This study used photovoice methodology to explore how people with early-stage dementia use their perceived strength and resources to cope with the illness. Purposive sampling was used to recruit participants. Thirteen women and seven men age 57 to 90 (mean 73.4) with MMSE scores ranging from 20 to 28 (mean 25.6) participated in the project. Participants were provided with a disposable camera and invited to take photographs relevant to their well-being. The photographs provided the means for participants to take the lead in dialogue sessions about their coping response. Grounded theory analysis revealed that initially, early-stage dementia precipitated a disruption in well-being. For the participants in this study, learning to live with the illness was an ongoing, continually shifting process of adjustment, where the participants moved from a familiar sense of well-being to an alternative sense of well-being. In this process the participants used a variety of strengths and resources ranging from those that supported them in reconstructing identity, regaining control, and rebuilding relationships to those that assisted them in reestablishing a healthy lifestyle and restoring meaning and purpose. Striving toward well-being while acknowledging the inconceivable notion of losing one's cognitive abilities was the central strength that the participants brought to this process. It captured the paradox the participants faced in living with early-stage dementia, which was to relegate the illness to the background of their lives while managing its symptoms in the foreground.

Bakgrund: I Sverige beräknas att cirka 40% av personer med kognitiv sjukdom vårdas på särskilt boende och innan de flyttar dit är det ofta anhöriga som ger informell om­vårdnad i hemmet. Tidigare forskning har visat att vården av en person med kognitiv sjukdom och processen att flytta denne till särskilt boende är påfrest­ande för anhöriga, med stor risk för att utveckla egen ohälsa. Regeringen har under 2022 beslutat om en anhörig­strategi för att stärka anhörigas rätt till stöd, och Socialstyrelsen publicerade ett kunskapsunderlag för vårdgivare under 2023 i syfte att underlätta implementering av anhörigperspektivet. Därför är det intressant att studera hur sjuksköterskor idag stöttar anhöriga under denna process. Syfte: Studiens syfte är att utforska hur sjuksköterskor i kommunal verksamhet beskriver stödet de ger till anhöriga till personer med kognitiv sjukdom under transitionsprocessen från ordinärt boende till särskilt boende, samt om de upplever att det finns förbättringsmöjligheter.  Metod: En kvalitativ intervjustudie med induktiv ansats genomfördes. Det gjordes 13 semistrukturerade intervjuer med sjuksköterskor inom kommunal hemsjukvård och särskilt boende, med minst ett års erfarenhet från ena eller båda verksamheterna. En kvalitativ innehållsanalys med en manifest tolkning gjordes för att få fram ett resultat.  Resultat: Analysen resulterade i fyra huvudkategorier: 1. Att hjälpa anhöriga ur en ohållbar situation. 2. Att skapa en god relation. 3. Att samverka. 4. Att förhålla sig till brister i verksamheten. Resultatet visade att sjuksköterskorna börjar stötta anhöriga i processen långt tidigare än förväntat och är medvetna om de svåra känslor som anhöriga brottas med innan de fattar beslut om flytt. Sjuksköt­erskorna på särskilt boende arbetar ofta hårt med att öka tryggheten för anhöriga och göra dem delaktiga, och ett väl fungerande teamarbete är viktigt för ett gott samarbete med anhöriga, liksom att det finns anhörigstödjare att tillgå. De pekade också på att det finns brister i verksamheten, både av organisatorisk och kulturell art, som påverkar stödet till anhöriga negativt.  Slutsatser: Studien visade att sjuksköterskor i hög grad är medvetna om de problem och utmaningar som anhöriga står inför när de måste separera från en familje­medlem med kognitiv sjukdom. Studien pekar på förbättringsbehov avseende sjuksköterskors kompetensnivå, rutiner som verkar för ett mer jämlikt tillhanda­hållande av stöd för anhöriga, samt att sjuksköterskor får mer resurser för denna folkhälsofrämjande verksamhet. / Background: Some 40% of persons with dementia in Sweden live in care homes, and before they move there, are cared for by informal family caregivers in the home. Previous research has shown that the process of caring for a person with dementia and moving them to a care home is taxing for family caregivers, with increased risk of developing health problems of their own. The Swedish government has in 2022 presented a national next-of-kin strategy aiming to strengthen the right to support for family caregivers and Socialstyrelsen published a guide for healthcare providers to implement the next-of-kin perspective in 2023. In this light, it is of interest to study how registered nurses working in homes and care homes support family caregivers today.  Aim: The aim of the study is to investigate how registered nurses in the context of elder care, both in ordinary homes and in nursinghomes, describe the support they give to relatives of persons with dementia during the transitionprocess from ordinary living to care home living, and if they see possibilities for improvement.  Method: A qualitative interview study with inductive approach was made. There were 13 semistructured interviews made with registered nurses working in home care and care home settings, having at least one year of experience from one or both of the settings. A qualitative content analysis with a manifest interpretation was made to generate a result.  Results: The analysis resulted in four main categories: 1. Helping family caregivers in an untenable situation. 2. Creating a good relationship. 3. Cooperation. 4. Relating to the shortcomings of the area of care. The result showed that registered nurses support family caregivers long before expected and are aware of the difficult feelings relatives deal with before they decide on care home living. The nurses in care homes often work hard aiming to create a sense of security and participation for relatives. A well functioning team is a foundation for a good collaboration with relatives, and access to external support is an important resource. The nurses also identified organizational and cultural problems, affecting the support negatively.  Conclusions: The study shows that registered nurses are highly aware of the problems and challenges facing family caregivers when needing to separate from a family member with dementia. The study indicates areas of improvement concerning the nurses need for further education, routines that facilitate a higher degree of equal opportunities for relatives, and that the nurses have more resources allocated for this area of preventative public health care.

