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Materialising memories: exploring the stories of people with dementia through dress

Published online by Cambridge University Press:  11 May 2015

CHRISTINA BUSE*
Affiliation:
School of Sociology and Social Policy, University of Leeds, UK.
JULIA TWIGG
Affiliation:
School of Social Policy, Sociology and Social Research, University of Kent, UK.
*
Address for correspondence: Christina Buse, School of Sociology and Social Policy, University of Leeds, Leeds LS2 9 JT, UK E-mail: C.Buse@leeds.ac.uk
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Abstract

In this article, we use clothes as a tool for exploring the life stories and narratives of people with dementia, eliciting memories through the sensory and material dimensions of dress. The article draws on an Economic and Social Research Council-funded study, ‘Dementia and Dress’, which explored everyday experiences of clothing for carers, care workers and people with dementia, using qualitative and ethnographic methods including: ‘wardrobe interviews’, observations, and visual and sensory approaches. In our analysis, we use three dimensions of dress as a device for exploring the experiences of people with dementia: kept clothes, as a way of retaining connections to memories and identity; discarded clothes, and their implications for understanding change and loss in relation to the ‘dementia journey’; and absent clothes, invoked through the sensory imagination, recalling images of former selves, and carrying identity forward into the context of care. The article contributes to understandings of narrative, identity and dementia, drawing attention to the potential of material objects for evoking narratives, and maintaining biographical continuity for both men and women. The paper has larger implications for understandings of ageing and care practice; as well as contributing to the wider Material Turn in gerontology, showing how cultural analyses can be applied even to frail older groups who are often excluded from such approaches.

Type
Articles
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/3.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © Cambridge University Press 2015

Introduction

Clothes are imbued with memories, intertwined with our histories and identities, interwoven into the ‘fabric of our lives’ (Goett Reference Goett2008). They are narrative in material form, part of the stories we live, and as such powerful prompts for memory. Clothes tell stories of ageing, embodying the passage of time through changing styles, as well as the material decay and ageing of garments. They can retain past identities and histories, or may be cast aside as our lives and identities change (Woodward Reference Woodward2007). In this paper, we use the materiality of dress as a lens for exploring the narratives of people with dementia. Dress is used as both a ‘phenomenon and a method’ (Weber and Mitchell Reference Weber, Mitchell, Weber and Mitchell2004) – a springboard for eliciting the stories of people with dementia, at the same time as exploring the ongoing role of dress as part of memories and identity. This analysis builds on a growing recognition of narrative and biography in dementia studies, and material and biographical analyses of ageing, highlighting the role of dress as part of maintaining the biographical self, and negotiating continuity and change in later life.

We begin by outlining previous literature on the use of narrative in research and practice involving people with dementia. Following this, we examine the role of material objects – including dress – as a tool for structuring and stimulating narrative. We then draw on the findings of a study, ‘Dementia and Dress’, funded by the Economic and Social Research Council (ESRC), to explore the ‘kept clothes’ (Banim and Guy Reference Banim, Guy, Guy, Green and Banim2001) of people with dementia, and their significance in retaining aspects of embodied identity, prompting memories and narrative (Weber and Mitchell Reference Weber, Mitchell, Weber and Mitchell2004). We then explore themes of loss, transition and forgetting through their material embodiment in discarded garments. The final section analyses the significance of absent clothes – clothes which have been lost or discarded, but are conjured up through the sensory imagination (Mason and Davies Reference Mason and Davies2009). Through remembering these clothes, aspects of the self are recalled, and carried forward into the context of care.

Narratives, ageing and dementia

In this section, we provide a brief overview of literature that has used a narrative approach to understanding experiences of ageing and dementia. Narratives are the ‘stories we live by’ – our own ‘personal myth’ by which we order and reorder life events to make sense of past experience, and maintain a coherent sense of self in the present (McAdams Reference McAdams1993). Narratives are inherently social and performative, told to particular audiences within particular social contexts, and used to remember, persuade, engage or entertain (Riessman Reference Riessman2008). As part of the ‘cultural turn’, age studies are increasingly incorporating narrative approaches, drawing on insights from oral history, literature, and the arts and humanities more broadly (Twigg and Martin Reference Twigg and Martin2014). Narrative and biographical approaches offer new possibilities for representing ageing (Phoenix and Griffin Reference Phoenix and Griffin2012), challenging static views of old age, and situating experiences of later life within the context of a person's broader life history (Bornat Reference Bornat, Jamieson and Victor2002; Kenyon and Randall Reference Kenyon and Randall1999). They provide a way to understand experiences of both change and continuity within individual lives (Kaufman Reference Kaufman1986), and the intersecting trajectories of age, period and cohort (Jamieson Reference Jamieson, Jamieson and Victor2002).

In the field of dementia studies, narrative and biographical approaches are increasingly incorporated into research and practice. Reminiscence and life history work can support identity and personhood (Bruce and Schweitzer Reference Bruce, Schweitzer, Downs and Bowers2008; Schweitzer Reference Schweitzer2007; Williams and Keady Reference Williams and Keady2006), challenging the reduction of the person with dementia to their condition, and placing ‘the person before dementia’ (McColgan Reference McColgan, Innes, Archibald and Murphy2004: 179). Understanding the biographies and life histories of people with dementia facilitates understanding of current behaviour, experiences and preferences, supporting the delivery of person-centred care (Goldsmith Reference Goldsmith2002; Kitwood Reference Kitwood1997).

