2009 fieldwork experience — by Michaela Mangrum
Below is text selected from an e-mail message sent by Michaela Mangrum to her professor/supervisor while on her fieldwork at an adult day care center. She describes her experience of entering the world of a participant who had dementia, using a game of cribbage to bring about a meeting of minds. The details and meaningfulness of the everyday occupation of game-playing are expressed so well (shared here with permission).
“I have been spending time in an adult day center for part of my FW. Mostly, I have been trying to meaningfully engage the participants there. Many of them have dementia or some other kind of cognitive deficit. One woman in particular poses a challenge for the other staff. When they tell her/ask her to do something, she usually says ‘no.’ She has dementia, but can still communicate, do word searches, play dominos, walk, and many other things. I heard that she also plays cribbage. I know how to [play cribbage] and I looked forward to the next time she didn’t want to do something so we could play!
We sat down at the table, I dealt the cards, and she immediately laid a match down. Note: that is not how you play cribbage. I was confused for a moment, and stuttered over trying to ask her if she meant to ‘throw those in the crib,’ but quickly realized she didn’t remember how to play. So, I tried to follow her lead. We drew from the deck (not part of cribbage), laid down matches and runs, and basically played some sort of go fish/rummy. The other staff were watching and started saying things like ‘Well, if that’s cribbage, I can play cribbage!’ and ‘Aren’t you supposed to say 15 this, 15 that and move the pegs?’. . . Finally, one of the staff realized what was going on, and whispered to the other, ‘If she thinks it’s cribbage then it’s cribbage.’
Okay, so we played a few hands like this and I admit I felt a little disappointed because I thought she would be able to do it. In retrospect though, cribbage is a very complicated game. However, after about the 4th time I dealt the cards, she said, ‘Your crib or mine?’ which is a perfectly appropriate question for the game of cribbage. I told her it was mine, and we played cribbage for about 30 minutes! Sometimes she added wrong, counted her points twice, or moved the pegs up and down the board instead of in one direction, but we definitely played the essential elements of cribbage!
I would catch myself starting to correct her sometimes, and learned what focus and patience it takes to go with the flow and back down about being ‘right.’ I can not imagine doing this as a 24-hour caregiver . . . It really helped to begin putting things in perspective.
After about 30 minutes, though, I dealt the cards for another round, and she laid down a match. Cribbage was gone. I wish I could have seen her brain activity, before, during and after cribbage. How amazing . . . It was really nice to use what I’ve learned (like following their lead and letting go of being right) and witness the power of meaningful occupation!
One more aside: Even though the score keeping wasn’t technically accurate, I would say that ultimately, she kicked my butt. I think that this woman was quite the card shark and I was so glad to give her that opportunity again.”
Thank you, Michaela. This is what it is all about. Betty