Dementia of Alzheimer‟s Type is a degenerative neurocognitive disease accounting for majority of Dementia‟s. It affects millions of people worldwide and thousands of people in South Africa. Apart from the economic burden this illness places on the country, it has detrimental effects for those who provide care for individuals with this illness, who are mostly spouses. The spousal caregivers bears great financial, social and emotional burden which worsens as the disease progresses. The aim of this study is to phenomenologically explore and describe the lived experiences of spousal caregivers in caring for the spouses with Dementia of Alzheimer‟s Type. This South African study was therefore qualitative in nature and was conducted in the province of KwaZulu- Natal, in the city of Pietermaritzburg. Eight participants were interviewed using a semi-structured questionnaire. Data was analysed using interpretative phenomenological analysis (IPA). The main findings of this study are the negative emotional affects that the caregiving role creates. Caregiver stress and strain is experienced as well as the experiences of various losses including lack of intimacy and ruined expectations for the future as the disease progresses. The caregiving role also created negative implications for the social lives of caregivers and coping mechanisms were seen to be very important. / Psychology / M.A. (Psychology)

(in English): The thesis focuses on the quality of life of carers of people with dementia being cared for at home. The theoretical section describes the concept of quality of life in general terms, but also considers carers accounts of their own personal experience. This section then outlines the various stages of dementia and how they impact the quality of life of caregivers. To complete the picture, this is followed by an assessment of care burden but also the various positive aspects arising from caring for dementia patients. By conducting semi-structured interviews, this work aims to investigate how excarers assess and value their experience of caring and whether, either while they were caring or retrospectively, they were aware of any positive aspects of caring for dementia patients and if so, specify what they were and if caregivers found personal meaning in their caregiving experience. Hence, the core area of interest is whether positive aspects of caregiving, finding meaning and cognitive restructuring could form the basis of a successful intervention, which may positively impact quality of life of current caregivers of dementia patients. While excarers mentioned numerous positive aspects associated with caregiving, some also referred to the meaning that they have found through caregiving....