SPECAL CONVERSION

After reading and posting about SPECAL, the organisation run by  Penny Garner (which proposes a radical but highly practical approach to caring for people with dementia) I contacted them and asked if I could film one of their training days.  Penny herself replied and suggested I should start by participating in one of the courses.  So I signed up for a one day session for professionals working in the care sector.   I spent Thursday at their headquarters in an old hospital in Burford near Oxford with a group of people who had come from as far as New Zealand to learn how to apply the Specal way to their work.  Making up the group were managers of nursing homes run on holistic principles, psychiatric nurses working for the NHS who objected to the over-use of medication to tranquilise patients with dementia, a journalist, a lawyer working with vulnerable elderly clients, and a behavioral therapist.

In the morning 2 female volunteers went back over the ideas in the book, clarifying what SPECAL is about, then in the afternoon Penny herself went into greater detail and discussed strategies for converting nursing homes or other institutions into SPECALed environments. 

As yet I haven't seen SPECAL in action with a 'client' (as they refer to those with dementia) but from all my current understanding of it and my experiences of dementia, I think its a completely sensible and excellent idea.  Penny is utterly convinced that with time its principle ideas will be adopted nationally and internationally as THE way to cope with the problem of dementia.  The problem is that at the moment she is struggling to get the backing of the Alzheimer's Society which dominates the field and is actively distancing itself from SPECAL. On its website it has a statement outlining its reservations:

"SPECAL in particular supports the view that it is acceptable in many instances to lie to people with dementia and to move away from offering them an effective range of choices."

Bizarrely, immediately below their statement they have published an account by a lady called Pam for whom SPECAL worked and was the answer to everything.  She writes:

"I felt I should write this article so that the many people who are living with this dreadful disease, both carers and sufferers, should feel some hope that there is a potential way of coping with the disease. I have met many people who are as devastated as we were. I believe everyone should at least have the opportunity to access SPECAL."

From everything I can understand about the situation, the problem is that large institutional bodies like the Alzheimer's Society and the NHS can't embrace SPECAL because of the way it accepts dementia for what it is, and then exploits the few benefits it has to offer. For example, the fact that someone with dementia doesn't get bored of repetition means that you can constantly return to a memory or action which makes them feel safe and in control, as opposed to being lost and confused. The central goal of SPECAL is to create and sustain permanently the 4 states of emotional wellbeing: 

Personal Worth        Agency        Social Ease       Trust

Yes, this does involve a degree of deception but it must be done out of love and in good faith in order to avoid the far more cruel alternative; that being to rub the sufferer's nose in the truth of their dire prognosis. Of course people with dementia should be given the chance to exercise choice for as long as possible but there comes a time when such politically correct considerations become meaningless.  This is a matter for the judgement of the individual's carers, one of many difficult decisions that have to be made as someone becomes progressively more dependent.  Perhaps SPECAL should produce something like a Organ Donor card which says "If I ever get dementia I hearby give my consent to be guided into SPECAL LAND by those who know me best:________"

A woman on the course had the theory that in order for the  Alzheimer's Society to get its funding it needs to sustain the narrative that dementia is a hopeless, horrible, disease for which a cure must be found by people spending loads of money on medical research. The fact that SPECAL's book is called 'Contented Dementia' is too much for them to handle...  

Penny is convinced that that the field of dementia care is nearing a tipping point and as a separate documentary project I think it could be interesting to follow the story of her attempts to bring about this transformation.  Either way next week I am going back to film their weekly Friday session where clients and their careers spend the day at the centre. I am also going to try to film at the Beth Ezra nursing home whose staff have done the same course and are apparently experiencing good results.