Abstract
ABSTRACT Meaningful activities in dementia care can promote the co-construction of narrative identity in caregiving relationships, helping to preserve the sense of self in people with dementia. Purpose: Informed by symbolic interactionism and Deweyan transactionalism, the aim of this study was to develop a transactional model of how narrative identity and relationships are promoted through the use of a new technological solution, SENSE-GARDEN, that uses digital technologies and multisensory stimuli to facilitate individualized, meaningful activities. Method: We conducted a qualitative interview study to explore the experiences of people with moderate to advanced dementia and their caregivers in Norway and Portugal. After using SENSE-GARDEN for 12–16 weeks, 20 participants (7 persons with dementia and 13 caregivers) were interviewed. The interviews were analysed using reflexive thematic analysis. Results: Three themes were generated: openness, learning, and connection. Findings suggest that SENSE-GARDEN can stimulate emotional experiences, preserve narrative identity, and foster interpersonal relationships. These findings are illustrated through a transactional model. Conclusion: This study highlights the complex multitude of factors affecting person-environment interactions in which narrative identity and relationships are constructed. To better understand these factors, future work should adopt a holistic approach to studying new methods of creating meaningful activities in dementia care.
Highlights
Common forms of dementia, such as Alzheimer’s Disease, primarily affect memory, language, and beha viour
The second theme, “learning”, reflects the way in which caregivers felt that their knowledge of the person with dementia had improved through the use of SENSE-GARDEN and wanted to apply similar techniques to optimize the care environment in gen eral
The findings suggest that an individualized technological intervention such as SENSE-GARDEN has a promising impact on facilitating meaningful activities in dementia care, with regard to stimulating emotional experiences, preserving a sense of narrative identity, and improving interper sonal relationships—both on a familial and profes sional level
Summary
Common forms of dementia, such as Alzheimer’s Disease, primarily affect memory, language, and beha viour. These impacts can lead to difficulties in com municating and socializing with others, which means people living with dementia often experience stigma tization as a result of behaving in a way that deviates from social norms (Mukadam & Livingston, 2012). Discourse on demen tia is shifting away from a reductionist biomedical perspective, that portrays the disease primarily in terms of loss, towards a more holistic perspective that considers the person with dementia not as a “sufferer” but as an individual who can be sup ported to cope and potentially live well with the condition (Beard et al, 2009; Kitwood, 1997; Swaffer, 2014). The way in which people with dementia experience social interactions in care impacts their sense of self and their state of psychological well-being (Clare et al, 2008; Lee, Boltz, Lee & Algase, 2017)
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