Background and Purpose While the marital relationship with partners with dementia has an impact on spousal carers’ well-being, the spousal understandings or expectations of their marital relationship have not been fully identified. As the marital relationship is formed by individual backgrounds including society, culture and psychological status, the aim of this study was to identify the experience of being the spouse of a person with dementia in the context of their marital relationship. The study was conducted in Japan. Research Design To identify spousal experience of being, Heideggerian perspectives of interpretive phenomenology were applied. Study Sample Seven couples aged over 65 years, each comprising one partner with dementia who received home nursing, and their spouse participated in this study. Data Collection The couples were observed, and semi-structured interviews were conducted. Data Analysis Interpretive data analysis based on the Hermeneutic circle of Heideggerian perspectives was applied. Results In the findings, the experience of being a spouse, contextualised by spousal understandings of marital relationship, was formed through seven themes. The main context for spousal understanding of their marital relationship was helping each other as husband and wife, and this relationship was seen as natural and unchanging. It reflected on spousal potentiality of being, that is, living together indefinitely as before. Spouses tried to provide suitable care for their partners using memories while preserving a sense of identity, maintaining external relationships and accepting unanticipated internal responsibility. Conclusions In conclusion, fulfilling unmet needs could help spouses to ease intense care load, which re-acknowledges their own and their partner’s identity, and their relationship by reminiscing their past.

Aim:The purpose of this clinical practice guideline is to provide and recommend methods of assessing aspiration and pharyngeal residue during eating and swallowing and methods of selecting and implementing nursing care for adults in order to prevent the development of aspiration pneumonia through early and appropriate management of oropharyngeal dysphagia.Methods: In April 2018, Japan Academy of Nursing Science established the Supervisory Committee in Nursing Care Development/Standardization Committee to develop clinical practice guidelines for aspiration and pharyngeal residual assessment during eating and swallowing for nursing care. This clinical practice guideline was developed in accordance with Minds Manual for Guideline Development 2017, with the aim of providing a specific pathway for nurses to determine the policy for selecting management for oropharyngeal dysphagia based on research evidence and multifaceted factors such as the balance of benefits and harms and patients' values.Results: Based on 10 clinical questions related to assessment by physical assessment, the Repetitive Saliva Swallowing Test, Modified Water Swallowing Test, Food Test, cervical auscultation, observation using an ultrasound diagnostic device, and an endoscope, 10 recommendations were developed. Eight recommendations were evaluated as GRADE 2C, and the other two were evaluated as no GRADE. Conclusion:We were able to produce the first reliable clinical practice guideline from an academic nursing organization that focuses on assessment for nursing care and incorporates the latest findings.