Narrative approaches are also increasingly used in qualitative research exploring the experiences of people with dementia. Despite impairment of short-term memory, people with dementia are ‘often able to recall details of events long past’ (McColgan Reference McColgan, Innes, Archibald and Murphy2004: 176), particularly those which hold emotional significance (Westius, Andersson and Kallenberg Reference Westius, Andersson and Kallenberg2009). Rather than focusing on the temporal continuity or accuracy of narratives, the focus should be on the performative and relational elements of storytelling (Hyden and Orulv Reference Hyden and Orulv2009). Within social interaction, shorter fragments which are told and retold can hold significance for identity construction, resembling ‘small stories’ or ‘fleeting moments of narrative orientation to the world’ (Georgakopoulou Reference Georgakopoulou and Bamberg2007: 146). The telling of stories is also an embodied performance; and bodily gestures and contact can be used to support this when verbal communication is impaired (Hyden and Orulv Reference Hyden and Orulv2009). Appearance can be part of this, as Ward and Campbell (Reference Ward and Campbell2013, Reference Ward and Campbell2014) discuss in their work on hairdressing and ‘appearance biographies’.

The narratives of people with dementia may begin to ‘dissolve’ as the condition progresses, and stories are ‘faded from memory’ (Mills Reference Mills1997a : 673). However, these stories can be ‘held’ and passed on by other people, so that the narrative identity of the person is never truly lost (Mills Reference Mills, Miesen and Jones1997b : 63). Crichton and Koch (Reference Crichton and Koch2007: 365) describe this as ‘curating’ identity; a process ‘in which the teller draws on narrative to perpetuate the lived experience of the person living with dementia, and in doing so carry forward her identity as a person’. This involves weaving together stories told with, about and for the person with dementia, maintaining a coherent account of their life story.

Clothing, material culture and narrative

Biographies and narratives are inseparably intertwined with stories of things. These biographical objects become ‘entangled in the events of a person's life and used as a vehicle for selfhood’ (Hoskins Reference Hoskins1998: 2). Objects are embedded in identity construction, representing an extension of the self (Belk Reference Belk1988), and providing potent sources of memory, triggered through their relationship to embodied practice (Hallam and Hockey Reference Hallam and Hockey2001). Clothes are particularly potent memory objects because they are not just owned, but are worn by the person, and become imbued with their essence, shaped around their bodies (Ash Reference Ash and Kirkham1996: 219). Objects worn on or against the body carry particular emotional charge (Lupton Reference Lupton1998), capturing memories through their ‘sensuality and tactility’ (Woodward Reference Woodward2007: 5).

As a result, clothes provide a rich source of narrative, enabling the wearer to ‘tell their life-stories through the clothing they wore’ (Woodward Reference Woodward2007: 24). Mundane items of dress become ‘part of the fabric of life’ and ‘their power to evoke feelings and experiences is revealed in the stories of which they are part’ (Goett Reference Goett2008: 6). People can often a recall a particular moment, event or relationship through what they were wearing. Weber and Mitchell (Reference Weber, Mitchell, Weber and Mitchell2004: 4) comment how when constructing narratives, ‘an item of clothing becomes a springboard, an axis of rotation or structural grounding for a detailed account of life events’. They describe dress as both a ‘subject’, and a ‘method of inquiry’ – a tool for accessing broader life stories and eliciting discussion of identity, embodiment and culture, which otherwise remain tacit and abstract.

Reminiscence practice and research has highlighted how material objects can be particularly significant as ‘memory triggers’ for people with dementia; stimulating memories through their visual, tactile and sensory properties. In reminiscence theatre work with people with dementia, Schweitzer (Reference Schweitzer2007: 241) found that ‘handling items from the past’, including clothing, ‘stimulated memories of how they were used or worn’. Fabrics such as satin, fur and velvet were ‘particularly pleasurable to handle’, evoking ‘the feel of the past’ (Schweitzer, Bruce and Gibson Reference Schweitzer, Bruce and Gibson2008: 62). Similarly, Wallace et al. (Reference Wallace, Wright, McCarthy and Oliver2011: 5) found that ‘dress fabrics held intense meaning’ for a woman with dementia, triggering memories of experiences, emotions and events. These insights in relation to dress and its materiality are most commonly associated with women; and indeed the greater part of academic work on dress focuses on women (McNeil and Karaminas Reference McNeil, Karaminas, McNeil and Karaminas2009). But they apply also to men, as our ethnography will show.

However, despite insights from reminiscence work, dress studies literature has tended to focus on a narrow set of identities; and the lives of people with dementia have generally not been considered in the context of dress. Therefore, using the materiality of dress as tool for narrative contributes to new ways of looking at dementia, and understanding experiences of people living with the condition. Dementia, however, can disrupt our relationship to material objects, including clothes (Phinney and Chesla Reference Phinney and Chesla2003), impairing the ability to dress and choose clothing independently (e.g. Baldelli et al. Reference Baldelli, Boiardi, Ferrari, Bianchi and Hunscott Bianchi2007; Beck et al. Reference Beck, Heacock, Mercer, Walton and Shook1991). Such changes may disrupt continuity between past clothing biographies, and present identities, leading to conflict between maintaining ‘the person as they were’ and adapting to change (Twigg Reference Twigg2010). It is these tensions between continuity and change that we aim to explore through the materiality of dress.

