners about the problem of retirement. Lear goes from being an all-powerful ruler to being merely ‘my lady’s father’, ignored and dismissed by Goneril’s household staff, and this proves an unbearable demotion for the old king. Several of you could identify with Sir Ian’s observation, about the ageing monarch, that in giving away the ‘sway’, ‘revenue’ and ‘execution’ of his kingship, Lear is giving away the authority that defines his sense of self. Lear divests himself of purpose and of status, and a number of learners have commented to say that they, too, initially experienced a sense of aimlessness and loss upon retiring from their profession. Others, meanwhile, said that the discussion of Lear has made them think differently about retirement, and has encouraged them to ensure that they have hobbies, activities and new challenges to look forward to after giving up work.

For many learners who’ve engaged in the discussions this week, retirement has been a wholly positive experience, an opportunity to pursue their own interests and passions, and to spend more time on the things that really matter to them. However, it is undoubtedly the case that for people who love their work, and for people whose work takes up most of their time, it can be difficult to adjust to the sudden lack of structure that comes with retirement. Learners have emphasised the importance of remaining physically and mentally active after retiring, and of finding meaningful uses of time. Indeed, some of you have even remarked that you’ve taken up online courses as an excellent way of engaging the brain and connecting with other, like-minded people!

Week 6: Ageing and Dementia

Our exploration of King Lear has also encouraged us to reflect, this week, on the way the elderly are treated, and on the vital importance of carers. As Sir Ian observed in our conversation, Lear is utterly dependent upon the support and patience of his companions. It is far from easy to be loyal to Lear. His behaviour is changeable, rude and petty, and he regularly insults and rejects those closest to him. Indeed, a number of learners have commented that they do have some sympathy for Lear’s older daughters, and for Goneril in particular, who is forced to accommodate her difficult father and his ‘riotous’ knights at almost no notice. Yet we instinctively feel that Lear deserves more kindness and respect than he receives from his older daughters, in spite of his unpleasant behaviour. We are appalled that Goneril and Regan would leave their ageing father without a roof over his head, and we admire those characters in the play who faithfully and selflessly stand by their king. Several learners have shared their own experiences of looking after difficult older relatives in the discussions this week, and have spoken very movingly of the patience, kindness and emotional resilience that is often required.

Like Dr Simon Curtis, a number of learners have voiced their concerns about the treatment of older people in medical contexts. Several of you have written about elderly relatives who were ignored, patronised and maltreated in hospitals or nursing homes, and it is appalling to think that vulnerable people, in need of care, are sometimes treated with so little respect or dignity. At the same time, however, it is important that we acknowledge the thousands of brilliant carers out there, who work so incredibly hard, often with very limited time and budgets, to help us look after our elderly. Many care homes do their utmost to treat residents as individuals who matter, providing activities, entertainment and substantial one-to-one care. We’d once again like to thank all those in the medical and care professions who work so hard to look after us, and whose hard work so often goes unnoticed.

As well as reflecting more generally on some of the challenges of ageing, we’ve also focused, this week, on the associated mental health condition, dementia. The very moving account given by Melvyn Bragg of the progression of his mother’s Alzheimer’s was familiar to a number of you, who had also witnessed loved ones suffering from this and other forms of dementia. Other well-known people have also started to share their stories of looking after ageing parents with dementia, including the actor Christopher Eccleston, whose article you can read here. Although dementia is most commonly associated with the loss of memory, many learners have commented that the personality changes often caused by the syndrome can be far more upsetting to witness. Sufferers can, for instance, exhibit unexpected outbursts of anger and even violent behaviour. However difficult it may be, it is important to try to remember the person you know and love in these situations, and to realise that their angry behaviour is entirely the result of their disease.

Having listened to the contrasting views of Sir Ian McKellen and Simon Russell Beale on the subject, we also asked learners whether they thought it was helpful to think of King Lear’s behaviour as the product of a form of dementia. The question has divided opinion among learners as much as it has among actors. Some of you commented that it was unhelpful to attempt to ‘diagnose’ a character over four-hundred years after the play was written; others added, moreover, that a medical explanation oversimplifies King Lear, failing to take into account the play’s complex themes of power, pride and family relationships. Some learners, on the other hand, found Simon Russell Beale’s interpretation of the character utterly convincing, often commenting on the similarities between Lear’s behaviour and the behaviour of elderly friends or relatives who suffer from dementia. A third group of learners felt that the two interpretations could co-exist, and that Lear’s mental state is determined by an actor’s delivery of Shakespeare’s words, and by directorial choices in a particular production. Simon Russell Beale’s King Lear, then, is suffering from Lewy body dementia; Sir Ian McKellen’s is not.

