Credit: Norwegian National Opera & Ballet/Erik Berg.

Learning Something New

Once a ballet dancer, Pauline Hasse retrained as a nurse when she left the stage, and later combined her passions with an MA in community dance. For the past three years, she’s worked with dance and elders, as well as taking shifts at a nursing home. When COVID-19 arrived, bringing lockdowns in its wake, she stepped in to use her skills at the nursing home exclusively. As restrictions have loosened, she has returned to leading dance sessions at supported living residences.

Over the past several months, we’ve talked with some of those who found themselves on the outside of nursing homes during lockdowns. In May, we learned from Pauline a little of what her experience was like on the inside.

For some people, the isolation that came in the wake of the lockdown differed little from daily life prior to lockdown. ... I hope being isolated ourselves helps us as a society to remember those we too often overlook.

How did the pandemic influence your interactions with residents, particularly those with dementia?

We were very fortunate in that there has been no outbreak of COVID-19 at this nursing home so far. The personal relationships that develop when you have worked or lived with other people over time were in some ways the same, but I believe both staff and residents missed more personal signs of connection in daily interaction, such as the simple act of sitting closely together with someone.

At the same time…I was surprised and humbled to see how accepting many of the residents were of the situation. This is a Norwegian generation that has childhood memories of German occupation during WW2, remembers tuberculosis as a serious threat until the mid-1950s, and recalls tales from the Spanish flu epidemic that their own parents told them about when they were young, so the need to pull together for the common good was very relatable to most residents.

Just imagine if you absentmindedly coughed in your hand or wiped your nose, only to have someone rush in to help you clean your hands and perform surface disinfection on surfaces you had just touched.

Other situations challenged my ability to think ahead and became clear to me only when I had made an error in trying to maintain necessary procedure. I personally found that maintaining the heightened hygiene procedures required some extra thought to avoid making anyone feel stigmatized or “dirty.” Just imagine if you absentmindedly coughed in your hand or wiped your nose, only to have someone rush in to help you clean your hands and perform surface disinfection on surfaces you had just touched. I made this mistake once and immediately regretted my reaction.

A simple solution proved to be to clean something nearby, work your way into the area, and then let both the individual, yourself, and anyone who might be sitting together with them clean their hands. Small things can make a huge difference in working with people, because precautions and clinical procedures alone are never enough.

Pauline Hasse leads a dance session. Credit: Rune Martinsen.

Did you discover any new barriers or opportunities within your work?

Social distancing has probably reminded almost all of us how important social gatherings, physical closeness and human touch is for most of us. People who were used to having visits from family and loved ones naturally missed these shared moments and the hugs and caresses that mean so much. Preparation to contain any possible outbreak also caused in-house barriers, as residents were unable to spend time with friends that lived on different floors.

At the same time this new situation also reminded me of how ingrained ideas are of how social or active people “should” be to have what is often described as a quality life. In a few cases, there were people who seemed to thrive on the freedom to withdraw from perceived expectations from others. This was an opportunity to reflect over the fine line between encouragement and pressure, be it ever so well intentioned.

The lockdown and the awareness through experience of what it’s like to be cut off from other people to a greater degree also created some very special moments and opportunities. Within a few weeks, there were musicians holding outdoor concerts in the courtyard, which people could enjoy from the common balcony of each floor, or even from their rooms. This brought a special sense of community, as even those who felt uncomfortable in larger gatherings or who might not want to attend something where they might feel it was complicated to leave if they didn’t enjoy it were able to be included (or leave) easily.

One gentleman proclaimed it was the most wonderful thing he had ever seen.

The same was true for courtyard church services. As some regulations began to ease up, the first thing The Norwegian National Ballet did was to organize small groups of dancers and send teams of technicians that could build small temporary outdoor stages so that dozens of care homes have already been visited with more visits planned ahead. I understand this has been a moving experience for residents and performers alike, and I know one gentleman proclaimed it was the most wonderful thing he had ever seen. I hope this new awareness and these new initiatives live on after the current danger has passed!

