What is empowerment?
The following are quotes from an easy read pamphlet from the Local Government Association, written I think for people with learning difficulties, who historically have often been regarded as not having capacity to make decisions about their lives.
‘Empowerment means people having power and control over their own lives. People get the support they need that is right for them. … You can’t empower someone else or make someone empowered. It is about ways of working and supporting someone that means they can take control and responsibility for their own lives.
How will we know if people are empowered? What would this look like?
It will be clear that the person has the power – they will set their own goals and make their own decisions
If people need someone else to make a decision for them it will be made in their best interests
People will have a voice and be treated like equal citizens
This means they will have the same opportunities as everyone else to live good lives in the community
People’s experiences and feelings will be valued and they will be listened to and respected
People will be safe and will feel safe
People will know about their rights and can act on them
People will have the information and advice they need so that they can make their own decisions
There will be good advocacy for people. Advocacy and empowerment go hand in hand because advocacy is about speaking up and getting your views heard. For people who need help to make decisions or someone to make a decision for them advocacy is really important
People will have the freedom and support they need to do things that are important to them’
I think we need to differentiate between empowerment and confidence.
Empowerment is knowing your rights, having necessary skills and support, and making decisions about your life.
Confidence is perhaps about having the skills and courage to speak out.
You can have all the knowledge in the world about your rights, but you will only speak up about them if you have the confidence to do so.
And if you have lived a life in which you didn’t speak up for yourself you will find it hard ever to do so. But you can learn to.
The same is true of people living with dementia. If a person has cognitive difficulties they may lose confidence. That stammering attempt to find a word, or to formulate a reply to someone; that getting lost in town; that indecision about what to buy, or why on earth you came into the shop…these all feed the beast which destroys your confidence.
When someone else decides what you eat, drink, do, read, listen to, who you meet, and where, that is when you lose the ability (not capacity) to make decisions for yourself. You withdraw. You may feel relief at not having to work something out for yourself.
But that loss of confidence leads to loss of skills, and may start a spiral of decline.
Disempowerment leads to loss of confidence.
Empowerment, therefore, can build skills and confidence.
Peer groups and facilitators can hand over to members authority or power to make decisions. That is a process.
Confidence to make decision and choices and carry them through…that is different.
People may have legal power and authority to act in their own right, but they may lack the confidence to do so, especially if they have grown up or lived in a situation where they were restricted from exercising their freedom, either deliberately or by social norm.
The same will be true of people living with dementia who have fallen out of social engagement, and/or have had decisions taken away from them by those who provide care and support.
How then do we enable people to grow the self confidence and skills they need to act in an empowered way?
Making decisions requires a process. Many decisions are made with little or no conscious thought or deliberation, such as choosing what to eat for breakfast, or what to watch on TV.
Other decisions require us to work through a process of considering pros and cons and to decide what we value most.
If you have never made decisions for yourself, or have become used to not doing so, it takes practice and courage to do so.
We often say that facilitation should be about carrying out the tasks necessary for a DEEP group to meet, not about controlling what the group does. It may also be providing support for those members who need it.
Just like in a residential care setting, the best facilitation or care is the minimum that a person needs to live as they choose. It’s essential to leave as much autonomy as possible with the person. To take this away is to infantilise them, to disempower them, and to lead them to lose the skills and confidence of a lifetime.
All groups – and all individuals – are different. People with more advanced dementia need more support. The great skill in care and support must be to identify the things that a person can do for themselves, even if it is at times a struggle. Use it or lose it, we say of skills and knowledge.
Younger people who develop dementia often are still working, and their identity and self are defined to some extent by that work. They need a different sort of support, and different peer group activities, specific to their age group.
Older people may have developed their post retirement identity away from work, taking up activities that they enjoy and that keep them active. Some will have, and will still remember, the skills of leadership and management; some will remember being managed!
Either way, most people learn to distance themselves from their previous world and may not wish to take on responsibilities. Some may have grown into a new deferential role of allowing, indeed welcoming, someone else to make decisions for them. That is where facilitators come in!
The facilitator can step back to allow, indeed to encourage, members to make decisions, and can engineer situations where members have to do this. Staying in the background is the skill that the best teachers have, so that people or youngsters develop their confidence without risk of failure.
Facilitators step forward when they are needed. And back into the shadows when they are not.
Dementia Engagement and Empowerment (Project) is about bringing people living with dementia together:
• to support each other,
• to share experiences and feelings,
• to have social engagement, and
• to empower them to use their voices.
The empowerment is not about telling members of groups to go out and shout and influence and be heard. It is, rather, enabling them to feel confident enough and supported enough to have their voices heard if they have something to say. It is giving people the knowledge and skills they need to be able to make their own decisions and to have their voices heard.
Some groups just socialise and support each other. Some get stuck into influencing politicians, commissioners, companies, healthcare providers…whoever they want to persuade to change something, or indeed to hear them.
It matters not one jot whether you or your group become influencers with a purpose, because just by meeting together you are changing the way people living with dementia are supported, and live their lives.
The act of meeting socially in a peer support group, of talking together about shared experiences and feelings, or about the differences in these, this simple act gives a voice and confidence to speak up if you wish to. And it is an opportunity to learn the knowledge and skills that empower you to do so.
So facilitators can do powerful things for their groups, to share with their members the knowledge and skills they need, and to support them if they stumble.
‘Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it’s the only thing that ever has’. (Margaret Mead)
We are all, in our own ways, changing the world.