A number of learners, this week, were concerned to point out that dementia is not an inevitability in old age. According to Dr Simon Curtis, it is estimated that 1 in 3 people will have some form of dementia by the end of life, but this means that many other people will not experience the syndrome. There is a difference between typical age-related memory loss and the memory loss that accompanies dementia; occasionally forgetting words, or where your glasses are, for instance, is entirely normal. Having said that, it can be incredibly worrying to feel as though your memory is worsening, and we would encourage anyone who is concerned to talk to their GP, who will be able to assess the situation and offer the appropriate advice.

In the passage from King Lear quoted above, we learn that Lear is at least eighty years old, or ‘fourscore and upward’, as he puts it. At a time when the average life expectancy was shorter than it is today, this was, as we’ve said several times this week, a remarkable age; yet Lear is not Shakespeare’s only eighty-year-old. A number of our learners have commented in the discussions on the overwhelmingly negative portrayals of old age in the media, so we wanted to end this section by mentioning two Shakespearean characters who thrive in their eighties. Adam, from the comedy As You Like It, is – like King Lear – ‘fourscore’, yet he is ‘strong’, capable of ‘do[ing] the service of a younger man’, attributing this good health to the avoidance of alcohol and reckless behaviour in his youth. In The Winter’s Tale, meanwhile, the Old Shepherd finds himself suddenly made a gentleman at ‘fourscore three’, after over eight decades of a rustic, relatively poor existence. Aged eighty-three, this Old Shepherd sheds his ‘first gentleman-like tears’, and looks forward to living ‘to shed many more’. For some of Shakespeare’s octogenarians, then, old age brings adventure and hope, and a number of you have shared stories, this week, of elderly relatives who have also found new and exciting leases of life in their later years.

The ‘inward eye’

William Wordsworth’s ‘I Wandered Lonely as a Cloud’ – also commonly referred to as ‘Daffodils’ – is one of the poems that John and his mother recite together in Melvyn Bragg’s Grace and Mary. This poignant moment in the novel is based on one of Melvyn’s own experiences, and a significant number of learners have commented to say that they, too, have shared songs or poems with loved ones suffering from dementia. Many of you remarked on the noticeable change in temperament brought about by singing or reciting passages of familiar verse; learners wrote of friends and relatives with dementia becoming less agitated and anxious upon listening to a song or poem, and in some cases, this familiar recitation also brought about a general improvement in memory and understanding. A number of you have shared your experiences of running reading groups and poetry workshops in care homes, and can attest to the overwhelmingly positive responses among the residents which the few existing studies cite. Some learners commented that such groups should also be made more easily available to elderly people who live alone or in sheltered accommodation.

Wordsworth’s ‘I Wandered Lonely as a Cloud’ is often mentioned in articles about poetry workshops in care homes, as a text that dementia sufferers enjoy recalling, so we decided to ask learners what – if anything – is so memorable about this poem. Several learners remarked on its regular rhythm and rhyme, as well as on its vibrant imagery. These bright, dancing flowers, so vivid to the poet’s ‘inward eye’, are vivid to ours as well; as several of you very astutely pointed out, daffodils are relatively easy to recognise and visualise, even for people who know little about flowers in general. Lots of learners knew the poem from their school days, but interestingly, a number of you were still familiar with the text despite having no memory of studying it or even reading before you signed up for this course. The poem perhaps exists, as several of you have suggested, in a kind of cultural consciousness. Particular lines and images are referred to so often – in books and films, for instance – that we come to know Wordsworth’s poem even without sitting down to memorise it.

Week 6: Ageing and Dementia

We’d like to apologise to those people who were unable to participate in the Poetry and Memory activity this week, as well as those who had similar issues with the Missing Word activity in Week 5. This is the first time we’ve tried to run activities of this nature on such a large scale, and so we’re still experiencing a few technical teething issues. Thank you to all those learners affected for their patience and understanding.

