Proximal Discourses in Residential Facility Care Providers' Sense-Making of Their Communication with Family Members of a Loved One with Alzheimer's Disease.

Abstract

Families often stay involved in the care of a loved one with Alzheimer's disease even after relocation to a residential care facility, and through this transition, communication between the residential care providers and families becomes integral to keeping family informed and providing good care to the patient. However, care providers of people with Alzheimer's living in residential facilities find themselves overwhelmed by expectations related to their caregiving role and struggle with making sense of their experiences. Fifteen care providers of people with Alzheimer's disease living in a residential facility participated in qualitative, semi-structured interviews. Using relational dialectics theory as the framework through which to examine how residential facility care providers make sense of their communication with families of patients with Alzheimer's, analysis revealed three sets of competing proximal discourses: family inclusion and exclusion, reality and positivity, and expert and layperson provision of care. We address conclusions for scholars, implications for care providers and facilities, limitations, and suggestions for future research.