Re-socialising sound: investigating sound, selfhood and intersubjectivity among people living with dementia in long-term care

ABSTRACT

Over the last decades, an increasing amount of attention has been given to the acoustical environments of health care settings. Through innovative multi-disciplinary research and practice, sound in health care is being conceptualised as an object to be measured, controlled and minimised to improve individual well-being and health outcomes. Among the settings and populations being addressed are people living with dementia in residential long-term care. The trend toward acoustical separation between people overlooks the social possibilities of sound in care settings. This paper argues that we should resist narrow conceptualisations of sound as unwanted noise that must be reduced, and that sound should still be considered as a social tool. Drawing upon fieldwork in a Canadian long-term care facility among people living with dementia, ethnographic vignettes illustrate the significance of sound for selfhood and social relationship. Tensions between institutional control and acoustical agency are discussed, as well as implications for biomedical understandings of dementia as a loss of self. The paper concludes with a discussion of future research directions.

KEYWORDS:

• Acoustical separation
• agency
• dementia
• long-term care
• ethnography

Disclosure statement

No potential conflict of interest was reported by the author.

Notes

1. Pseudonyms have been used throughout to ensure participant anonymity.

2. During my fieldwork, the call bell systems were updated so that they would only ring at the nursing station and only signal with a flashing light above the resident’s door instead of making a sound in the hallway.

3. The administration advised staff to ensure that particular news channels were not played on the common televisions because their content and audio broadcast were potentially upsetting for residents.

4. In later work, Rice (2013) referred to “the ethnographic ear” as a methodology which he understood to mean a situated and emplaced effort to listen while immersed in the hospital environment (16).

Additional information

Funding

This work was supported by the Social Sciences and Humanities Research Council of Canada [767-2015-1245].

Notes on contributors

Megan E. Graham

Megan E. Graham is a doctoral candidate in the Department of Sociology and Anthropology at Carleton University, Canada. Her research engages with the lived experience of long-term care, particularly among people living with dementia. Her recent work has investigated the social dimensions of the participative creative arts in long-term care and its impact on selfhood and sociality. Her research interests include critical phenomenology, spaces of care, experience of sound and the use of creative arts as therapy.