Facing dementia as a we : Investigating couples’ challenges and communicative strategies for managing dementia

Sammanfattning: We live longer than ever before, which means that we also live longer with disorders such as those connected with dementia. Most people diagnosed with dementia live in ordinary housing for a long time, relying on their social network for support, mainly involving spouses or adult children. There is limited research on how families and couples manage daily life with dementia, and social workers may only have knowledge and skills at a general level about older people with the condition.The aim of this thesis is to investigate how couples manage dementia-related challenges, as well as whether and how these challenges and ways of managing relate to aspects of couples’ we-ness. This aim has been specified in terms of research questions which involve the couples’ communicative management of dementia-related challenges, and how they approach and talk about sensitive topics connected with dementia. An additional question involves how the couples relate to and use their we-ness in managing dementia. Multimodal conversation analytic theory and methodology has been adopted to study sequences from 15 video-recorded joint interviews involving couples where one of the partners had a diagnosis of dementia.The articles demonstrate how the spouses managed dementia jointly, and how they used their common ground as a couple as an important resource for telling stories and remembering. When the spouses without dementia approached sensitive topics related to dementia, they made use of strategies such as mitigating talk, or touching the partner with dementia as they spoke. The spouses without dementia approached the issue of the future carefully, whereas the spouses with dementia were more direct in the way they talked about the future. A final finding involves the spouses without dementia using strategies such as giving clues or prompting to help their partner with dementia remember. However, this was seldom successful, and may even have had face-threatening effects. Taken together, the different aspects of this thesis emphasise the challenges faced by the couples and the communicative strategies they used, as well as the abilities and agency which surfaced during a micro-level analysis of their interaction. The results are further discussed in the light of implications for social work education, practice and theory, largely highlighting the importance of adopting a couplesensitive approach in which relational and interactional aspects are emphasised.

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