How couples with dementia experience healthcare, lifestyle, and everyday decision-making
| Autor: | Josephine M. Clayton, Michelle Hogan, Kirsten Auret, Craig Sinclair, Susan Kurrle, Meera Agar, Romola S. Bucks, Kate Gersbach |
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| Rok vydání: | 2018 |
| Předmět: |
Family therapy
Male Decision Making Psychological intervention Context (language use) Developmental psychology Interviews as Topic 03 medical and health sciences 0302 clinical medicine Health care Adaptation Psychological medicine Dementia Humans Interpersonal Relations 030212 general & internal medicine Everyday life Life Style Qualitative Research Aged Aged 80 and over Family Characteristics 030214 geriatrics Interpretative phenomenological analysis business.industry Australia medicine.disease Psychiatry and Mental health Clinical Psychology Caregivers Spouse Geriatrics Female Geriatrics and Gerontology Psychology business Gerontology Delivery of Health Care |
| Popis: | Objectives:Recent research has demonstrated the challenges to self-identity associated with dementia, and the importance of maintaining involvement in decision-making while adjusting to changes in role and lifestyle. This study aimed to understand the lived experiences of couples living with dementia, with respect to healthcare, lifestyle, and “everyday” decision-making.Design:Semi-structured qualitative interviews using Interpretative Phenomenological Analysis as the methodological approach.Setting:Community and residential care settings in Australia.Participants:Twenty eight participants who self-identified as being in a close and continuing relationship (N = 13 people with dementia, N = 15 spouse partners). Nine couples were interviewed together.Results:Participants described a spectrum of decision-making approaches (independent, joint, supported, and substituted), with these approaches often intertwining in everyday life. Couples’ approaches to decision-making were influenced by “decisional,” “individual,” “relational,” and “external” factors. The overarching themes of “knowing and being known,” “maintaining and re-defining couplehood” and “relational decision-making,” are used to interpret these experiences. The spousal relationship provided an important context for decision-making, with couples expressing a history and ongoing preference for joint decision-making, as an integral part of their experience of couplehood. However, the progressive impairments associated with dementia presented challenges to maintaining joint decision-making and mutuality in the relationship.Conclusions:This study illustrates relational perspectives on decision-making in couples with dementia. Post-diagnostic support, education resources, proactive dyadic interventions, and assistance for spouse care partners may facilitate more productive attempts at joint decision-making by couples living with dementia. |
| Databáze: | OpenAIRE |
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