Expressed Sense of Self by People With Alzheimer’s Disease in a Support Group Interpreted in Terms of Agency and Communion

Abstract

The self is constructed in cooperation with other people and social context influences how people perceive and express it. People with Alzheimer's disease (AD) often receive insufficient support in constructing their preferred selves, but little is known about how they express themselves together with other people with AD. In accordance with Harré's social constructionist theory of self, this study aimed to describe how five people with mild and moderate AD express their Self 2 (i.e., their personal attributes and life histories) in a support group with a facilitator experienced in communicating with people with AD. The participants' expressions of their Self 2 were analyzed with qualitative abductive content analysis and interpreted in terms of agency and communion and a lack of agency and communion. The findings highlight the importance of supporting a sense of agency and communion when assisting people with AD in constructing their self.

Communication in healthcare interactions in dementia: a systematic review of observational studies

“…Furthermore, there was evidence that patients used humor to assert themselves, for example to raise concerns (Robinson et al, 2010), manage difficult feelings and lighten serious discussions (Hedman et al, 2014a), claim control in assessments and group conversations (Saunders, 1998b;Hedman et al, 2014b), and hide miscomprehension and maintain interactional flow (Saunders, 1998b;Lindholm, 2008). These studies argued that by using humor flexibly to both dominate talk and be self-deprecating, patients are showing insight into their expected responses and limitations and demonstrating that they are "productive members of the interaction" (Saunders et al, 2011).…”

“…There were several studies that evidenced the assistance that patients give each other to maintain face in support groups (Mason et al, 2005;Hedman et al, 2014aHedman et al, , 2014b or day center group interactions (Lindholm, 2013). Lindholm found that group members would compensate for others' difficulties, for example by slowing down their talk and repeating turns.…”

A systematic narrative review of support groups for people with dementia

“…Table 1 provides details about the studies evaluating support group outcomes, Table 2 lists the outcome findings from these studies and the processes, such as reflection or mutual support that occurred within groups. Publications spanned 25 years: the first paper reported a time-limited group with psycho-education components (McAfee et al, 1989), whilst recent publications referred to an open-ended group with no additional components (Hedman et al, 2014a;2014b). Papers referring to open-ended Table 1.…”

“…Caregivers could also attend the support group but groups that did not include the person with dementia were excluded, therefore caregiver support groups were not included. How authors defined their group was noted but due to the variable use of the term "support group" (Hedman et al, 2014a) all interventions were critiqued against the definition of a support group developed for the review. For the review, support groups were defined as:…”

“…Support groups can be based on a range of theoretical models and groups may be led by professionals or lay facilitated. The term support group has been applied to different types of meetings: groups which focus on mutual support and topics suggested by attendees, groups which have combined mutual support and education, selfhelp, user-led groups and psychotherapy groups (Hedman et al, 2014a). It is therefore difficult to define the specific characteristics a group should have to be categorized as a support group.…”