In Their Own Words: Exploring the Methodology and Ethics of Ethnotheatre in Qualitative Dementia Research

Abstract

This article discusses the development of two short plays based on qualitative data from separate research studies related to dementia, both of which were performed in the UK in 2022. The first drama (Voices from the front line) is a relatively standard piece of verbatim theatre, based on interview data and written accounts from a research study about the experiences of the dementia workforce during the COVID-19 pandemic of 2020–22. The second (The Other Side of the Wall) is based on ethnographic data from a research study carried out with people with dementia living in long-term care, and it introduces elements of invention and absurdism. In both pieces, non-professional actors co-developed the performances, drawing on the spoken words of the original research participants. Using extracts and examples from the script development process, the article attempts to chart the developmental process for a novice ethnodramatist (although experienced dementia researcher) in meeting ethical, aesthetic and methodological challenges.

Background

This purpose of this article is to outline the process of creating two short dramas from data created during the course of qualitative dementia research. The first is drawn from research with members of the dementia workforce about their experiences during the COVID-19 pandemic of 2020–22, while the second is based on research carried out with women living with dementia in a long-term care environment. Using extracts and examples from the two scripts, I illustrate some of the ethical, aesthetic and methodological challenges that arose in the process and link them with key debates in the fields of arts-based research and research-informed theatre. In particular, I seek to explore tensions between the researcher-self’s desire to use arts-based approaches to reach new audiences and enable participants’ voices to be heard, and the artist-self’s quest for creative approaches and modes of representation. Whilst arts-based research is often justified on the basis that it helps us to be ‘true’ to participants’ experiences or concerns, it is also the case that art never corresponds, objectively, with the events and situations it aims to bring to an audience’s attention. These debates seem to take on particular point in the context of dementia research, where vicissitudes of memory, language, and orientation to time and space often require more creative approaches to be adopted.

In recent years there have been a number of cases of research data related to dementia being dramatised. For example Mitchell et al.’s (2006) play, I’m still here! is based on research data from people with dementia and family members. Kontos and Naglie (2006) used dramatised observational data from a care environment to create a drama that was played back to care staff with a view to improving care. Schneider (2017) used participant observation to create a drama related to the experiences of direct care staff, and Speechley et al. (2015) used ethnographic research data to create a script on home-based care. More recently, Gray (2022) have consulted people living with dementia and their families to develop a drama based on the ways their relationships have changed and evolved since diagnosis. Such approaches clearly have great potential for increasing the reach of qualitative dementia research and ensuring that the voices of people with dementia, their families and paid carers are heard more widely.

Denzin (2018b, p 1), in his work on ‘performed ethnography’, suggests that those carrying out such work should be ‘committed to the belief that, through performance, we can change reality by making social injustice visible’. As Snyder-Young (2010) points out, however, Denzin is also critical of the ‘aesthetic of objectivity’ which pervades much contemporary research-informed theatre, in which ‘performances intentionally rely heavily on monologue form, using extended sections of interview text’ and realism is pursued by ‘privileging text over image, naturalistic imitation of interview participants and direct address of text to audience’ (Snyder-Young, 2010, p. 885/889).

While the first of the two plays discussed here (Voices from the Front Line) is a fairly standard piece of verbatim theatre sharing many of the characteristics identified by Snyder-Young, the second (The Other Side of the Wall) has more of the subversive and even absurdist elements that Snyder-Young suggests can begin the work of ‘rupturing’ the aesthetic of objectivity. The form of The Other Side of the Wall has, for example, been influenced by the participants’ chosen forms of self-expression, including community singing and playground rhymes. As such The Other Side of the Wall is less easy to categorise as a piece of verbatim theatre (I am toying with the term ‘documentary musical’).

Research-Based Theatre: Notes on Terminology

Although dramatic performance is becoming an increasingly popular way of disseminating research findings, the associated terminology can be somewhat confusing and a variety of models have been used in what Conquergood (2013, pp. 56–57) describes as the ‘ethnographytheatrical paradigm’. Beck et al. (2011) make a useful distinction between a research continuum (terms derived from research methodology) and a performance continuum (terms derived from theatrical contexts). On the research continuum, the terms research-based theatre and research-informed theatre are widely used, although not informative about the nature of the research in question or the methodological commitments underpinning the approach. Saldaña (2011) uses the term ‘ethnodrama’ to refer more explicitly to scripts that are informed by an immersive, or ethnographic, approach to the creation of qualitative data. An ethnodrama dramatises data from interview transcripts, observational field notes, journal entries, personal accounts, and other forms of cultural artefact or historical document.