We were interested to read the reflections of those learners who were able to take part, about the relative ease or difficulty of remembering particular texts, and about the memorising techniques that they employed. Some of you who expected to find the poems more memorable were actually able to remember the prose text more easily, because of its vivid and sometimes jarring imagery. For a few learners, the poems had to be spoken aloud to be remembered, while the prose was easier to recall if it was written out from memory several times in full. Filling in the blanks was made easier for some of you by particular word associations that had emerged when you were reading the texts. Several learners, meanwhile, described how they had created short narratives surrounding each of the passages, to help them to remember the development of images and ideas, while for others, walking around while memorising the text was essential to the process. This activity was designed not to test learners, but rather, to explore the relationship between poetry and memory; we weren’t expecting learners to remember every missing word, so please don’t worry or feel demoralised if you weren’t able to fill in the blanks on this occasion.

For the final time in the course, we invited learners to explore the Poetry Foundation app and website this week, to find poems that seemed in some way relevant to the theme. ‘Forgetfulness’ by Billy Collins came up a number of times in the discussion, as did Dorianne Laux’s Mother’s Day, and although it doesn’t feature in the Poetry Foundation archive, Jenny Joseph’s amusingly audacious ‘Warning’ was a favourite for many. We’ve included a few of the poems shared in this week’s PDF, which can be downloaded by following the link at the bottom of the page.

Coming soon: online book group

Later this year, ReLit, in association with a very high profile literary organisation, will be launching an online book club focusing on works of contemporary fiction that, directly or indirectly, address some of the great questions of mental health and wellbeing. It will include author interviews, suggested topics for discussion and a forum for participants to share their ideas, comments and experiences. You will receive more information about this in a post-course email: we hope that some of you will wish to join us when we launch.

Final thought: keeping the conversation going

We’re immensely grateful to all those of you who have chosen to join the conversation on this course, whether you’ve been listening to our course contributors, reading other learners’ comments, or offering your own thoughts and ideas in the discussion sections. Although the course itself is drawing to a close, we’re really keen to make sure that the conversation doesn’t stop here, so we’d like to end with a few ideas about how we can keep talking.

We’re aware that some learners have taken the initiative to set up a ‘Closed’ Literature and Mental Health Facebook group, in order to continue some of the conversations that have been taking place on the course. This group is not administrated by Jonathan or Paula, or by anyone else affiliated with the University of Warwick, ReLit or FutureLearn, so we’re unable to add learners to the group ourselves.

If you’d like to keep up to date with news on the latest ReLit initiatives via Facebook, you can like our Page. You can also follow us on Twitter, for links to interesting articles about reading, mental health and wellbeing, as well as updates about our charity’s work, including announcements about our upcoming online book club. Don’t forget to use the hashtag #FLliterature when talking about the course on these and other social media platforms. If you haven’t already, you can also have a look at ReLit’s website, which contains more information about the charity’s projects and publications, and gives you the opportunity to get in touch if you have any questions about our work.

A huge thank you to all those of you who’ve agreed to be part of our post-course online study. We’ll be in touch with further details about this soon.

Remember that all of the course materials will remain available for you to revisit and explore even after the 6 weeks of the course are over (just make sure that you don’t select ‘Leave this Course’ on the course page, or you won’t be able to get back in to access the materials). If you’ve skipped particular steps, if you joined us after the course started, or if you’ve been taking the course at a slower pace, there’s still plenty of time left for you to catch up on anything that you’ve missed. You’ll also still be able to read through your fellow learners’ comments and offer your own responses, although we won’t be checking the discussions regularly once the 6 weeks of the course are over.

You can register interest in a future run of the course on the right-hand side of the course page if you’d like to be part of the conversation again next time round. We know some learners have already said that they’d sign up again for the course discussions, and we cannot say how delighted we are to hear that some of you are eager to repeat the experience! In the mean time, if you’ve enjoyed exploring some of Shakespeare’s plays in this course, and would like to find out more about his world and works, you could sign up for Jonathan’s other University of Warwick FutureLearn course, Shakespeare and His World, which begins its next run on 18 April this year.

This course was made possible by all those people who were willing to be part of our conversation. We’d like to say thank you to all of our wonderful course contributors – Kate Behrens, Melvyn Bragg, Lucy Clarke, Simon Curtis, Stephen Fry, Rachel Kelly, Jack Lankester, Sir Ian McKellen, Sophie Ratcliffe, Peter Robinson, Andrew Schuman and Jennifer Wild – for giving up their time to share their expertise and their experiences with us.

We’d also like to say a not-quite-final thank you to everyone who is reading this. We’ve been consistently overwhelmed by your very moving, sensitive and insightful responses to the course materials and to one another, and we’re immensely grateful to all of you for choosing to join us as we’ve progressed through this course.

We hope you’ll carry on the conversation with us!

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Literature and Mental Health: Reading for Wellbeing

The University of Warwick

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