Organisational learning in dementia practice

Abstract

This thesis presents a sociomaterial perspective on how dementia care practices and the digital systems through which care is increasingly situated shape one another. Conducted across two residential aged care providers in Aotearoa New Zealand, the study suggests that training delivered to individuals cannot meet the complex realities of dementia care, and connects local practices. Learning in dementia care is situated, collective, ongoing, and materially mediated. Building on foundational dementia theories, the study extends that tradition through practice-based theory within a post-qualitative frame, positioning dementia learning as assemblages of human and non-human relations, and relationship-based care as enacted through co-constitutive relationships with the digital infrastructures around it. Following eight months of fieldwork across four sites, the findings suggest learning is often oriented around emergent challenges. Sociomaterial arrangements influence how problems show up, who and what gets enrolled, and how new ideas are mobilised. Within these arrangements, data performed in different ways, and what mattered was the material arrangement and how leadership supported sensemaking. The relational and psychosocial dimensions of care were not always visible within the digital arrangements in ways useful for organisational learning. Methodologically, the thesis contributes a post-qualitative, practice-based approach to researching learning in dementia care, one that follows practices and materials rather than measuring individual competence. Conceptually, it introduces digitally informed practice leadership, a capacity that supports emergent learning, working from within rather than above a network. It also introduces epistemic architecture, making recommendations on the sociomaterial arrangement of digital systems, working practices, and practice leadership through which organisational learning could emerge.