Ethnography is often referred to as ‘thick description’; that is, it involves the collection of very detailed, or rich, fieldwork observations over significant periods of time, during which relationship-building and entering into the lifeworld of the research participants are seen as major commitments. It follows, then, that ethnodramas and their performances (‘ethnotheatre’ in Saldana’s terms) should be socially committed works which provide audiences with detailed insights into the experiences of the characters and novel perspectives on their lives

On the performance continuum, to return to Beck et al. (2011), documentary theatre is part of a theatrical tradition concerned with representing real-world events, particularly those considered newsworthy, or in need of change. Verbatim theatre is a branch of documentary theatre in which actors reproduce the words originally spoken by those who experienced the events in question. As Owis et al. (2021, p. 324) suggest, ‘Both artists and researchers are drawn to verbatim theatre because it can create a space where voices, experiences, and testimonies from marginalized communities are heard’. And yet, of course, a dramatic performance will never be identical with the words or events it purports to reproduce. Performance inevitably changes things.

The two pieces of verbatim theatre discussed in this article are dramatised, non-fiction versions of qualitative research data which use the research participants’ own words, as spoken (or in some cases written) by them, to the researchers, during the course of each study. At the same time, however, they are theatre pieces, transformed during the initial script development, and again during the process of co-creation and performance with cast members.

Transcript and Script: ‘From Page to Stage’

Rich qualitative data are often already suggestive of dramatic performance because of the way transcripts of interviews or ethnographic fieldnotes appear on the page. Here, for example, is an extract from The Other Side of the Wall, in which Eileen (all names of participants and places have been changed) is talking about growing up in a children’s home in the 1940s:

Eileen: The matron there, she wasn’t a nurse or anything; just some woman with no proper training. She didn’t know how to look after us. When we had a shower, she used to invite her friend round; a man she knew, he used to come round and watch. It’s not right, is it? It’s not still like that now, is it, for little kiddies in homes? I hope it isn’t…

The move from ‘page to stage’, as Saldaña (2011) puts it, involved juxtaposing this data extract with others that show how, more than 60 years later, Eileen still interpreted present day events in the residential care setting in the light of this earlier traumatic experience. Snyder Young (2010) also points out that irony and juxtaposition are among strategies that can be used to rupture the ‘aesthetic of objectivity’. Near the end of the play, for example, Eileen asks

So how has it come about that I’m here again? …I was in the shower and someone saw me. That can’t be right can it? I think I’ve mixed it up…

The woman Eileen’s character is based on often seemed to compare the care environment where she was now living with the children’s home where she had grown up, and there is a narrative strand running through the whole piece which attempts – while using entirely her own words – to dramatise her longing to escape, both past and present. She had been a keen cyclist, and the actor playing her wheels a bike on stage at one point, with the music track ‘Blue skies’ by Jim Reeves (one of her favourite singers) as a background.

Performances such as this offer scope for discussion with a variety of audiences. The Other Side of the Wall might be used with care practitioners, for example, to discuss aspects of care home life that might trigger distressing memories, or how to reassure residents who have experienced historical trauma. It may also be used with members of the public to counter the view that dementia involves global memory loss, and to establish instead that people living with dementia often retain recall for long-past events, particularly those which carry a strong emotional charge. Frank (2017) in his work on ‘narrative healthcare’ writes of the importance of ‘amplifying’ the voices of those who are seldom-heard in research contexts or in public discourse. By this Frank means drawing on the lived experiences of those with a health condition, disability or marginalised status to inform professionals of what it is like, not only to have the condition, but also to be on the receiving end of health or social care interventions. Part of the work of amplification is connecting the stories of individuals together to achieve what Frank refers to as a ‘chorus of voices’. Stories become louder through re-telling, and when they are joined together a whisper can become a shout.

Ethical Approval

Ethical approval for the Coronavirus and Dementia in Care Homes study which led to Voices from the Frontline was granted by the University of xxxx Humanities, Social and Health Studies REC in July 2020 Ref E825). Participants gave written consent for all outputs from the study to be used for purposes of education or enhancing public awareness.

