ACM Interactions

Authors:
Jayne Wallace

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Heritage is perhaps most commonly couched in terms of things that are left to us (inheritance) or things we leave to others (legacy). But it is also part of a patchwork by which we define ourselves. Implicit in the notion of heritage is a richness of some kind—traditions earned, trades passed on, a sense of pride, things worth having and rights to these things. These terms have an emotional quality to them and relate to things that strike a chord with us at a fundamental level. Heritage may often never be formally acknowledged in our appreciation of or attachment to an aspect of our culture, but it is something that we "know" nonetheless. Several projects involving people with dementia that I've been lucky to be involved with have recognized the importance of this fundamental quality. These projects have caused me to consider not only heritage as a resource for interaction design that taps into local culture and the role that it can play for persons with dementia, but also what we are, in terms of heritage, ourselves.

I've chosen a couple of projects to further illustrate these aspects of heritage and self, relating to both local culture and the realm of the intimate and personal.

  Cultural Heritage

Through the Tales of I project, I was part of a team working with an adult mental health unit, Francis Place, within a hospital in the U.K. specializing in the assessment and treatment of older adults with severe dementia [1]. The unit was a newly constructed secure facility, accommodating up to 16 clients, where assessments usually ranged from between two and four weeks but could be longer depending on diagnosis and treatment plan. The unit had been designed architecturally to maximize light and had wide pathway corridors meandering through the unit, with large windows and courtyard gardens. We initially worked with staff to learn about their practice, the kinds of activities that clients engaged in, and the general contexts of clients' experiences within the unit. These understandings became the starting point to work with staff more collaboratively to design pieces of interactive furniture that would at a basic level bring points of interest to and aesthetically punctuate the plain white wander pathway inside the unit and bring purpose to one of the unused dayrooms. More pointedly, the pieces would support staff practice and hopefully enhance the lives of clients in the unit.

Of the two pieces of furniture, one was a wall cabinet housing a series of resin globes encapsulating small objects and imagery; the second was a television cabinet. Each globe was developed around a specific theme informed by what staff thought would have real relevance for their client group. When a globe was taken from the wall cabinet and placed on the television cabinet, a film related to the globe's theme played. This simple premise gave us the opportunity to build layers into the pieces that drew heavily on local heritage and led to staff reports of some significant client-staff interactions and changes to staff practice.

As the client group consisted almost exclusively of people who had been born and lived all or most of their lives in the neighboring area, we were able to really steep some of the content in local culture. We focused one globe on the local football team, one on local industry, and another on holiday spots all along the east and west coastlines in the north of the U.K., with the confidence that the objects, imagery, archival film footage, and music that we included in the films and encapsulated in the globes themselves would be "known" by clients at some fundamental level. The remaining globes centered on more general themes, such as objects, nature, and making, but we peppered these heavily with region-specific references.

We (the researchers and the staff) were trying to go beyond the reminiscence activities in the unit, which centered on the ability to recall. We were drawing on local culture to provide references to anchor points that may trigger not only memories for people but also connections to aspects of themselves, and further, to provide "ways in" for staff members and clients' families. In addition to including celebrated cultural moments, we layered in references to things that had been part of the everyday, that had been lived with and through over the course of many years. Here, beyond the footage we took ourselves, the archives from museums came into their own. Some of the materials were in the form of film archives; others were objects that people had bequeathed to museums and that we were able to photograph and film ourselves. We wanted to make objects and films that would resonate with clients even though their dementias were profound. Our methods in achieving this focused on not only things but also aesthetics. And within considerations of aesthetics, the notion of beauty became very important.