Methodology

The article draws on an ESRC-funded UK study, ‘Dementia and Dress’, which explored the significance of clothing and dress in the daily lives of people with dementia, their carers and care workers using ethnographic and qualitative approaches. The research was conducted across three care homes in Kent, and with people with dementia and their family carers living in their own homes. The sample included 32 case studies of people with dementia: 15 living in their own homes and 17 in the care home sample (nine men and 23 women from different class and occupational backgrounds, and at different stages of dementia). We interviewed an informal/family carer for each participant in the domestic sample (15 in total), relatives of care home residents where possible (14 in total) and 28 care home workers (care workers, managers, activities workers and laundry/domestic workers), which included the person's keyworker or a care worker regularly involved in their care. As the study included people without capacity, ethical approval was sought from the Social Care Research Ethics Committee, and research proceeded according to guidelines set out in the Mental Capacity Act.

Data were gathered using observations, qualitative interviews and ‘wardrobe interviews’ – interviewing people with dementia alongside their wardrobes, and asking them to tell us about their clothes (Woodward Reference Woodward2007). Interviews were guided by a list of topics including: memories; meanings of clothes (e.g. favourite clothes, what is important about clothes); identity; decision making; and challenges and difficulties. In domestic households wardrobe interviews were generally conducted jointly with family carers, which enabled them to provide support during the interview, as well giving insight into interactions and negotiations around dress (Valentine Reference Valentine1999). Interviews included a biographical element, exploring memories of clothes and change over time, facilitated by visual prompts such as photograph albums and images of past fashions. During one-to-one discussions and reminiscence groups, fabric samples and vintage garments were passed around for people with dementia to hold and touch, prompting memories and discussion through their tactile properties. Creative visual and sensory methods can support communication with people with dementia, clarifying verbal questions and stimulating memories (Bartlett and O'Connor Reference Bartlett and O'Connor2010).

Dress stories were not only elicited through interviews, but also emerged spontaneously during informal discussions and observations in the care homes, told as part of everyday interactions in these settings. The researcher spent time sitting with and talking to people with dementia in the public areas of the care homes, observing activities at different times of day and different days of the week, including: everyday care routines (meal times, morning and evening routines); non-verbal responses and reactions to clothing; assistance with dress; and informal discussions and interactions around dress among residents and staff. Detailed fieldnotes were recorded after each observation session.

Data were analysed using qualitative thematic analysis. Initial analysis took place after each fieldwork session as part of writing up fieldnotes, exploring potential themes and issues. Formal analysis began with a careful reading and re-reading of transcripts and fieldnotes, noting down emerging themes and concepts. From this a list of themes was developed collaboratively by the research team, and used to code transcripts and fieldnotes, assisted by NVivo qualitative software. While organising data into themes, we retained sensitivity to biographical stories and their implications for identity construction, in keeping with narrative approaches (Riessman Reference Riessman2008). The themes ‘kept clothes’, ‘discarded clothes’ and ‘absent clothes’ emerged through this analysis. Other key themes (explored elsewhere) included: identity and dress; bodily boundaries and intimacy; decision making and choice; maintaining personhood through dress; stigma and normalisation; public and private space.

Kept clothes: retaining memories and identity

We begin by exploring the ‘kept clothes’ of people with dementia: garments that are stored and retained but no longer worn, kept because of the histories inscribed in them, and the memories and aspects of the self they come to embody (Banim and Guy Reference Banim, Guy, Guy, Green and Banim2001: 206). As argued by Hallam and Hockey (Reference Hallam and Hockey2001: 3): ‘In contemporary Western societies, memories are often conceived as possessions: we “keep” or “preserve” our memories almost as though they are objects in a personal museum.’ In this case, clothes were kept to maintain biographical continuity (Williams Reference Williams2000), challenging the erosion of memories and identity associated with dementia. These garments provided a vehicle for accessing broader life stories – evoking memories of working lives, family relationships, ‘dressing up and going out’ and rites of passage (Hockey et al. Reference Hockey, Dilley, Robinson and Sherlock2013; Weber and Mitchell 2007).

Clothes are frequently kept following a change in work status, representing the ‘remnants of a working life’ and the ‘work self’ (Woodward Reference Woodward2007: 53). In particular, men in the study often retained work clothes in their wardrobes, reflecting their high level of investment in this sphere, and the challenge of adapting to retirement (Barnes and Parry Reference Barnes and Parry2004). Suits signify work identities for many older men, encoded with meanings of masculinity and authority (Entwistle Reference Entwistle2000). Douglas had retained several suits in his wardrobe, some enclosed in garment bags which ‘manifest a desire to preserve them’ and ‘the aspects of the self they embody’ (Woodward Reference Woodward2007: 53). Suits materialised his transformation from a ‘telegram boy’, to holding a position of authority as post master for the local area, as his wife Cora describes:

Interviewer: Did you have to wear a suit as well for…?