Ethical approval for the research study which led to The Other Side of the Wall was granted in September 2012 by the Social Care Research Ethics Committee for England (Ref 12-IEC08-0034). Three of the 10 participants were assessed to have capacity to give informed consent to taking part. Under the terms of the Mental Capacity Act for England and Wales (2005) personal consultees were asked for an opinion about their likely wishes of the remaining seven participants. All personal consultees were of the opinion that their relative would wish to take part, although several expressed doubts about whether the person in question would be able to do so. Participants or their personal consultees gave consent for all outputs from the study to be used for purposes of education or enhancing public awareness.

Fictitious names were used for all participants in the research. Characters in the play have been given the same fictitious names that were used when reporting the original research.

New ethical issues that arose during the dramatisation process outlined in this paper are discussed later in this article.

Voices From the Frontline

From July to November 2020, I led a qualitative research study related to the experiences of the UK social care workforce in long-term dementia care during the COVID-19 pandemic. Twenty social care practitioners took part, all of whom were working in, or with, long-term care environments for people living with dementia during the first wave of the COVID-19 pandemic (March to June 2020). At the time, the impact of coronavirus on long-term care environments was barely being reported by the media, and it is fair to say that throughout the pandemic care home staff received less public attention and valorisation than those working in acute hospital care. However, in the 2 years to January 2022, care home residents accounted for one in four of all those who died as a result of the pandemic (Office for National Statistics, 2022).

The implications of the pandemic for staff working in long-term dementia care were immense. They had received little if any preparation for dealing with anything on this scale, and had to attempt to implement guidance which changed frequently and was not designed with the needs of people living with dementia in mind (Rajan et al., 2020). In addition to illness and death resulting directly from coronavirus, measures such as social distancing, personal protective equipment (PPE), COVID testing and the cessation of family visits led to serious deterioration in many people living with dementia, who were often unable to remember why such measures were needed (Embregts et al., 2020). Residents who were ill from conditions other than coronavirus could not be admitted to hospital and as a result had to be nursed in accommodation intended for residential use. There were also acute staffing shortages resulting from staff contracting coronavirus, needing to self-isolate or leaving the sector.

Findings from Coronavirus and Dementia in Care Homes study were published in academic and practice journals (Capstick et al., 2022; Capstick & Barbosa, 2022; Capstick et al., 2023) and presented at conferences, but it seemed vital also to share our findings with other audiences. Ethnodramas, as Denzin (2018a, p 4) notes, ‘examine moments of crisis in the culture, liminal moments, suspended in time. They open up institutions and their practices to critical inspection’. The coronavirus pandemic was certainly one such moment.

When the University where I work held a community engagement festival, in March 2022 this seemed a good opportunity to showcase the findings, and harness the power of having the participants’ words spoken aloud in front of an audience. I began to turn the qualitative data into a piece of verbatim theatre in which six non-professional actors performed extracts from what the research participants had told us. A basic narrative structure was achieved by splitting the coronavirus pandemic into three main phases titled, respectively, ‘In the beginning’ (covering the start of the lockdown); ‘Tough times’ (the period between April and June 2020), and ‘The Legacy’ (the ongoing impact of the pandemic at the point the research ended).

In keeping with the core principles of ethnotheatre, Voices from the Frontline highlights the experiences of a relatively low-paid, predominantly female, culturally diverse workforce. It ends with a plea for government to apply principles of restorative justice (Mazzucato, 2020) in the aftermath of the pandemic. Despite my own undeniable focus at this point on the collective power of individual voices, it was interesting to note during rehearsals how relationships between the actors and the characters they were playing began to evolve. Initially the cast members performed their parts as unconnected monologues, but over time a more interactive process developed with the characters speaking their lines to each other and using gesture and touch to communicate and respond to feelings that were expressed. Music, audio and back-projected photography were all added as the rehearsals proceeded, often on the suggestion of the cast members. This seems to support the view that verbatim theatre and ethnodrama are a means for building support, solidarity and relational care (Saldaña, 2011; Gray, 2022) not only between cast members but also with the original participants.

The Other Side of the Wall

Carried out between 2013 and 2015, the research underpinning The Other Side of the Wall took place before the Coronavirus and Dementia in Care Homes study. However, the play was several years in development, and was not performed until after Voices from the Frontline. The original research aimed to find out whether a method called participatory video helped to improve social participation and wellbeing for people with dementia who were living in long-term care (Capstick & Ludwin, 2015). The study lasted 18 months and took an immersive approach in which the researchers spent a whole day each week at the housing-with-care facility in question, getting to know the 10 participants, finding out how they spent their time and what their main concerns and interests were, before embarking on the 6-week film-making process with each participant individually.

The 10 participants were aged between 76 and 98 at the beginning of the study. They could make films about any subject they chose, but in the event all chose to tell the story of their own earlier lives. We kept detailed field notes from each visit, and this resulted in a large amount of rich ethnographic data. The resulting films ranged from 3 to 11 minutes in length and it became apparent that each of the participants had their own core narrative, which was consistently returned to and elaborated on during the process. Three key themes were identified from the overall body of data: escape, historical trauma and triumph over adversity (Capstick & Ludwin, 2015).

It has been widely assumed that people living with moderate to severe dementia like those in our study are not able to take part in research which involves providing an account of their own experiences, so we were particularly keen to disseminate the findings from this study as widely as possible, particularly to those working in the dementia care field. The findings demonstrated that people with even quite advanced dementia could relate a story, express preferences, and gain enjoyment from making films. All but one of the 10 films resulting from the study includes the participant’s own voice-over as part of the narrative. In the remaining one, music the participant enjoyed was used as a soundtrack over her family photographs.

We found that social participation increased as a natural process during the study. Relationships between the participants developed and staff began to draw on the findings in their own interactions with those who took part. Five women who were participants in the research formed a particularly tightly knit group. They enjoyed watching the films they had made together, often sharing memories of the local area, and engaging spontaneously in community singing. The stories these women liked to recount about themselves were frequently set in what have been described as the ‘reminiscence bump’ years, which lie between the ages of about 5 and 30, with a peak in the teenage years (Thomsen & Berntsen, 2008).

Performing the Plays

Voices from the Frontline has been performed twice, in March and May 2022, at the University where the author works, which has an on-site theatre. Both of these performances took place as part of academic festivals. The first was internally organised and aimed to build and expand on links with the local community, who made up the majority of the audience, together with some care home staff who were not participants in the research. The second performance was part of a national series of academic events and the audience was predominantly academics.

The Other Side of the Wall has been performed once at a local venue external to the University, as part of a series of annual national events showcasing experimental performances under development. This event was coordinated by a theatre company, who provided publicity, support and performance space. The audience was mixed – predominantly members of the local community, and representatives of arts organisations.

Audiences to date have been in the region of 50 people for each performance. In order to make the plays more widely available to a greater variety of audiences, performances of both have also been filmed (Rao et al., 2021). These stories were often humorous, occasionally lewd, and were emphatically not about the experience of living with dementia.

One of the more interesting themes to emerge was the strategies the women had developed in order to resist the prevailing culture of the present day care home. Often they did this by drawing on resources that had served them well in the past (Capstick & Chatwin, 2016). Lil, for example, had learned to control a stammer in childhood by singing, and still often broke into song. It was a way, she sometimes said, of ‘beating this’, which we took to mean overcoming the challenges of her current living situation.

The idea of turning the five women’s stories into theatre did not emerge straight away. In 2017 I went to a participatory theatre workshop where one of the exercises was to develop a brief concept for an experimental theatre piece. The line which came to me fully formed was ‘One morning I arrived to find the five women out on the corridor, apparently plotting their escape’ – something which had happened more than once during the course of the research, From this starting point, I began to turn my ethnographic fieldnotes into the script of the short play The Other Side of the Wall, featuring the five women, whose fictional names were Lil, Nora, Eileen, Rita and Flo.

A version of this theatre piece was performed for the first time in November 2022 as part of a competition related to experimental theatre in progress. Due to time constraints (performances were limited to 20 minutes) the part of Flo was removed from this version of the script. The four female actors playing the remaining parts were not age-matched with the research participants, and wore costumes that reflected key themes in their story rather than the clothing that might (stereo)typically be expected for care home residents. Eileen wears a cycling jersey and shorts, for example, to represent her love of cycling, and Nora wears a bright red dress, mentioned in her account during the play of going dancing in post-war Berlin.

The interwoven stories of Lil, Nora, Eileen and Rita are, as they wished, not about dementia, but about formative and deeply ingrained experiences from their ‘reminiscence bump’ years. Sometimes these memories were deeply treasured, and sometimes they were traumatic, but the play attempts above all to represent the interpenetration of past and present and the disruptions of the space-time continuum which often seem to be a feature of the experience of dementia.

