The development of a dementia process within the family context: The case of Alice

Qualitative analysis was used to analyse a diary written over a period of t wo years by the sister of a dementia patient. The analysis is directed at t he question of how a patient and a social network respond to each other dur ing the dementia process. The diary highlights features in the development of the dementia process wh ich receive scant attention in empirical studies: changes in the interactio n process between patient and social network; a patient's residual capaciti es; a caregiver's perceived rewards of caregiving. We designated three phas es in the interaction process: the phase of recognition, the stable phase a nd the phase of destabilization. This diary illustrates how a stable phase in the interaction between patient and primary caregiver can be established . The caregiver derived rewards by noticing and using the patient's residua l capacities and by a feeling of being useful. In this case caregiving is n ot unidirectional. The quality of future support programmes may be enhanced by combining programmes aimed Lo influence patient's behaviour and to supp ort caregivers. (C) 1998 Elsevier Science Ltd. All rights reserved.