Deception in the Alzheimer family shares characteristics with deception in a variety of other settings, in that it becomes routinized and contextualized. However, deception in the Alzheimer family is utilized toward the end of informal social control rather than primarily for information control. A key differentiating feature of the Alzheimer context is the gradually diminishing mental capacity and awareness of the person with the disease. This four‐year longitudinal study, involving participant observation of a caregivers' support group and in‐depth interviews of its members, examines how deceptive practices are learned; the various forms such practices take, including two‐party deception and collusion with others; and conflict posed for the caregiver between treating the family member with dignity and coping with the daily ordeal of managing in the home.

This article explores family caregivers' management of the courtesy stigma acquired in the course of their relationship with a family member suffering from the progressive deterioration of Alzheimer's disease. Caregivers' accounts from in-depth interviews and from support group meetings suggest that stigma management by the Alzheimer caregiver moves through two distinct phases: the first marked by collusion with the person with Alzheimer's; the second by realignment and collusion with an expanding circle of others. As caregivers move through these phases there is a gradual shift of management priorities from control of information to control of problematic situations.

ZusammenfassungIn der vorliegenden Studie wurde die Wirksamkeit der Extrakorporalen Stoßwellentherapie (ESWT) für die Behandlung des PodotrochloseSyndroms anhand des klinischen Lahmheitsverlaufes getestet. Das Patientenmaterial setzte sich aus 42 Pferden verschiedener Rassen, Alters sowie Geschlechts zusammen. Bei allen Tieren bestand eine mindestens dreimonatige chronisch-rezidivierende Lahmheit einer oder beider Vordergliedmaßen, die zuvor mit einer oder mehreren konventionellen Therapiemethoden erfolglos vorbehandelt waren. Das Patientenmaterial wurde in zwei Gruppen untergliedert. In der ersten Gruppe (24 Pferde) wurden 38 erkrankte Gliedmaßen über die Hufsohle behandelt. Bei den 18 Pferden der zweiten Gruppe erfolgte die ESWT an 25 Gliedmaßen über die Fesselbeuge. Nach Ablauf eines Beobachtungszeitraumes von 6 Wochen waren die Pferde der ersten Gruppe auf 47,4% der behandelten Gliedmaßen lahmfrei. In der zweiten Gruppe führte die ESWT bei 80,0% der behandelten Gliedmaßen zur Lahmfreiheit. Statistisch lag in beiden Gruppen eine signifikante Verbesserung der Lahmheitssituation nach Stoßwellentherapie vor (p ≤ 0,05), wobei die Stoßwellenapplikation über die Fesselbeuge zu besseren Ergebnissen führte als in der ersten Gruppe mit Applikation über die Hufsohle.Schlüsselwörter: Pferd, Lahmheit, Stoßwellentherapie, Hufrolle, Podotrochlose-SyndromThe use of extracorporeal shock wave therapy in horses with navicular diseaseIn this study the effectiveness of the treatment of navicular disease by the means of extracorporal shockwave application (ESWT) has been tested. The tested patients composed of a total of 42 horses of different race, age and gender which showed lameness of a duration of at least three months on either one or both front extremities. In addition all patients needed to have a history of one or more attempts of conventional treatment and the occurrence of a relapse. The tested horses were devided into two groups; group one was undergoing application of shockwaves through the sole of the hoof whereas in group two the shockwaves were applied over the bulb region. All horses were treated standing without undergoing general anestesia, only receiving sedation when necessary. The application of shockwaves to the navicular bone was done without ultrasonographical or radiological aid. After an observation period of six weeks 47,4% of the treated legs of patients out of group one have been found to be free of lameness, whereas in 80,0% of treated legs of patients out of group two were sound and showed no signs of lamness any more. Statistical evaluation of the captured data showed that in both groups a significant improvement of the disease pattern could be noticed (p ≤ 0,05). In comparison of both groups the second one achieved even better results. None of the treated horses showed severe problems during or after shockwave application. Therefore shockwave therapy is found to be an probable alternative in treating navicular disease, even though there has to be further investigation on how shockwave therapy wor...