Wandering in Dementia and Trust as an Anticipatory Action

ABSTRACT

The increase of dementia makes cognitive disorder a global challenge. Even if wandering is not a symptom of dementia in general, professionals and scientists dominate the definition of wandering as an aimless movement of people with cognitive impairment, mainly dementia. In consequence, professional types of wandering management were elaborated trying to avoid or replace it. However, this can cause negative effects. The article analyses an apparently common informal type of wandering management. It consists of slipping an address paper in the wallet of the ill person. The analysis reveals that this practice is normatively structured by a gift of trust.

Video abstract

Read the transcript

Watch the video on Vimeo

FRENCH ABSTRACT

La prévalence de la démence fait des troubles cognitifs un défi mondial. La déambulation n’est pas un symptôme de démence en général. Cependant, les professionnels de santé et les chercheurs dominent sa définition. Les types actuels de gestion professionnelle de l’errance essayent de l’éviter ou de le remplacer. Mais, ces dispositifs peuvent causer des effets négatifs. L’article analyse un type méconnu de la gestion d’errance: il consiste à mettre un papier d’adresse dans la poche de la personne malade. L’analyse révèle que cette pratique est structurée par la norme du don de confiance.

KEYWORDS:

• Anticipation
• dementia
• gift
• social figure
• trust
• wandering

MOTS CLÉS:

• Anticipation
• confiance
• démence
• don
• errance
• figure sociale

Acknowledgments

Un grand merci to my colleagues Emmanuel Hirsch, Léo Coutellec, Robin Michalon, and Paul-Loup Weil Dubuc from the Espace éthique Ile-de-France and the Labex Distalz for their support and ideas during the research process. I would also like to thank the following institutions: FMSH Collège d’études mondiales, SFB948 “Heros-Heroizations-Heroisms” at the University of Freiburg (Germany) and the Wissenschaftszentrum Berlin. The first draft of this article would not have been possible without their support. Finally, I would like to thank very kindly Matthias Revers and Lars Schneider for their helping comments to the final version of the article.

Notes

1. Philosophers or artists promote more positive meanings of wandering as a way of being and a critical posture. The art of flâner, treated by authors like Charles Baudelaire or Walter Benjamin, as well as the theory of the Dérive, formulated by Guy Debord, considers deviant practices as escapes from a normalized life guided by plans and marked paths (Gwiazdzinski 2012).

2. Even while the viability of these measure instruments could be implemented for assessing the risk of getting lost, very little attention has been paid to this possibility. Most existing assessments scales “have been designed for research purposes rather than decision making in the social work setting” (Bantry White and Montgomery 2014:409).

3. The present research was conducted in France where the SafeReturn® service does not exist. Only a flyer entitled Errance et Disparition (Wandering and Disappearance) is available in local offices of the French Alzheimer’s Association.

4. This is, according to Algase (2006) and Dewing (2006), a general problem of the research published in the field of dementia-related wandering.

5. See Moser and colleagues (2017). It is part of the transdisciplinary research project “Development of Innovative Strategies for a Transdisciplinary approach to ALZheimer’s disease” (DistALZ; http://distalz.univ-lille2.fr).

6. To examine wayfinding capacities of people living with dementia, Sheehan and colleagues (2006) accompanied participants taking a walk in their local area. Such a methodological approach is ethically questionable in the case of studying the effectiveness of the address-in-the-wallet practice. How could it be ethically justified to observe the person with dementia who got lost from a distance without intervening only to see reactions of third parties?

7. People with dementia, living in small rural communities, might also have an address paper in their pocket but never really use it, because they benefit from the fact that everyone knows each other (Wiersma and Denton 2016). Hence, the concrete realization of the address-in-the-wallet practice is an urban phenomenon.

8. “Predictive anticipation” approaches the future under the register of probability and thus statistical calculation (Coutellec and Weil Dubuc 2016:15). What seems probable is a prolongation of the past, supposing that repetition and reproduction are the main figures of historical development. It is a form of preemption of the future, an (over-)determining of what will happen from what already has been.

Additional information

Notes on contributors

Sebastian J. Moser

Sebastian J. Moser is a postdoctoral student in sociology at the Espace éthique Île-de-France, Department of Ethics at the Université Paris-Sud/Paris-Saclay, Laboratory of Excellence DISTALZ, and research associate at the Center Max Weber, Lyon (France).