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Awareness context theory and the dynamics of dementia

Improving understanding using emergent fit

Linköping University, Sweden, ingrid.hellstrom{at}ituf.liu.se

Mike Nolan

University of Sheffield, UK, m.r.nolan{at}sheffield.ac.uk

Ulla Lundh

Linköping University, Sweden, ulla.lundh{at}ivv.liu.se

This article presents the initial results of an ongoing constructivist grounded theory study (Charmaz, 2000) exploring the impact of dementia on the everyday life and relationships of older spousal couples. Using a process of ‘emergent fit’ (Glaser, 1978) and drawing upon data from 74 interviews with 20 spouse couples living with dementia, it considers the relevance of ‘awareness context theory’ (Glaser & Strauss, 1965) and the ‘dynamics of dementia’ (Keady, 1999) to an understanding of interpersonal relationships among spouses. The combination of existing literature and new data provide further insights into how couples actively work to ‘construct’ awareness in a way that, for the majority, maintains both a sense of ‘self’ for the person with dementia (PWD) and the integrity of the relationship between couples. It is suggested that a ‘mutual acknowledgement’ of the diagnosis and a subsequent focus on maintaining a meaningful life in the present combine to create a ‘nurturative relational context’ in which living with dementia unfolds.

Key Words: awareness contexts • dynamics of dementia • grounded theory • spousal relationships

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