Niziolek (2021) explores the role of participatory theatre in preserving memories that have lived on in folk history without ever becoming recognised in official historical discourse. Often, as in Niziolek’s research, such censored testimonies relate to war, forced displacement and homelessness. This was also the case for the women who took part in the research on which The Other Side of the Wall is based; in addition to Eileen’s experience of the children’s home, Nora had witnessed the hunger marches of the 1930s, Lil had to go and live over a relative’s public house when her father died, and Rita had been evacuated during WWII at the age of eight. Because people living with dementia often lose the ability to censor memories in the same way that similar age-cohorts without dementia do, their accounts can often be counter-hegemonic (First author and Another 2013).

Extract from the script of The Other Side of the Wall

[Rita goes out, stepping carefully over the threshold and comes back, carrying a suitcase, which she hitches up as though it’s heavy.]

Rita: Me mother said, ‘I’m not sure they’ll want you; not two of you’ – but they did. A young married couple with no children…But then they had a baby of their own…That was when it all changed…

After a while, me dad came and brought us all back home again…They hadn’t stopped the bombing; we just couldn’t stand being split up. After that we just went down in the cellar whenever the alarm sounded…

[Sound of air raid siren: 6 seconds]

Discussion: Ethics, Aesthetics and Methodology

Cox et al. (2022) suggest that tensions can easily arise in research-informed theatre between, on the one hand, the tendency to use ‘dramatic licence’ to enhance impact, and on the other hand, the desire to stay true to participants’ stories. Counter to this, however, is the view put forward by opponents of the ‘aesthetic of objectivity’ that art is not about verisimilitude or reproduction of the ‘real’; there is, in any event, no single version of reality to be reproduced (Snyder-Young, 2010).

On the surface, verbatim theatre may seem not only a creative approach to research dissemination but also a transparent one, with little or no ‘translation’ involved in the process of changing data into drama. There are, however, many complexities in the ethnodramatic process; so much so that Goldstein et al. (2014) have developed a 30-item questionnaire in order to tease out some of the challenges. Some of the key issues arising from the writing, devising, rehearsal, performance and evaluation of Voices from the Frontline and The Other Side of the Wall relate to the selection, ordering and presentation of material from the original data set; the ethics of representation, and the iterative processes of script development and group interaction.

Selecting Material

In selecting extracts to include in both theatre pieces, I encountered many of the same problems that arise when selecting extracts for more standard reporting of research findings. It isn’t possible to include everything, so transcripts need to be edited. From carrying out the ethnographic research which underpinned The Other Side of the Wall, we felt – as a research team – that we had already identified the core narratives related to each of the participants’ individual lives and these were represented in the films we made with them as part of the original study. Yet in the course of that research the participants had evolved as a group and, in relation to the key overarching themes from the research – escape, historical trauma and triumph over adversity – there were also now shared narratives and collective experiences.

I wanted to write The Other Side of the Wall – in a nutshell – because I could not leave these stories alone. After the study had officially ended, things would come back to me at unexpected moments, and sometimes slot into place when least expected. When we arrived at the care facility in the morning, there was always a particular reality TV series playing in the communal lounge. Titled Homes under the Hammer, it has been a staple of morning TV viewing in other care environments I have visited over the years, a familiar part of the cultural ambience in residential care. I did not, for a long time connect the TV show – which is about buying, refurbishing and selling houses – with the sense of unrest among the women who took part in the research study which led them to make their regular morning escape plans. As Eileen told me, of herself and Rita, ‘We’re going to go and look at a little cottage together’. This line is reproduced at the beginning of The Other Side of the Wall, along with the theme tune from Homes under the Hammer, an ironic counterpoint to the women’s lived experience of confinement in a place that was not of their own choosing.

Kazubowsky-Houston (2018, p. 414) writes about the ‘trails’ that we follow in ethnographic fieldwork, noting that her own trails are non-linear and haphazard, with ‘off-shoots, twists and turns’ associated with a sense of awkwardness, which she represents as an itch needing to be scratched (‘I could not leave these stories alone’). The example given above is one of many where a sense of something unfinished led me from the emerging script back into the fieldwork again, showing that research-informed theatre is as much about (re)analysis of data as it is about dissemination.

