Communicating with a family member who has cognitive impairment : a caregiving family perspective

Alzheimer disease (AD) and related dementias affect nearly one in thirteen Canadians over the age of 65. Difficulties in communicating are frequently cited as the greatest source of stress for individuals who have a diagnosis of dementia and their families. Despite the wide recognition that the family is affected by a relative’s diagnosis of dementia, there has been little research aimed at understanding the experience of the family as a unit. The purpose of this study is to gain insight into the family experience of communicating with a relative who has dementia. This study used a qualitative single case study design, drawing on the theory of Symbolic Interactionism. Three members of one family participated in two individual interviews and a family interview. The family member who was experiencing symptoms associated with AD but whose diagnosis was referred to as “cognitive impairment” (CI), participated in one individual interview. Interviews were transcribed and the data was analyzed using constant comparative analysis. The findings that emerged from the data indicate that the participating family approached communication with the intention of achieving three particular goals in their interactions. These goals were to include, protect, and bring happiness to their afflicted family member. Three strategies were identified as the primary strategies used to achieve these goals: interpreting, scripting, and translating. Further, the family was organized in such a way that members were positioned either as part of the ‘core’ of the family or on the ‘outskirts’ of the family. Family members that pursued and achieved the three goals in their interactions with the relative who has CI were considered to be part of the core while others who were not willing or capable of interacting in this way were positioned on the outskirts of the family. Understanding the communication experience of the family as a unit offers a vital link to meet the needs of families dealing with the effects of CI. This knowledge will aid in formulating important new questions and insights for researchers and clinicians to provide the care and support necessary to promote the well-being of families affected by CI.Applied Science, Faculty ofNursing, School ofGraduat