Douglas: Yes. You've got to remember that, you know, I was in charge of … of a thousand people.

Cora: So he used to have a moustache to make him older, didn't you?

Douglas: Yes, I did.

Although he rarely wears a suit now, the suits in his wardrobe are part of his biography, and are also significant to identity construction in the present. While Douglas struggles to dress independently, with assistance from Cora, he maintains an aesthetic of smartness, situated within stories of his work history: ‘you won't get him in anything that's not smart … all the time he was at work he had to be smart’.

Memory is materialised through ‘the relationships between embodied action and material objects’ (Hallam and Hockey Reference Hallam and Hockey2001: 13). Where verbal communication is impaired, there is a greater emphasis on storytelling through the body, and embodied practice (Hyden and Orulv Reference Hyden and Orulv2009). Tom was forced to give up his work as a self-employed builder due to his dementia, which his wife Jane said ‘was the hardest thing’. However, he still retains a row of work clothes in his wardrobe – jeans and old shirts – which carry the marks of his occupational history, covered in plaster and holes. Tom's verbal communication is quite impaired, and he struggled to express why he keeps these clothes, however, his wife Jane said that: ‘he does love to get his working clothes on’, wearing them whilst ‘pottering about in the garage and things … he just likes to feel he's at work I think’. Therefore, by wearing these work clothes his ‘past is reactivated’ and ‘made present through clothing’ (Woodward Reference Woodward2007: 52), and he is able retell his story through ‘physical sensation and action’ (Schweitzer Reference Schweitzer2007: 241).

For women with dementia, kept clothes were sometimes those they had made themselves, embodying gendered work histories (Parker Reference Parker1984). Belk (Reference Belk1988: 150) argues that when items are made by a person the ‘creator retains an identity in the object’. These garments were also significant as part of enacting generational and working-class femininity as family carer Mark said: ‘there was a bonding when women were out … talking about that … a woman who couldn't knit a jumper or make a dress or something was almost sort of looked on as inadequate’. Eva was predominantly employed as a factory worker, but carried out dressmaking for friends and neighbours in her spare time. She had made all the clothes she owned, and would not throw them away because, as her son explained: ‘that's what she is. That's what she did. She was the best dressmaker … that's what was important to her’. Another participant, Rose, had worked professionally as a dressmaker, and her wardrobe was full of dresses she had made, and she had also kept sewing patterns, fabrics and equipment. When looking at these garments, Rose remarked proudly: ‘that's one of the best ones’, and ‘I worked in Bond Street … and they were top-rate’. Rose and Eva are no longer able to sew, but retaining the things they had made helped them to retain this aspect of the self.

Another category of clothing often retained – particularly by women with dementia – were garments associated with dressing up, bought for occasions such as weddings, christenings and anniversaries. These garments invoked memories of special moments: ‘the dress I was wearing when…’ (Weber and Mitchell Reference Weber, Mitchell, Weber and Mitchell2004: 5). They were ‘too special’ for everyday wear (Banim and Guy Reference Banim, Guy, Guy, Green and Banim2001: 214), capturing an ‘idealised self’ (Tssëlon Reference Tssëlon1995). Alice, a housewife, had kept various outfits worn for anniversaries and weddings, and the shoes and handbags bought to complement them. She rarely had the occasion to wear them now – as her dementia has progressed they seldom go out anywhere ‘dressed up’. However, she said: ‘we don't want to get rid of them. They're part of me, aren't they?’ Like many women she had retained her wedding outfit – a simple white lace dress, and pair of high-heeled gold court shoes, kept for 60 years. Wedding dresses represent a ‘sacred object’ imbued with particular personal and emotional significance, embodying transformation and transition (Friese Reference Friese, Guy, Green and Banim2001). Her husband recently brought it down from the attic, and had left it out because she ‘keeps asking to see it’.

Following transitions to care, possessions are often discarded (Ekerdt and Sergeant Reference Ekerdt and Sergeant2006; Fairhurst Reference Fairhurst, Chapman and Hockey1999; Nord Reference Nord2013); it is difficult to maintain ‘kept clothes’ which have little practical value in this context. However, ‘small things’ – watches, jewellery, handbags – items worn close against the body, are often carried forward into institutional care (Hamlett and Hoskins Reference Hamlett and Hoskins2013). These items act as ‘transitional objects’, which help displaced persons maintain connections to their biography and identity (Parkin Reference Parkin1999). Marie constantly carried her handbag around the care home, using it to store objects connected to various aspects of her previous life: her hairdressing kit; an army cap badge belonging to her uncle; and a locket displaying pictures of her parents. The bag embodied various aspects of her identity, including those connected to work roles and family relationships (Buse and Twigg Reference Buse and Twigg2014). Another care home resident, Harry, always wore a watch bought for him by his late wife, and a gold wrist chain which had belonged to her. These items of jewellery were significant because of their connections to her, relived through the embodied practice of wearing them (Ash Reference Ash and Kirkham1996). These ‘small things’ not only acted as memory triggers for the person, but also worked as a prop for telling their life story to staff and other residents. Staff talked about how they acquired clues about the person through the things ‘they come in with’, and supported them to maintain jewellery, watches and handbags. As one care worker said: ‘if they've got [brooches or necklaces] in their room and that's what they wore I think it's nice to keep it like that’.