In The Other Side of the Wall there is a line, already mentioned above, about how as a schoolgirl Lil had ‘beat’ her stammer by singing. It is strongly implied that Lil believes she can also use singing in the present day to ‘beat’ her dementia (or, as she says, ‘whatever it is’). There is a note of irony here in the way Lil mimics the more ‘refined’ accent of the teacher who instructed her on how to cure her stammer, also using her ‘Sunday-best’ name, rather than its vernacular form; ‘Lilian, if you sing you can get over this’.

Later, Lil comments that Winston Churchill was ‘always very clear [when he] spoke to us’ in his wartime broadcasts. We can infer from these juxtaposed references to the clarity and acceptability of speech, that as a young child at school Lil had been made to feel ashamed of the way she (and by extension her family) spoke; their own ‘broad Yorkshire’ in noticeable contrast with the BBC English of schoolteachers and politicians heard on the radio. By frequently breaking into song with her favourite, decidedly ‘low culture’ ballads Lil was perhaps not only trying to beat dementia, but also answering back to the establishment. The actor playing Lil spontaneously banged on the table when she said the word ‘beat’.

Kazubowsky-Houston (2010) points to the value of Bakhtin’s concepts of polyphony and dialogical truth in staging absurdist drama, and here we see how heteroglossia – a related concept of Bakhtin’s – comes into play. Heteroglossia, according to Bakhtin is the need to subordinate privileged language by using it for one’s own purposes. ‘The word does not’, Bakhtin says, ‘exist in a neutral and impersonal language… but rather it exists in other people’s mouths, in other people’s contexts, serving other people’s intentions; it is from there that one must take the word, and make it one’s own’ (Bakhtin, 1981, p. 294).

Ethics and Relational Responsibility

Requirements for formal ethical approval aside, Gray (2022) point to the need to locate research-based theatre within an aesthetics of caring. In the case of Voices from the Frontline there was frequent correspondence between the research team and the participants about dissemination materials, all of which were shared, including the versions of the script current at the time of each performance. Participants were still under great pressure due to post-pandemic staffing shortage and other related problems which may have limited active engagement, but there was clear and consistent agreement to go ahead. One research participant – a senior care assistant in a care home for people living with dementia – acted as co-director of Voices from the Frontline, attending all rehearsals and contributing actively to the script development.

At the end of the participatory video study we checked with all participants and their consultees that they were happy for any future outputs of the study to be used for purposes of education or to raise public awareness, and all agreed. We had ongoing contact with the four women whose stories are told in The Other Side of the Wall in the following ways. The films made with the participants were shown at a series of dissemination events; including a launch at the University in question, which two of the women were able to attend. We continued to visit the care environment where the study took place on a regular basis. When a researcher on the study had a baby the year after the project ended we took the baby to visit. Nora was admitted to hospital, discharged to a nursing home and then readmitted to hospital where she sadly died the following year, a cycle of deterioration all too common for those living with dementia in long-term care. We visited her several times at each of these venues, taking things to amuse her and helping her with meals, and we attended her funeral. Lil was also transferred to another care home where we visited her. Eileen and Rita continued to live in the same long-term care environment where the research was carried out, but in-person contact was eventually made impossible by the COVID-19 restrictions. We have, however, received consistent responses from personal consultees that although they do not wish to be actively involved, they still wish any outputs from the original study to be disseminated.

Getting Into Role

One of the first questions asked by several of the volunteer cast-members was, ‘Do I need to learn my lines?’ In verbatim theatre it seems preferable as a matter of principle to have the lines read accurately (sometime described as a ‘rehearsed reading’ or ‘read ethnography’), rather than memorised inaccurately or forgotten during the performance. For both plays, we ended up doing a hybrid performance in which some cast members were close-to-word-perfect and others used prompts which were sometimes concealed by a prop, such as a manager’s clipboard or even, in one case, a COVID-19 test kit. In The Other Side of the Wall, Lil’s prompt sheet was worked into the action in the form of a shopping list which she frequently consulted and referred to ‘in character’ as needing to refer to due to her memory problems.

Using self-identified objects of reference as props was a way of helping the actors to get into role. In The Other Side of the Wall, lost items regularly re-appear from Lil’s shopping list including a set of bingo balls which are then used to refer back to key elements of each character’s story. For example, Eileen awkwardly tries to cover her legs with her cycling shorts on hearing the bingo call ’77 Sunset Strip’; the word ‘strip’, which she anxiously repeats, linking back once more to her experience in the children’s home shower. Among other things, this is a reminder of how frequently even quite mundane aspects of care home life can trigger memories of past trauma.

