Fluctuating interpretations: Striving to maintain a sense of self in early dementia

Coexisting with anomie: Experiences of persons living with early-stage dementia: A grounded theory study

Individuals in the early stages of dementia often endure elevated levels of stress and anxiety, which can hinder their ability to adapt to the progression of dementia. To mitigate the negative impacts of dementia more effectively, it is necessary to explore the trajectory of the adaptation process of persons living with dementia. This study aimed to construct a theoretical framework for the adaptation process of individuals in the early stages of dementia. Participants were dyads of persons diagnosed with mild dementia or mild cognitive impairment (≥ 60 years of age) and their primary family caregivers. This longitudinal study used a grounded theory approach to explore the adaptation trajectory changes in persons with mild dementia over a 3-year period. Data were collected from dyads with face-to-face interviews. Analysis of the interview data revealed the core category was 'Coexisting with anomie: Progressive disappointment and striving', which was comprised of three categories: awareness of alienation, unsettled feelings, and restorative avoidance coping. Categories changed depending on levels of cognition and constituted progressive and cyclical dynamic processes. Four contextual factors positively or negatively influenced adaptation: level of insight about dementia, personal traits, caregiving style of the caregiver, and level of social interactions. These findings provide a new perspective about the mental health of persons in early-stage dementia. Understanding coexisting with anomie and related influencing factors could facilitate the development of support interventions by mental health nursing staff, which could improve emotional safety, promote psychological well-being, and increase quality of life for persons living with dementia.

Moving between doing and being-Meanings of person-centredness as narrated by nursing home managers. A phenomenological hermeneutical study

AIM

This study aimed to illuminate meanings of person-centredness as narrated by nursing home managers in nursing homes rated as highly person-centred.

DESIGN

A phenomenological hermeneutical approach was used.

METHODS

Twelve nursing home managers in 11 highly person-centred nursing homes in 7 municipalities in Sweden were included in this interview study. The findings were interpreted, reflected and discussed through the lens of Ricoeur.

RESULTS

Meanings of person-centredness could be understand as moving between doing and being through knowing, sensing, sharing and giving for person-centredness. These aspects contributed via knowledge, understanding, interaction and action that involved doing for and being with older persons through these caring dimensions. By moving between doing for, being with and being part of the overall nursing home narrative, knowing, sensing, sharing and giving could support the persons' identity in different ways. This may also contribute to sense-making, preserving dignity and promoting self-esteem when aiming to provide a good life for older persons in nursing homes, within an ever-present ethical frame.

NO PATIENT OR PUBLIC CONTRIBUTION

This study illuminated meanings of person-centredness as narrated by nursing home managers. No patient of public contribution was investigated.