Skilled carers' ways of understanding people with Alzheimer's disease.

Five carers in a group dwelling for people with dementia were observed and interviewed concerning their interactions with five residents with Alzheimer's disease. The tape-recorded and transcribed data were analyzed as text. The carers' personal ways of achieving understanding were defined as: affect attunement; affect attunement and completing a puzzle through explanatory connections of observation, knowledge about the residents' life histories and behavior at the group dwelling; and affect attunement within the context of caring as an intrinsic end. Personal experience from childhood and motherhood, knowledge about the residents' life history and the nature of the disease, and personal talent seemed to form these carers' ways of achieving understanding.