Beauty is something I've long acknowledged to be a powerful tool in design. Our perception of beauty often becomes enmeshed with personal significance, and in some cases, even things we may think of as aesthetically ugly feel beautiful because of the association with a certain event or person. Here, beauty can move away from aesthetics alone; however, at a deep-seated level, beauty—in its full-blown aesthetic sense—is something that we respond strongly to and are drawn to regardless of association. This is something that Claire Craig and John Killick [2] emphasize in their approaches to creativity in dementia, and I'm reminded of a quote by Florence Nightingale that Claire pointed me to:

"The effect of beautiful objects, of variety of objects and especially of brilliance of color is hardly at all appreciated ... I have seen in fevers the most acute suffering produced from the patient not being able to see out of a window and the knots in the wood being the only view. I shall never forget the rapture of fever patients over a bunch of bright-colored flowers. Little as we know about the way in which we are affected by form, by color, and light, we do know this, that they have an actual physical effect. Variety of form and brilliancy of color in the objects presented to patients are actual means of recovery" [3].

Similarly, Paola Antonelli (senior curator, Department of Architecture and Design, Museum of Modern Art, New York) in her keynote at the CHI 2013 conference asserted that beauty is a civil right, a form of communication and respect. What both Antonelli and Nightingale are referring to is not only the power of beauty in a restorative sense, but also that beauty is something that should be a constant in our lives to underpin our respect for each other. In the Tales of I pieces, employing color, high-end materials, detailed processes, and quality craftsmanship were all very important to cumulatively convey to the clients with dementia in the unit that they were valued and deserving of beautiful things. We wanted people to be drawn to the pieces, to want to handle them, and for this dynamic to pave the way for meaningful forms of activity with staff and families around the use of the films and globe artifacts.

The use of the furniture in the unit led to some significant experiences for staff and clients' families that then resulted in changes in staff practice and positive effects regarding staff-client communication in the unit. Much of this was linked directly to heritage. The power of football is at the heart of one good example. A client who had hardly spoken since coming to the unit, who was continually agitated, walking around the unit for hours each day without resting and who became involved in altercations with other clients, sat for about 10 minutes to watch the film focused on the local football club. Staff reported this was a rare occasion in which something totally held his attention, calmed him, and caused him to hold a brief but meaningful conversation with staff in which he told the story of meeting one of the players as a child. Staff attributed a sense of well-being to this as he continued to remember aspects of this memory and tell people about it throughout the day; his behavior had been calmer and he seemed happier. This gave staff a "way in" for this client. They were able to use the football film (and other media, such as old football-match programs) to start to work with him, and to be able to engage him in conversations and re-create the sense of well-being that had resulted from his first viewing of the film. It was very clear that the football club was part of who he was.

Heritage is more than the recollection or recognition of memories of football matches or references to the objects within this culture (football strips, programs, tickets, seats, stadiums) and even transcends the dynamics of certain matches (scores, certain commentators' voices, the arguable decisions of linesmen and referees). It is about being part of something, an investment in a group or community where history and being part of an ongoing story mean more than the details of the present alone. It relates to the feeling of pride in the achievements of the club and shared disappointment with the failures, both historic and current. Matches are sporting battles that a supporter goes into along with the footballers. The game relates to a lifetime's shared passion where everything is linked to what has gone before and is referenced against that. The value of heritage for us as designers, and particularly in an extreme context such as severe dementia, is to be able to tap into these incredibly rich aspects of experience to create links to things that have deep meaning and that strike a chord even in severe cognitive decline. Heritage is therefore a hugely valuable resource and one that is only partly exploited in design. It has interesting implications for interaction design, regarding how it can be more fully worked with to create meaningful references and connections for people in the pieces we make.

  Personal Heritage

I am going to draw on an experience I had while at a dementia daycare center to discuss a different dynamic that relates to what we are as heritage ourselves.

When I met Maria, she was in her early 80s. She had been coming to the center for over a year, and although she seemed content to be among everyone as the various activities took place, she was withdrawn and quiet, just as many clients were. This shifted, however, when her daughter brought a box into the center containing items of clothing and needlework that Maria had made and some of the tools she had used to make them. Although her eyesight was poor, as she held and examined the fabrics and objects, Maria's gestural expressions transformed; she seemed to recognize them, to know them. Although subtle, her actions spoke loudly; the objects were part of her. Both staff and Maria's daughter were struck by the change in her; this stayed with me.

