liu.seSearch for publications in DiVA
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Sustaining 'couplehood': Spouses' strategies for living positively with dementia
Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Health Sciences.
University of Sheffield, UK.
Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Health Sciences.
2007 (English)In: Dementia, ISSN 1471-3012, E-ISSN 1741-2684, Vol. 6, no 3, 383-409 p.Article in journal (Refereed) Published
Abstract [en]

This article explores the strategies that spouses use in order to live positively when one partner has dementia. Data were collected from 152 interviews with 20 couples conducted over a period of five years. Using a constructivist grounded theory methodology, data were analysed to capture the main processes involved and charted how these changed over time. Three main phases were identified termed: `sustaining couplehood'; `maintaining involvement'; and `moving on', that operated in an iterative rather than linear fashion. The data highlight the very active role played by both partners, especially in the early stages of the disease, as they strive to maintain the quality and closeness of their relationship by creating what we term a `nurturative relational context'. The diverse strategies that the couples adopt are presented, and the gradual way in which the person with dementia `hands over' or `let's go' of responsibility to their partner is described. The article provides several new insights into the nature of spousal relationships in dementia and the ways in which they seek to maximize their quality of life, and, wherever possible, sustain couplehood.

Place, publisher, year, edition, pages
2007. Vol. 6, no 3, 383-409 p.
Keyword [en]
couplehood, dementia, grounded theory, spousal relationships
National Category
Nursing
Identifiers
URN: urn:nbn:se:liu:diva-13347DOI: 10.1177/1471301207081571OAI: oai:DiVA.org:liu-13347DiVA: diva2:20400
Available from: 2005-09-02 Created: 2005-09-02 Last updated: 2017-12-13
In thesis
1. Parrelationer i förändring vid demenssjukdom: en studie med konstruktivistisk grundad teori
Open this publication in new window or tab >>Parrelationer i förändring vid demenssjukdom: en studie med konstruktivistisk grundad teori
2005 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis is to gain a better understanding how people with dementia and their spouses experience dementia over time, especially the impact it has on their inter-personal relationships and patterns of everyday life. Data were collected using separate semi-structured interviews with 20 persons with dementia and their spouses of 6 monthly intervals over an 18-months period (132 interviews in total), and analysed using constructivist grounded theory.

Analysis suggested that whilst spouses are aware of and acknowledge the diagnosis of dementia, they do not routinely talk about it but rather the focus of their combined efforts is on making life as meaningful as possible. To do this couples, rather than individuals, actively ‘work together’ to create a ‘nurturative relational context’ in order to sustain the quality of their relationship, and maintain the self-image and sense of agency of the person with dementia.

In order to create a ‘nurturative relational context’ couples continued to ‘do things together’ for as long as possible by understanding complementary roles underpinned by a mutual appreciation of each others contribution in a way that builds upon the remaining strengths of the person with dementia. Their focus is therefore on ‘couplehood’ as much as ‘personhood’.

An analysis of the complete data set identified three temporally sequenced but overlapping phases of the experience of couplehood termed ‘sustaining couplehood’, ‘maintaining involvement’, and ‘becoming alone’. ‘Sustaining couplehood’ had the primary goal of ensuring that the spuses’ ‘work’. This involved four interrelated sets of activities: talking things through, in order to ensure good communication and acknowledge and value differences; being affectionate and appreciative by demonstrating continued attractiveness to their spouse; making the most of things by enjoying everyday pleasures, looking for positive interpretations of events and focussing on the present (living for today); and finally, keeping the peace by being aware of potential points of friction and not responding to difficult behaviour. Both the person with dementia and the non-affected spouse were active strategies in the above process.

In addition both spouses worked to ‘maintain the involvement’ of the person with dementia by ensuring that they had an active role to play. However, despite their efforts, eventually the non-affected spouse took on an increasing role and this occurred in a number of ways, either by the person with dementia consciously ‘handing over’ responsibility or more passively ‘letting go’, or by the non-affected spouse ‘taking over’.

‘Sustaining couplehood’ and ‘maintaining involvement’ often occurred simultaneously but the relative emphasis changed over time as ‘sustaining couplehood’ became more difficult and increasing effort was expended in ‘maintaining involvement’. As this occurred the data suggested that the non-affected spouse became increasingly ‘alone’ as the dementia progressed. This process has yet to be fully explored, however, it is clear that for spouses a complete understanding of the dementia experience is not possible without consideration of ‘couplehood’.

Place, publisher, year, edition, pages
Institutionen för vård och välfärd, 2005
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 895
Keyword
dementia, spousal relationship, couplehood, grounded theory
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-3518 (URN)91-85299-04-9 (ISBN)
Public defence
2005-05-20, , Kåkenhus, Campus Norrköping, Norrköping, 09:00 (English)
Opponent
Supervisors
Available from: 2005-09-02 Created: 2005-09-02 Last updated: 2009-02-25

Open Access in DiVA

No full text

Other links

Publisher's full textLink to Ph.D. Thesis

Authority records BETA

Hellström, IngridLundh, Ulla

Search in DiVA

By author/editor
Hellström, IngridLundh, Ulla
By organisation
Department of Social and Welfare StudiesFaculty of Health Sciences
In the same journal
Dementia
Nursing

Search outside of DiVA

GoogleGoogle Scholar

doi
urn-nbn

Altmetric score

doi
urn-nbn
Total: 344 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf