Abstract
Dementia diagnosis is complex and hot topic. It is a public health priority, which highlights the need for early diagnosis. This is regarded as “the policy of diagnosis” and is explored and unfolded as a matter of fact in this article. The article draws on a practice theory as a research approach and shows how different modes of diagnosis frame certain care practices. Three different orderings are elaborated: the knowing, the governing, and the relational orderings. Two of these individualize and isolate the care for people with dementia, while the third ordering enacts diagnosis by connecting people, things, and places. An ethnographic approach is used drawing on interviews with 15 families of people with dementia and professional careers. The article contributes to a wider understanding of how “the policy of diagnosis” shapes some possible way to live with the disease and at the same time closes others.
Highlights
A dementia diagnosis is complex, and is it a hot topic for people living with dementia and a public health priority (World Health Organization [WHO], 2012)
Policy documents subscribe to strategic moves and actions to develop an increasingly inclusive society for people with dementia and to highlight the need for an early diagnosis (Helse-omsorgsdepartementet, 2015)
This study was developed as a response to the observation that early diagnosis in policy documents is presupposed for the benefit of people living with dementia and of society
Summary
A dementia diagnosis is complex, and is it a hot topic for people living with dementia and a public health priority (World Health Organization [WHO], 2012). Mol (2002) illustrated how the body becomes multiple because the body was enacted different in different medical diagnostic practices, and Moreira (2010) demonstrated how dementia is understood, managed, and experienced differently within the memory clinic These latter contributions approach diagnosis as a fragile and performative object that changes in relation to the community it is acted upon. This study is informed by practice theories that became prominent toward the end of the 20th century (Nicolini, 2012) In these theories, practice is understood as situated and as enacted, focusing on how humans and objects are actively engaged in knowing and being known through the community to which they belong (Mol, 2002). Knowledge and representations of knowledge are constituted in and through practice, which makes practices performative because they allow certain understandings to emerge, whereas others are overshadowed (Moser, 2011)
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