Quiet please, there's a lady on stage:

Resilience in older people living with dementia - A narrative analysis

Dominant discourses surrounding dementia tend to focus on narratives of loss and decline. Simultaneously, individuals living with dementia are vulnerable to being dispossessed of personal narratives supportive of identity and well-being. How older people with dementia story their experiences of resilience in this context has not previously been investigated. In response, this qualitative study utilised a narrative approach to understand lived experiences of resilience shared by eight older people living with dementia. Structural analyses indicated that participants' personal narratives regarding resilience in living with dementia contained distinct and common phases (The Diagnosis, Initial Tasks, 'The High Point', Reflecting on Limitations and Focusing on Today) as well as a variety of dynamic characters. Overarching themes within participants' narratives included sense of self/identity, being connected to others, sense of agency and having positive attitudes. Participants narrated richer, more active personal stories than those typically represented in dominant social discourses surrounding dementia. As such, their narratives depict lived experiences of resilience that unfolded over time in response to adversity and uncertainty and involved a dialectical process in relation to adjustment and well-being. The findings have important implications for the way resilience in living with dementia is framed and supported.

Learning From the Cultural Challenge of Dementia

Learning from the profound challenge of dementia is an urgent priority. Success will require a critical deconstruction of current cultural and linguistic representations of this condition, and a kindling of novel and courageous approaches to re-conceptualise dementia's meaning and experience. This symposium collects provocative ideas arising from various discourses, theoretical perspectives, and methodolgical approaches to explore new ways to understand dementia.

Stories about life narrated by people with Alzheimer's disease

AIM

To explore how people with Alzheimer's disease present their life story.

BACKGROUND

Life story work is a key concept in a person-centred care. An important aspect in understanding the subjective experience and supporting the identity of people with dementia is to listen to their life stories.

DESIGN

A narrative design with interviews was used.

METHOD

Nine participants with Alzheimer's disease were encouraged to tell about their lives from childhood, adult life, to present life and about their thoughts on the future. The interviews were conducted between September 2010-March 2011 in the participants' homes, with their spouses present and were analysed with a method for analysis of narratives.

FINDINGS

Contentment, Connectedness, Self-reliance and Personal growth were identified as core dimensions in the participants' life stories and shown like threads throughout life, from childhood, adult life to present life. All participants expressed an overall contentment with life, and connectedness was related to their relation with significant persons and to be included in the local community. Self-reliance was expressed as a strong confidence in the own ability and an overall curiosity throughout life as a sustained quest for personal growth.

CONCLUSIONS

It is important for healthcare professionals, who work with people with dementia, to understand that people with Alzheimer's disease can maintain an overall trusting and hopeful approach to life. It is also important to use life story work to enhance feelings of being connected to the world and thereby support their identity and sense of self.

Finding meaning in everyday life with dementia: A case study

This paper presents a case study exploring an older woman’s perspective on the quality of her life with dementia. The case study establishes the importance of coherence across the life course in understanding how she evaluates her changed situation in the present compared to the past. The metaphoric description of moving from ‘up there’ to ‘down here’ represents the perceived struggle to maintain a sense of worth despite a marginalised social position. Being able to define self and social identity in ways that preserve a sense of social status is important to find meaning in everyday life. Finding meaning involves looking backwards to sustain continuity with the past and looking forwards to maintain momentum and keep going. A narrative framework is valuable in showing that quality of life is a dimension of meaning associated with maintaining a sense of social worth.

Storytelling in dementia: Embodiment as a resource

In narrative research about persons with dementia, much research focuses on individual storytellers and their stories often stressing the discursive or textual aspects of stories. As persons with Alzheimer’s disease generally have difficulties in telling stories according to often implicit narrative norms, they may appear to be less competent and agentive than what is actually the case. In the article, I argue for a change of focus from the textual aspects of narratives and the story as a product, to a focus on performative aspects and the embodied aspects of storytelling. A focus on the storytelling activity implies a change from the individual storyteller to the interaction with other participants in the storytelling situation. Drawing on two particular cases of storytelling, I stress the collaborative and embodied aspects of storytelling and argue that embodiment is less an individual expressive phenomenon than it is an interactive resource.

A self narrative of life-long disability: A reflection on resilience and living with dementia

Illness such as dementia has particular linguistic and cognitive difficulties, not the least of which is its depiction in narrative, which may not be taken seriously. This paper builds upon a recently published manuscript by the authors, that describes a methodological approach utilising structural and thematic forms of narrative analysis to keep the person with dementia ‘centre stage’ in their own life story narrative. The aim of this paper is to utilise the same methodological approach and data to explore the narrative threads of a life-long disability, as experienced by a person called Janet who lives with dementia. Janet’s story locates disability not as personal impairment but within the social and cultural context of family and religious life. This contributes to a better understanding of resilience built up over time; in so doing, provides further insight into Janet’s enduring sense of self as she embraced a more challenging journey along the pathway of dementia.

Doll therapy: A therapeutic means to meet past attachment needs and diminish behaviours of concern in a person living with dementia – a case study approach

Method:

A single case study of a female participant, with moderately advanced Alzheimer’s disease, was the subject of this research. The case study used both qualitative and quantitative research design and methodology in data collection and analysis.

Results:

Demonstrated that doll therapy was a positive intervention for the person living with dementia who was the participant in this research. The findings indicate a reduction in behaviours of concern related to the need for attachment and a considerable decline in levels of anxiety and agitation. There was extensive ongoing improvement in social interaction and communication.

Conclusion:

This research supports doll therapy as a therapeutic intervention that may be utilized within the ongoing care of some persons with dementia to meet needs for attachment and to reduce behaviours of concern. Despite some controversy on this topic, doll therapy should be considered as a therapeutic approach to further dementia care in light of this positive outcome.