I made the piece of work Threads in response to Maria's reaction to her work that day. It was a reminder of how making becomes a part of us, and that the objects and tools we have skillfully and lovingly made and used retain something of us. But there is also something beyond this at work that relates to a personal heritage, and again there is a connection on a personal scale to things known.

In one sense, knowing can mean a form of knowledge, of making, held evident in a handmade artifact, that can communicate the maker's knowledge and skill to others; but in a different sense, the known held evident in an artifact can act as a reminder of ourselves for ourselves, as Maria's handmade garments acted for her that day. This form of heritage functions at the very personal level; it is a connection with ourselves through things that we have been passionate about or had a significant connection to. Social anthropologist Catherine Degnen, drawing on her lengthy ethnographic study within a particular U.K. town, maintains that "[t]he significance of knowing ... exceeds a simple 'familiarity with' or 'knowledge of.' Instead, knowing speaks to what it is that is said to matter in the webs of relations which connect (and sometimes disconnect) people" [4].

Knowing, then, goes beyond the recognizable, beyond memories alone, and is about something more intensely meaningful to someone. What enabled the male client at the hospital unit and Maria in the daycare center to connect to aspects of themselves was a connection to something known in a deep sense. Although reminiscence activities were part of daily practice and activity in both the hospital and daycare center, the act of reminiscing alone or the generic context of the reminiscence materials was not enough to enable the connections to self, which staff and family members witnessed and commented on as so unusual, to occur. In terms of design, it seems significant that to create genuinely meaningful digital interactions/artifacts/devices/systems, we need to find anchor points within a particular context to things that are known, that strike a deep chord and that may resonate even in severe cognitive decline. But this naturally poses a significant challenge. Heritage denotes a passionate connection between people and something other, which relates to cultural heritage and also to heritage on a very personal scale and that enmeshes things known and often things beautiful. Acknowledging this, we can potentially view it as a more powerful notion than in current practice and use it as a more purposeful lens to find connections that run deep for people. Heritage, while speaking of the past or of what we will leave for others in the future, is firmly experienced in the present, and is an active strand within a web of things that makes up how we see and reconnect to ourselves.

  Acknowledgment

This research was partially funded within the SIDE (Social Inclusion through the Digital Economy) RCUK Digital Economy Research Hub.

  References

1. Wallace, J., Thieme, A., Wood, G., Schofield, G. and Olivier, P. Enabling self, intimacy and a sense of home in dementia: An enquiry into design in a hospital setting. Proc. CHI 2012. ACM Press, 2012, 2692–2638.

2. Killick, J. and Craig, C. Creativity and Communication in Persons with Dementia: A Practical Guide. Jessica Kingsley Publishers, 2011.

3. Florence Nightingale 'notes on nursing' – 1859. Quoted in Department of Health Report of the review of arts and health working group. London, 2007.

4. Degnen, C. 'Knowing', absence and presence: The spatial and temporal depth of relations. Environment and Planning D: Society and Space 3, 4 (2013).

  Author

Jayne Wallace (digitaljewellery.com) is a reader in design at Northumbria University and soon to be reader and research fellow at Duncan of Jordanstone College of Art and Design, University of Dundee, U.K. Through collaborative, interdisciplinary research she explores the potential of jewelry, digital technologies, and design artifacts within meaningful spaces in people's lives. A key focus in her work is the support of a sense of self and identity in dementia.

  Figures

Figure. Football-themed globe from Tales of I pieces.

Figure. Hospital staff member with holiday-themed globe from the Tales of I project.

Figure. Tales of I wall cabinet.

Figure. Threads piece made after witnessing Maria's response to her own work.

Figure. The television cabinet being used in the hospital unit.

 

©2013 ACM  1072-5220/13/09  $15.00

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