In Voices from the Frontline an actor playing the role of a family support worker carries a box of disposable gloves and wears a flimsy plastic apron as a way of referencing the appalling lack of PPE experienced by care home staff during the pandemic.

As another character in the play notes

We had to ring round the local vets and dentists asking for gloves, because our order of gloves wasn’t guaranteed to come. So, we had to sort of beg, borrow and steal them from whoever we could get them from.

Because actors in verbatim theatre are there predominantly to reproduce the words spoken by others it seemed initially unimportant whether they were similar to the original research participant in any dimension of outward appearance. In the time available, particularly for Voices from the Frontline, it was a challenge to find actors to play all the parts, so everyone who volunteered was welcomed. The characters in Voices from the Frontline are described by generic job titles, including: Care Assistant 1, Manager, Family Support Worker, and some, although not all, of the characters were composites based on data from more than one participant. In this case it did not seem problematic if a part was taken by an actor of a different social class, culture or ethnicity, because a culturally diverse workforce was represented by a culturally diverse cast.

.In The Other Side of the Wall, however, each character was based on a specific person, whose appearance, mannerisms and accent were unique to them and here it becomes much harder to escape the fact that performance is a representation, rather than merely a faithful rendition of the words of the other. The actors who played the parts of Eileen, Rita, Nora and Lil were different from the original research participants in age, appearance, accent and in one case ethnicity (a black, non-British female actor played the part of Nora, a white woman who came from the North-East of England and had a noticeable ‘Geordie’ accent). Debates about colour-blind and colour-conscious casting continue to rage (Geraghty, 2021) but in this instance it would clearly have been unethical to exclude the volunteer in question. Whilst the actors found it helpful to listen to audio recordings made with the five women during the research study in order to gain a sense of their personalities and modes of self-representation, they did not attempt to reproduce regional accents.

Conclusion

As Speechley et al. (2015) note, ethnodrama is a valuable means for doing justice to research participants, and can catalyse both critical thinking and action. Dramatising data is also a way of making research findings accessible and engaging to non-academic audiences, of creating impact, and standing in solidarity with research participants from socially marginalised or excluded groups (Saldaña, 2011). Research-informed theatre can, however, perpetuate many of the same problems that characterise dementia research generally, particularly if dominated by an ‘aesthetic of objectivity’ (Denzin, 2018a).

Saldaña (2011) suggests that an ethnoscript undergoes continuous modification during the process of rehearsal. The creative process which unfolds as the actors begin to identify with the original participants and develop their roles is an important part of devising ethnodrama or performed ethnography. In the sense that this devising is, as mentioned above, also a re-analysis of the data, this is not a process that ends when the performance has taken place. I had not fully realised until writing this article, how much development had taken place in my own thinking between the performances of the two plays discussed above. Writing the script from the research data was, in the end, a far less creative exercise than the script development process during the rehearsals, which gave the eventual performances much of their life and vibrancy.

It was from this developmental group process, for example, that we added to the beginning of Voices from the Frontline an audio clip of (at the time) UK Prime Minister Boris Johnson’s radio announcement of the first lockdown. The three ‘pips’ announcing the 10 o’clock BBC evening news are the first thing the audience hears as the actors come onto the stage. It was also from this process that we introduced back-projected photographs of victims of the pandemic, Lil’s bottomless shopping bag, and some hilariously choreographed dance moves.

During the rehearsals for Voices from the Front Line we had not been successful in recruiting any male cast members and discussed what to do about this. We decided to place an empty chair on the stage to represent a (named) male member of care staff who had died of coronavirus, as a way of marking the deaths of almost a thousand UK social care workers who lost their own lives to coronavirus.

I do not intend to suggest that I think either of the approaches discussed above is ‘better’ than the other. Voices from the Frontline draws attention to the plight of a workforce whose voices are often elided in public discourse, and who experienced this social exclusion again in the extreme context of the COVID-19 pandemic. It is the more overtly ‘political’ of the two pieces, and has a raw urgency well-fitted to its subject matter. The Other Side of the Wall attempts to map the experiences of people living with dementia onto 20th century social history, and to show the implications of troubled pasts resurfacing in the present. It is a more playful, layered and complex piece, and draws on a wider range of elements to create its effects. Both pieces have taken me into a completely new research territory, and one which I only wish I had discovered sooner.