It was not only people with dementia who retained items of dress; they were also kept by families as a way of extending or memorialising the identity of the person (Belk Reference Belk1988), particularly following transitions to care. This memorialisation of the person through objects generally occurs after the death, but in this case it began earlier, a process of retaining a trace of the person partly lost, which one family carer described as part of ‘the long goodbye’. Brenda talked about the items of dress she had retained when her mother went into care:

I have got a nightdress of hers … which she used to like wearing because she always said it was nice and soft … I've got her wedding ring … But I wish I could have my Mum back, I tell you. I really, really do.

Brenda described how the nightie triggered connections to her Mum, remembered through the ‘feel’ and ‘texture’ of the soft fabric, and the memories of her wearing it (Ash Reference Ash and Kirkham1996). It is a particularly intimate garment, associated with the private self. Wedding rings represent an extension of the person, always worn, always part of them. However, the potential of these objects to stand in for the person is partial and incomplete; though Brenda had ‘got’ these objects, she still wished she could ‘have [her] Mum back’.

Keeping these garments is not only about remembering past identities, but also about future trajectories – preserving a ‘legacy’ of the person for future generations, as well as a preparation for death as the final stage of loss (Hockey et al. Reference Hockey, Dilley, Robinson and Sherlock2013). Ellie's storage cupboard was full of her Nan's ‘boxes and trinkets’: her jewellery, berets, hat pins, handbags and fur coats. She had kept these items because of their connections to her Nan, but also because she: ‘wants to be buried in her fur coat and her beret – one of her nice berets – so that's how she wants to go: smartly dressed’. Rita's son had stored his Mum's beaver lamb coats as ‘not quite heirlooms, but things that … we can remember from some time ago’; whilst Mark had retained jumpers knitted by his Mum, hoping to pass them on to a family member ‘who might appreciate them’. Mavor (Reference Mavor, Weber and Mitchell2004: 24) argues that objects – including dress – not only: ‘signify death, they also … keep death away. Collecting these objects in the nooks and crannies of our homes keeps them and our memories alive’. Items of dress are thus kept as a way of extending and retaining the identity of the person with dementia (Belk Reference Belk1988), passing on their story in material form.

Discarded and forgotten clothes: negotiating change, transition and loss

The clothes kept by people with dementia tell us about their memories, and aspects of identity they wish to retain, particularly in the context of transitions which threaten continuity of self. However, clothes which have been abandoned also tell a story – forgotten or discarded due to the ‘biographical rupture’ resulting from the progression of dementia (Woodward Reference Woodward2007: 52). As Forty (Reference Forty, Forty and Kuchler1999: 4) argues: ‘if objects are made to stand in for memory, their decay or destruction … is taken to imply forgetting’. Exploring the reasons why items of dress were abandoned reveals how relationships to clothing and the body change during the ‘dementia journey’, illuminating stories of transition and loss.

Narrative accounts of people with dementia emphasised continuity in dress style and identity, however, they were often in disjuncture with the ability to maintain appearance and dress. This disjuncture between the embodied and narrative self – or the self as ideal and actualised – is captured in forgotten or discarded garments (Banim and Guy Reference Banim, Guy, Guy, Green and Banim2001). Maggie recounted that she had always dressed up for the occasion: ‘if I'm going anywhere special I like to wear my dress. I like to have my hair done and have my dress and all the rest of it’. This was caught also in family photographs, with images of her immaculately turned out at christenings, weddings and family ‘dos’. However, her grand-daughter Ellie, who cared for her, felt that this aspect of her embodied self was now somewhat lost: ‘she used to dress up smartly for such occasions but now I don't think so much’. Maggie forgot – and was sometimes reluctant – to change clothing without regular prompting and assistance. Ellie recounted how one Christmas, Maggie kept asking ‘what should I wear?’, so she went shopping with her, ‘hunting everywhere’ for the perfect Christmas outfit. Together, they selected a long-sleeved, burgundy wool dress, which Ellie carefully laid out on the chair, ready for Christmas Day. However, on Christmas Day she put ‘the same clothes on that she'd had on Christmas Eve. Even though it was all laid out for her so she could see it, she didn't put it on’. The dress remained in her wardrobe, forgotten and unworn.

As biographical objects, clothes: ‘share our lives with us, and if they gradually deteriorate and fade with the years, we recognise our own ageing in the mirror of these personal possessions’ (Hoskins Reference Hoskins1998: 8). Clothes ‘age and die’, moving from their initial ‘shine’ as new fashion objects (Schiermer Reference Schiermer2011), to becoming ‘dowdy’, worn or out of style (Twigg Reference Twigg2013). However, this ageing and decay of clothes sometimes went ‘unnoticed’ or ‘unseen’ by the person with dementia: as one family carer remarked: ‘they weren't too shabby to her’ but ‘to us they were beginning to show signs of quite serious wear and tear’. Therefore, family carers – and sometimes care workers – would take on the role of conducting a wardrobe ‘clear out’ on behalf of the person, discarding ‘shabby’, ‘tatty’ and ‘aged’ clothing:

… if we hadn't have cleared out all of her wardrobe she would still be wearing clothes now from when she was like 50 years old, if she still had them, whether they fitted or not, whether they have holes in them. She wouldn't see it so she would still be wearing old tatty clothes. (Ellie, family carer, age 26)

A failure to recognise the ageing of garments was mirrored in the broader disruption of trajectories of ageing and biography, reflecting increased impairment of short-term memory. More recent years – and garments – were most likely to be forgotten, as Ellie explained: ‘to begin with when she was first diagnosed she had lost a couple of years, now she's lost the last 50’. Older garments carry histories and stories which are ingrained in memory (Banim and Guy Reference Banim, Guy, Guy, Green and Banim2001), whereas more recent purchases were often forgotten or unrecognised, something which became apparent during the wardrobe interviews. Fred reflected that when he disposed of some of his wife's older garments, she kept asking ‘where's it gone?’, but ‘if you bought her something new this week she wouldn't ask for it’. Thus the ageing and decay of garments ‘became material enactments of the mental decay of images supposed to constitute the process of forgetting’ (Forty Reference Forty, Forty and Kuchler1999: 4).

Clothes are not only discarded because the garment itself has aged, but also due to the ageing of the wearer, and changes in their body which mean that clothes no longer ‘fit’ (Twigg Reference Twigg2013). People with dementia had sometimes altered their dress over time to adapt to more general changes associated with the ageing body: flatter, more ‘comfortable’ shoes; higher necklines; trousers rather than skirts (Hurd Clark, Griffin and Maliha Reference Hurd Clarke, Griffin and Maliha2009). However, specific changes and transitions experienced as part of the dementia journey also resulted in bodily changes and altered relationships to dress. Dementia can affect relationships with food and eating, sometimes resulting in weight loss (Alzheimer's Society 2013). For instance, Mark had ‘culled’ much of his Dad's wardrobe because: ‘he'd be wearing stuff that was all, you know, hanging off him and … trousers falling down’. On the other hand, the change of lifestyle and reduction in activity which often accompanies the progression of dementia can lead to weight gain, constituting bodies as more ‘static’. Clothes were discarded and replaced to accommodate this: jogging trousers for ‘comfort’; larger sizes; elasticated waists; and longer skirts and trousers which did not ‘ride up’ when sitting down. These bodily changes were particularly marked following the transition to care. As the advancement of dementia led to increased assistance with dressing the body, care workers described bodies becoming ‘inflexible’ and ‘stiffening’, resisting assistance. Therefore, care workers and managers would sometimes encourage families to replace garments without ‘stretch’ with ones which had more ‘give’ and could accommodate the process of dressing.

The transition to care marked a turning point in the life of the person with dementia (McAdams Reference McAdams1993), a moment when clothes were ‘sorted’: kept, discarded or put into storage. Sorting through clothes has wider meanings as a process of sorting biographies; discarding garments which do not fit with changing identities (Woodward Reference Woodward2007). Family carers described this as an upsetting and ‘really, really difficult’ task. In this case, the sorting of clothes was also shaped by meanings and expectations of the care home. Garments associated with dressing up and special occasions – for instance, fur coats, costume jewellery and high heels – were often discarded or put into storage by family carers, regarded as ‘impractical’ in this context. Decisions about which clothes to keep or discard also reflected the ambiguous meanings of the care home in relation to boundaries of public–private space (McColgan Reference McColgan2005). Clothing and underwear which was old or tatty was often thrown out by family members, viewed as ‘unsuitable’ for the more public setting of care. At the same time, items of clothing such as pyjamas were sometimes acquired as part of the ‘rite of passage’ into care (Twigg Reference Twigg2010); while clothes associated with ‘outdoor’ or ‘public’ spaces were discarded or left behind.

However, efforts to discard clothing were sometimes resisted by the person with dementia. Clothes represent an ‘extension of the self’, and therefore throwing away garments is experienced as diminishing identity (Belk Reference Belk1988: 142). The discarding of clothes could therefore become a site of struggle between family carers and people with dementia. This is illustrated by the following discussion during a wardrobe interview, where Rose resists Frank's suggestion that her large collection of handbags should be reduced:

Frank: I'm going to get rid of some of them. I must … I must get rid of them.

Rose: No you won't! I'll do what I want. I know what I need.

These tensions centre on differences in the perceived ‘value’ of the garments. As clothes are worn, they become ‘emotionally charged’, carrying the marks of their daily embodied interaction with the wearer, becoming an extension of the person (Lupton Reference Lupton1998: 144) and ‘a record of the self’ (McCraken Reference McCracken1987: 214). Although their monetary value declines, they take on greater personal value. Frank pointed out that some of Rose's handbags have to ‘be dumped’ because they are ‘aged’ and tatty, and also she ‘never uses’ and ‘doesn't need them’. However, Rose's clothes and handbag are significant to her identity, and despite ‘much wear’ and a lack of functional use, the emotional and affective connections these garments embody ‘are valuable, beyond the literal value of these objects’ (Jones Reference Jones, Jones and Miesen2004: 265).

