School Health Sciences, University of East Anglia, Norwich, UK.
Department of Clinical, Educational and Health Psychology, University College London, London, UK.
Gerontologist. 2023 Sep 2;63(8):1320-1329. doi: 10.1093/geront/gnad022.
A dementia diagnosis can affect social interactions. This study aims to understand how people living with dementia act as social beings within everyday interactions in their local communities.
Focused ethnography informed by Spradley's approach to data collection and analysis. Observations in community spaces.
Twenty-nine observations were undertaken in everyday social settings with 11 people with dementia who were part of a longitudinal interview study. Data consisted of 40 hr of observation, and researcher field notes. The overarching theme "the dynamic nature of being a person" encapsulates participants' exhibited experiences in negotiating to attain and sustain an acknowledged place in their communities. Two subthemes characterized contexts and actions: (1) "Being me-not dementia": Participants constructed narratives to assert their ontological presence in social settings. They and others used strategies to mediate cognitive changes evidencing dementia. (2) "Resisting or acquiescing to 'being absent in place'": Participants were often able to resist being absent to the gaze from others, but some social structures and behaviors led to a person being "in place," yet not having their presence confirmed.
People living with dementia can actively draw on personal attributes, familiar rituals, objects, and social roles to continue to present themselves as social beings. Identifying how postdiagnosis people may self-manage cognitive changes to retain their presence as a person can help health and social care practitioners and families collaborate with the person living with dementia enabling them to have a continued social presence.
痴呆症的诊断可能会影响社交互动。本研究旨在了解患有痴呆症的人在当地社区的日常互动中如何作为社会个体行事。
采用斯普拉德利(Spradley)的方法进行重点民族志研究,收集和分析数据。在社区空间进行观察。
在与 11 名患有痴呆症的 longitudinal interview study 参与者的日常社交环境中进行了 29 次观察。数据包括 40 小时的观察和研究人员的现场记录。“作为一个人的动态本质”这一总体主题概括了参与者在协商中获得和维持在社区中被认可的地位时表现出的经验。两个子主题描述了背景和行动:(1)“是我——不是痴呆症”:参与者构建叙述来断言他们在社交环境中的本体存在。他们和其他人使用策略来调解认知变化,证明患有痴呆症。(2)“抗拒或默认‘不在场’”:参与者通常能够抗拒他人的目光,但一些社会结构和行为导致一个人“在场”,但他们的存在没有得到确认。
患有痴呆症的人可以积极利用个人属性、熟悉的仪式、物品和社会角色来继续将自己呈现为社会个体。确定诊断后,人们如何自我管理认知变化以保持其作为人的存在,可以帮助医疗保健和社会护理从业者以及家庭成员与患有痴呆症的人合作,使他们能够继续保持社交存在。