The following interview became a part of a multigenre research project for a communication disorders class at Marshall University. The interview is the voice of a female spouse caregiver to her husband.
From a social constructionist perspective, the focus on preserving the personhood of the partner with dementia promotes more holistic, person-centered care. On the basis of several interviews with caregivers, four strategies were recognized. The caregiver must maintain continuity, sustain existing competencies, protect the partner from incompetence and strategize public encounters.
The cognitive changes that occur during the stages of dementia cause discontinuity between past, present, and future, and the individual is perceived as increasingly incapable of rational, intentional behavior and thought. In the absence of memory, an individual cannot maintain any sense of history or continuity, and this connection between past and present is essential for the maintenance of a sense of self. The patient with dementia is often no longer able to read, write or speak so a communication breakdown is inevitable. It is recommended while caring for an individual with dementia to try to preserve the personhood of the person with the disease. Often a caregiver has to speak for the patient. The words preserving the personhood is associated with self-esteem and the place of an individual in a social group. These are highlights from one of the interviews conducted.
I= Interviewer
S= Spouse

I=Describe the feelings associated with the experience of caring for a memory-impaired partner?
S=I feel it is an extension of my marital relationship. In our wedding vows we said in sickness and in health. I feel obligated to take care of this person. He's a person that I live with and I share a bed with. So I think maybe in my case there's a difference in the caregiving. I am taking care of a person I feel I have to, because he's my husband and it was a commitment I made. So I'm bound by that commitment. I feel in the era I grew up in, you got married and you stayed married, good, bad, thick or thin.

I=Does caring for a spouse with dementia change the way you feel about the person?
S=You dont change the way you think about the person because you remember they're entering a different phase. This disease has phases and everyone with the disease can go through phases differently. I usually tell myself, I must rethink of how I'm going to cope with this phase, because they are worse. I have to remember my husband is still my husband, it is the disease that makes him appear different.

I=Do you still feel you recognize the previous identity of your husband even though his actions are different today?
S=Well compared to the life we had before, which was very active and always included dancing, things are definitely different. My husband is no longer interested in socializing. If he is out of familiar surroundings he becomes extremely confused. I have to help him with everyday tasks like bathing and eating. He can't remember how to complete a task. He won't even answer the telephone anymore because he can't understand what the person on the other end is saying. I miss the way things used to be. He was an excellent dancer. And the first five years of our marriage we danced every week. We have two lovely kids and...He took care of the kids, now it's extremely difficult.

I=Sometimes its hard for spouses to realize the impact the disease can have on a persons ability to do things they always did on a regular basis like reading and writing. Do you find his current behaviors to be understandable?
S=He's never admitted there was something wrong up until about two years ago. He finally agreed that, yeah he's got something wrong. I guess maybe he had to go through a grieving process also. He won’t read any material on Alzheimers. He thinks if he ignores it, it will go away. I just knew there was something wrong because my husband was always a loving, caring patient and generous. After a while I realized it wasn't my husband, it was the disease. It took a while for me to realize that he no longer could comprehend the newspaper for instance or sign his name on bills. I began to think maybe that is why he won’t read information on Alzheimers. He used to always take care of the bills. The disease has taken away his ability to write. I can’t blame him, I have to blame the disease.

I=Do you believe that continued education about the disease to caregivers will provide an opportunity to better the relationship between caregivers and their loved ones with dementia?
S=Yes I do. I have already been given advice by our therapists on how as a caregiver I must also allow my husband to continue making an effort to use his retained abilities. I must avoid taking over
activities my husband can still manage. This advice has helped me to make those changes and has given me somewhat of a responsibility release instead of trying to do it all.

I=Are you aware of programs within your community that are available to support caregivers like yourself?
S=I wasn't aware at first until our physician recommended that I join the Alzheimers association. I have found a lot of support through this association. I receive newsletters and can actively participate in the advocacy of Alzheimers awareness. I know now that Alzheimers is only one form of dementia and that there are a lot of people inflicted with this
disease.
Perry, J., & Connor, D. (2002).