Absent clothes: recalling the self through dress as remembered

We now explore the role of absent clothes in ‘recalling the self’, with clothes long discarded but remembered and evoked through storytelling (Woodward Reference Woodward2007). Mason and Davies (Reference Mason and Davies2009: 601) argue that it is not only elements of the sensory that are ‘visible, audible, touchable’ in the present that are significant, but also ‘those that people could conjure up in their sensory imaginations’. These absent objects reside ‘somewhere between the tangible and intangible’, an ‘intangible invocation of the sensory’. Reflecting their powerful implications as part of identity, memories and personal history, clothes may be ‘vividly recounted’ long after they have been discarded (Woodward Reference Woodward2007: 60). Remembering clothing through stories not only evoked images of the garments themselves, but also aspects of the self which the teller wished to recall and draw to attention.

Through evoking images of clothes remembered, people in dementia care settings were able to recall aspects of the self which were threatened with erasure. Rita frequently retold stories to staff and residents about her favourite clothes from the past; ‘special’, glamorous items of dress such as her ‘beaver lamb coat’, silver court shoes and especially her gold lamé jacket:

I used to have a lamé jacket ‘n all … that used to sort of light up when I was in a room, they’d all stare because it sort of shone. You how it does, lamé? … I liked it and I like that lamé … it glittered, it stood out. Do get me? Sort of shone, like. It did! It's true.

Within this narrative, Rita's gold lamé jacket exudes a shine or radiance, imbued with magical and transformative properties (Schiermer Reference Schiermer2011). Although discarded because it ‘literally has lost its thread’, it still had the power to evoke images of her standing out, and attracting attention, as being ‘someone’. As she recollected: ‘when you're all done up and dressed up like you do … you thought you stood out!’ and ‘thought you were the bee's knees’. In telling stories and ‘conjuring up’ this garment, it casts a ‘reflection on the present person, the teller, an elderly resident in a care unit’ (Hyden and Orulv Reference Hyden and Orulv2009: 212), providing access to alternative images (Phoenix and Griffin Reference Phoenix and Griffin2012). These stories enhanced how care staff saw Rita whom they described positively as someone who had ‘liked the high life’ and ‘been quite glamorous’.

Dress stories therefore have the capacity ‘do’ things (Frank Reference Frank2010), recalling past aspects of the self and challenging images of dependency produced by social interactions of care. While current dress may reflect compromises imposed by the ageing body, clothes as remembered can evoke the ‘idealised self’ (Tssëlon Reference Tssëlon1995). Dot has severe physical impairment as well as dementia. Her dress stories provide a contrast with her current embodied dependency, drawing on dress as a device for evoking ‘vivid snapshots of youth, energy, and self-importance’ (Hockey Reference Hockey and Jefferys1989: 205). Dot described shoes as ‘her weakness’, recalling the four-inch heels she used to wear, in contrast to the slippers and sandals now in her wardrobe. She remembered buying her first pair of high heels: ‘when I left home. I don't think my father approved of them really. When you get to a certain age you're defiant as the day is long’. Buying these shoes marked a significant transition or turning point in her life, from childhood to adulthood and independence (Hockey et al. Reference Hockey, Dilley, Robinson and Sherlock2013). On another occasion during a group reminiscence session, Dot recollected that her father was ‘disgusted’ by the bathing suits of the time, thinking them too revealing – and would not let her wear one, but she ‘defied him’. This tale prompted laughter and shared memories from the other residents and staff. By retelling these stories Dot was able to establish social connections, and confirm her identity: ‘not only as a woman who used to be brave and daring, but also as (still) being the very same person’ (Hyden and Orulv Reference Hyden and Orulv2009: 212).

When people with dementia were no longer able to tell their own stories, family carers took over the role of telling stories ‘about’ and ‘for’ them – ‘curating’ their identity (Crichton and Koch Reference Crichton and Koch2007). Conjuring up garments from the past enabled them to recount aspects of the person ‘as they were’ and to ‘carry their identity forward’ into the context of care. Henriette's daughters recalled her gaudy Lurex trousers: ‘Bright purple ones … Very outrageous. But that was her life, wasn't it?’ Henriette has advanced dementia as well as Parkinson's disease, and her verbal communication and mobility were severely impaired, but these clothing stories summon something of the bold, outrageous person she was. Dress stories could also draw attention to skills and attributes of identity, such as being a ‘caring’ person, otherwise diminished in the context of advanced dementia. For instance, Mable's children recalled her knitting ‘for the whole family’, and her daughter described how she had ‘taught herself to knit and sew’ and was a ‘very, very clever woman’ who would ‘do anything for you … she was that kind’.

These stories of dress were often passed on to care workers, so that ‘curating’ identity could become a matter not only of verbal storytelling, but also embodied practice. Care workers described how the nuances of a person's individual style could be gleaned from talking to families: ‘Well mum always has tights. She never wears high heel shoes … she'll always have a scarf … she never wears her jewellery except for Sunday’. Where such detailed information was not available, care workers would piece together fragments of personal histories, ‘restorying’ the lives of residents (Holst, Edberg and Hallberg Reference Holst, Edberg and Hallberg1999): ‘she was an administrator all her life, you know, that kind of background and so she likes to be smart’ or ‘he was a ballroom dancer … so you have to be absolutely immaculate’. These stories were also interwoven with embodied practice, and efforts to maintain the ‘person they were’ at the level of dress and the body. As one care worker said: ‘she was like a real sort of lady … so I sort of keep that in mind’ and dress her in ‘things that I know she… as she was back then, would like to be in’. Therefore identity was intercorporeal (Weiss Reference Weiss2009), produced through sharing stories and embodied practice between care workers, relatives and people with dementia (Ward and Campbell Reference Ward and Campbell2013, Reference Ward and Campbell2014).

