Changes in communication of Deaf people with dementia: A thematic interview with a close family member

Formal caregivers' perceptions of everyday interaction with Deaf people with dementia

OBJECTIVES

Deteriorating interactive ability of people with dementia challenges formal caregivers. In Finland, Deaf people with advanced dementia may live in a nursing home designed for their care where the staff use Finnish Sign Language (FiSL). This study describes the perceptions of formal caregivers, focusing on the challenges, how they solve the challenges, and what support they need to improve interaction with Deaf residents.

METHODS

Semi-structured interviews with 13 formal caregivers who work with Deaf people with dementia were conducted and analyzed using qualitative content analysis. A purposive sampling was used.

RESULTS

Three key themes were challenges in interaction, strategies in supporting interaction, and support for coping. Caregivers perceived challenges in interaction caused by linguistic changes, deteriorating physical mobility and memory, and Deaf residents' behavioral challenges. Caregivers supported Deaf residents by learning to know them and using personal and linguistic strategies. Support for coping comprised supporting family members and other caregivers.

CONCLUSIONS

Efficient skills in sign language (SL) and knowledge of dementia are essential in interacting with Deaf residents and to build interpersonal relationships for care.

CLINICAL IMPLICATIONS

Supporting Deaf residents requires learning the way they interact which can be achieved over time.

How do we know what we don't know? Exploring Deaf people's experiences of supporting their Deaf family member living with dementia

Deaf sign language users living with dementia and their carers, some of whom are Deaf, routinely face everyday barriers in accessing information, support (both formal and informal) and services. The familial care situation is further complicated given that most Deaf people will choose a life partner who is Deaf and most Deaf couples will have hearing children. This study focussed specifically on the everyday experiences of Deaf carers and the impact of caring for a loved one with dementia. Drawing on data from a wider consultation about dementia care, three Deaf carers were directly interviewed in British Sign Language by a Deaf researcher about their everyday experiences of care, support, and services. Thematic analysis focussed on: access is more than the provision of interpreters; effective care for the carers; and unknowing risk taking. Findings demonstrate the multifaceted effects of barriers to knowledge and information when the care partner is also Deaf, the urgent need for effective support for Deaf carers and unrecognised safeguarding concerns that are a result of lack of access to forms of basic knowledge about living with someone with dementia and potential coping strategies. Nonetheless, the participants demonstrated novel solutions and resilience in the face of these multiple challenges. Implications are drawn for future targeted services to supported Deaf carers of people affected by dementia.

Weaving social reality around the grandparent/great-grandparent with dementia to maintain relational presence: A verbal and non-verbal dementia interactions model

We proposed a dementia interactions model based on analyses of five focus groups with grandchildren of grandparents with dementia. Interactions with their grandparent with dementia motivate grandchildren to maintain connection with a grandparent who is relationally present. To do so, they weave a social reality around the grandparent. To help the grandparent remain connected, grandchildren engage in scripts and routines and employ three intertwined psychological processes: perspective taking, vigilance, and knowledge about the grandparent's preferences, personality, state of mind, and context. Grandchildren use four relationship anchors to help the grandparent remain relationally present: family members, meaningful sensory objects and activities, physical space/context, and themselves. Implications for improving social interactions with close others with dementia are discussed.