Responses to dementia : a qualitative exploration of self and others

Patterson, Kirsty Michelle

Clinical psychology
June 2015

Thesis or dissertation


Rights
© 2015 Kirsty Michelle Patterson. All rights reserved. No part of this publication may be reproduced without the written permission of the copyright holder.
Abstract

This portfolio thesis contains three parts: a systematic literature review, an empirical paper, and a set of appendices.

Person-centred and social constructionist approaches to dementia have proposed that the experience of living with the condition is influenced by the responses of others towards the individual, and the personal response of the individual to dementia.

Part one is a systematic literature review that therefore critically evaluates and synthesizes the qualitative literature pertaining to the way in which people with dementia experience the responses of others towards them. The review aims to further our understanding of how people with dementia perceive the responses of others and the impact that these have upon them. This is deemed to be an important area to address given that theoretical understandings of dementia assign a critical role to the responses of others in influencing an individual’s experience of dementia, and yet this aspect of subjective experience has been overlooked in previous reviews. Following a systematic search of the literature, 23 studies were suitable for review based on the inclusion criteria. A critical interpretative synthesis was conducted, leading to the development of four main themes to capture findings across the reviewed literature: ‘Social outcasting – being treated as an other’; ‘Social relegation – being treated as lesser’; ‘The impact of others’ responses’; and ‘Strategies to manage the responses of others’. These themes and the subthemes within them are compared and contrasted to the themes developed by researchers in their original findings, paying attention to the discourses that may have been influencing their interpretation. The strength of the evidence is evaluated, and implications for clinical research and practice discussed.

Part two is an empirical paper investigating people’s personal responses to dementia, focusing upon subjective experiences of growth in older people living with dementia. A qualitative methodology was utilised, using semi-structured interviews to investigate participants’ experiences of positive and/or meaningful changes since living with dementia. Interviews were conducted with nine older people diagnosed with dementia living in the community. Interpretative phenomenological analysis was used to explore participants’ subjective experiences and how they had made sense of these. From this, a theme of ‘Moving Forward’ was developed, containing five subthemes. A second theme of ‘Living in the Now’ was also developed, containing two further subthemes. The findings are discussed with consideration of the discourses we use to talk about dementia, and the implications of a growth discourse to clinical research and practice.

Part three consists of a set of appendices for both systematic literature review and empirical paper, including a reflective account of the research process and a statement of epistemology.

Publisher
Department of Psychological Health and Wellbeing, The University of Hull
Supervisor
Wolverson, Emma; Clarke, Chris
Qualification level
Doctoral
Qualification name
ClinPsyD
Language
English
Extent
1 MB
Identifier
hull:12414
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