Recalling absent and remembered clothing not only establishes biographical continuity, but also highlights contrasts with current dress, drawing to attention instances when continuity in embodied identity was not successfully maintained. Melissa described how her Dad, a factory worker, was always smart, even when he ‘used to cycle to work … he had his coat on and everything, but underneath that he always had a shirt and trousers’. On one occasion she complained to the care home because he looked ‘scruffy’; his clothes were crumpled and dishevelled. This upset her because clothes represent an extension of the person (Belk Reference Belk1988), and she felt that this state of dress betrayed the person he was: ‘I've never seen my dad scruffy. Never. Until that day…’ Families of people with dementia could therefore act as the ‘safekeepers of their identities’ (Oppenheimer Reference Oppenheimer, Hughes, Louw and Sabat2006: 200), protecting the biographical self at a material and embodied level. However, as discussed earlier, sometimes compromises had to be made between biographical continuity in identity, and adapting to changing bodies and care needs – limiting the possible stories which could be told through dress.

Conclusion

This paper illustrates the significance of dress as a tool for storytelling, remembering and identity construction for people with dementia. Keeping items of clothing provided a way to ‘keep’ memories and aspects of the self, threatened by the progression of dementia and transitions to care. Clothes also facilitated storytelling at an embodied, material level, in the face of increasing impairment of verbal narratives. These narratives were not only constructed by people with dementia, but also with and for them, curating and memorialising identity through the collection and recollection of clothes and dress stories (Crichton and Koch Reference Crichton and Koch2007). Discarded clothing as an embodiment of ‘forgetting’ and loss illustrates the challenges of living with dementia, and balancing continuity with change. Nonetheless clothing – whether absent or kept, tangible or intangible – also provided a means for constructing alternative images of ageing and dementia, and a way of seeing the person before the dementia (McColgan Reference McColgan, Innes, Archibald and Murphy2004: 179).

Dress stories are interdisciplinary – represented in text, textiles, art and visual form. Therefore, this article has implications for further dialogue between arts, humanities, social sciences and dementia studies research and practice. The potential of the arts for engaging with people with dementia has been discussed in research and practice literature, and incorporated into programmes of therapy and activity (Basting Reference Basting2006; Beard Reference Beard2012; Mottram Reference Mottram2003). This article also underlines the relevance of material culture – and specifically clothing and textiles – to such practice, and their potential as tools for creative storytelling, reminiscence and enactment of memories. Visual and textual narratives have been used to record the stories and experiences of older people, including those with dementia, and inform person-centred care, for instance, use of life-story books and collages (Bruce and Schweitzer Reference Bruce, Schweitzer, Downs and Bowers2008) or photographic ‘personal archives’ (Permuth Reference Permuth2006). We suggest that clothing can similarly be used to maintain a material and visual record of the person, and inform care practice.

This article therefore has important practical implications for dementia care. Further training and education is needed amongst care practitioners to heighten awareness about the significance of dress, as part of the identities and biographies of residents. The article also highlights challenges associated with the transition to care and sorting of belongings, and the significance of decisions concerning which clothes should be brought with the person. Garments which seem of little practical use may in fact have worth as part of maintaining the biographical self, and a sense of ontological security. Family carers and care providers may benefit from further advice and support around this process.

The article also has wider implications for understandings of ageing, illustrating the significance of material culture – specifically dress – as a lens for understanding experiences of growing older (Chapman Reference Chapman2006; McCracken Reference McCracken1987). It thereby contributes to the increasing recognition of narrative and material analyses of ageing and old age, as part of the wider ‘cultural turn’ (Twigg and Martin Reference Twigg and Martin2014). Previous studies have explored the potential of dress for eliciting biographical narratives (Banim and Guy Reference Banim, Guy, Guy, Green and Banim2001; Weber and Mitchell Reference Weber, Mitchell, Weber and Mitchell2004; Woodward Reference Woodward2007), including those of older women (Twigg Reference Twigg2013), and for exploring the embodied and sensory dimensions of lifecourse transition (Hockey et al. Reference Hockey, Dilley, Robinson and Sherlock2013). This article extends these arguments into the context of frailty and dementia. It illustrates how clothes as material objects can be used to maintain personal histories and construct identity in the present, challenging static images of frail old age, and retaining positive aspects of the self associated with work, relationships and appearance. Nonetheless this analysis also illustrates fundamental tensions between continuity and change which are played out at a material and embodied level through dress, and the complexity of reconciling continuity of self with the disruption resulting from dementia.

Acknowledgements

The authors would like to thank all the participants in the ‘Dementia and Dress’ study for their insights and support with the project. The article draws on the ESRC-funded project ‘Dementia and Dress’ (RES 062-23-3195). The study was granted ethical approval by the Social Care Research Ethics Committee on 11 October 2012 (REC reference 12/IEC08/0038).

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