A lockdown can add to the feelings of loneliness so many people with dementia already experience. Were there ways you were able to alleviate this? Do any specific moments of connection stand out for you?

Something that has been largely unaddressed thus far is that for some people, the isolation that came in the wake of the lockdown differed little from daily life prior to lockdown. In some ways, the fact that those who have had the most support from loved ones were suddenly cut off from this support has been something of a wake-up call for society in general regarding the needs of those who have always been most isolated. In this sense, I hope being isolated ourselves helps us as a society to remember those we too often overlook. Meeting and attending to someone with dementia can be a new journey every day and to be honest, I found the moments of connection to be as varied during lockdown as during normal times.

The Norwegian National Ballet performs at a care home after lockdown restrictions have begun to loosen. Paired dancers live together, and audience members are spaced a meter apart.

How does Memory Bridge’s philosophy resonate with you in your work?

I think their work, philosophy, and effort to support and bring people together around the world in an open and inclusive way so that we can all grow individually and together has been the backbone of my Memory Bridge experience. For people living with loved ones who have dementia, I think there is great value in how Memory Bridge helps nudge focus away from loss to where we connect or re-connect.

On the one hand, we need the research, the tools and procedures that can contribute to a growing body of knowledge that can ameliorate some of the challenges dementia presents. Just think, for example, of how awareness of the fact that pain might be a problem expressed in ways we might not immediately recognize has helped people with dementia within our lifetime. In all likelihood, people with dementia have far too often suffered from treatable problems attributed to dementia itself, which were and may still be underdiagnosed due to the focus on something which is as yet incurable.

At the same time, the idea of healing without a cure, “letting go and letting be,” as I remember Michael saying, has a fundamental place in how we live together. In a situation where dementia brings many changes, change need not only be loss, but a chance to continue connecting in new ways. Perhaps particularly in a situation where procedures, observation, and charting are essential to duty of care and health needs, that elusive, happy, sad, beautiful, and many-faceted thing that is, in the end, our shared humanity is something we all need to safeguard, regardless of whether we are a provider, patient, next of kin, or any other part of the fabric of our society.

My own buddy at the Memory Bride retreat in 2014, a lovely woman living with dementia said it as well as I have heard anyone express it: “The only place to be is with another person.”

The only place to be is with another person.

Now that you’re able to work with dance and elders again, has the experience of the past months changed your outlook or approach to your work in any way? How?

I wouldn’t say my outlook has changed, but I would say the absence has made it even clearer in my mind how much I value sharing and committing to this work. The most obvious change is that we need to observe distancing measures, meaning both having smaller groups and being unable to use touch such as holding hands, and sadly, occasionally having to turn people away. The fact that we can’t partner up or stand and hold hands for balance also places certain constraints on what constitutes safe practice, so there is more seated work, but there has always been a seated option for everything we have done earlier as well.

We continue to work in a circle, but now we don’t have the closeness of a circle of up to 12 people, where we might have held hands or partnered with our neighbor which can enhance a feeling of group inclusivity. I will therefore take care to place chairs and arrange certain movement sequences so that each of the four to five participants can consciously reach out to and “connect” to someone across the room. We have always toyed with musical feeling and gesture, but perhaps we’ll work more on eye contact and gestures to a distant partner as part of what we aim for now.

A dance session led by Pauline. Credit: Rune Martinson.

One woman said something a few years ago that really stuck with me. She said it was wonderful to be taken so seriously that someone gave her the chance to learn something new – then she laughed and said, “Even if I might learn the same thing every week!” Her words have made me very aware of the gift and pleasure of the experience of learning regardless of whether or not we can recall the experience at will.

The value of using repetition of certain movement sequences to the same music over long periods of time as a support to stimulate and access motor memory supports the experience. When short term memory fails, music and fellow movers can help us discover how our bodies might still remember for us. There are also no mistakes (and if there are mistakes, we agree that the secret is to make mistakes with such panache that everyone else looks wrong). It works wonderfully!

Excerpts from a written interview on May 26, 2020. Text has been lightly edited and condensed for concision and readability.

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