The Artist Formerly Known as…”Respite”: A personal account of getting stuck, and unstuck during a PhD, by Dr Emma O’Shea

I began my PhD at the School of Nursing, Psychotherapy and Community Health, in Dublin City University in 2015. Prior to that, I had worked as a research assistant in the Centre for Gerontology and Rehabilitation (CGR) in University College Cork since 2013, across a number of dementia-focused research projects and a national audit of acute dementia care. My experience in the CGR fostered a deep appreciation for both dementia and research, and during this two-year period, I went from considering a career in research, to making that my number one goal.

I view my PhD as a time of intense learning and growth. Certainly, there was frustration, confusion and sometimes protracted bouts of imposter syndrome, however these are not the experiences or memories I focus on in retrospect. These moments have become critical junctures that I had to find ways to work through, with considerable support from the SPHeRE network, my peers and my supervisors. In particular, interdisciplinary peer-to-peer discussion both in- and outside of class, exposed me to a surprising volume of theories and perspectives that I had previously been unaware of, or naïve to.

In my third year, after a productive period of data collection and initial analysis, I started floundering, wondering what some of the preliminary findings meant for my research question. I came to my supervisor, discouraged: “I’m more confused now than ever”. “Oh, good!” she exclaimed…

My PhD focused on developing respite services for people with dementia and carers. A qualitative systematic review revealed that key problems with residential respite included under-provision, inequitable access, lack of specialist education and training, under-staffing, lack of ‘meaningful engagement’, and poor outcomes post-discharge.

Through my primary data collection however, it became clear that some stakeholders were unconvinced by the notion that measures could be taken to ‘improve’ or ‘develop’ residential respite services for dementia. After going around in dizzying circles, followed by critical discussions with my supervisors, I realized I needed to adopt a curiosity (not an aversion) about this in my ongoing qualitative work.

So I did, and I found that the ushering in of Kitwood’s ‘person-centred dementia care’ paradigm, seems to have intensified a certain tension for many residential providers, for whom ‘respite’ had historically been rooted in a standard custodial model of care. People with dementia wanted care at home/in the community, which supported their personhood and need for belonging and reciprocal engagement. The main concerns for family carers were safety, and above all, that respite service use would be mutually beneficial for the care dyad.

In sum, my research confirmed previous findings, but also added rich layers of contextual information for deciphering. So began a deeper dive, a period of concentrated reflexivity and critical thought regarding i) the range of assumptions that underpin the provision, structure and care approach of traditional residential respite services, as well as ii) the very concept of ‘respite’ – from health systems, social gerontology and historical perspectives.

My supervisor and I, who weathered this and many other hurdles together, eventually named this particular ‘stuckness’ juncture. We called it the ‘Artist formerly known as…Respite’ period; an in-joke to mark this shift in perspective. But it did more than that. It gave me a sense of clarity and ownership, that had previously seemed a little beyond my confidence grade. My supervisor always framed any ‘stuckness’ I was experiencing as an unexpected opportunity to learn, and/or to pivot, as appropriate. I began realising, the ‘self-doubt’-based internal dialogue was largely fruitless and indulgent. I also realized the critical skills and cognitive acrobatics needed for such a dialogue to take hold could be re-harnessed, refined, and fed into problem-solving in the research process – rather than ego. Shoutout to my supervisor Prof Kate Irving for her superb modelling of research supervision and leadership!

I graduated (virtually) from DCU in June of 2020. Currently, I am a post-doctoral researcher in the CGR, managing the HRB-funded ‘Mapping Parkinson’s’ project. The SPHeRE programme prepared me more than I could have imagined, both personally and professionally, to undertake this demanding role, imbuing me with robust research and project management skills, and markedly greater self-efficacy and confidence.

Finally, I want to sincerely thank the SPHeRE programme for giving me the opportunity, resources and unwavering support necessary to fulfil my goal of building a fulfilling career in gerontological health research.