The significance of view of life in persons with Alzheimer's disease

92 Pages·2010·0.63 MB·English

by  Anders Westus

Licentiate Degree Thesis

The significance of view of life
in persons with Alzheimer’s disease

Anders Westius
From The School of Health and Medical Sciences, Department of Medicine,
Örebro University, Sweden. Örebro Studies in Medicine
Örebro 2010

Licentiate Degree Thesis

The significance of view of life
in persons with Alzheimer’s disease

Anders Westius

From The School of Health and Medical Sciences, Department of Clinical Medicine,
Örebro University, Sweden. Örebro Studies in Medicine

Örebro 2010
Cover photo: the narrow footbridge, tolerably connecting the past and the future
journey over increasingly unsteady ground may be seen as a symbolic

representation of view of life and sense of identity in dementia.
CONTENTS

ABSTRACT
ORIGINAL PAPERS
ABBREVIATIONS
PREFACE
INTRODUCTION
OBJECTIVE
Study I
Study II
BACKGROUND
THEORETICAL BASIS
View of life
Life story
Sense of identity
Identity, memory and relationship
A threefold identity
METHOD
Participants
Data collection
Interpretation
Method of analysis
Phenomenological hermeneutics
ETHICAL CONSIDERATIONS
RESULTS
Study I
Naïve reading
Structural analysis
Comprehensive understanding
Study II
Naïve reading
Structural analysis
Comprehensive understanding
DISCUSSION
CONCLUSIONS
IMPLICATIONS
SVENSK SAMMANFATTNING
(Summary in Swedish)
ACKNOWLEDGEMENTS
REFERENCES
APPENDIX
PAPERS I - II
ABSTRACT

Making it possible for persons with Alzheimer‟s disease (AD) to
retain a sense of identity and personal worth during the process of
the disease poses a great challenge to caregivers. The objective of
the study was to investigate if the view of life of persons with AD
could be understood in the frame of their life story and to elucidate
the role of view of life in connection to their sense of identity. The
view of life of an individual is defined as a conception of reality, a
central system of values and a basic emotional attitude.
Twenty-one persons with mild to moderate stages of AD were
interviewed about their life story and their view of life. The narratives
were interpreted using a phenomenological hermeneutic method.
Despite their cognitive deterioration it was possible to understand
the view of life of the participants in the frame of their life story.
Their view of life was not erased by the disease. No exceptional
characteristics that could be traced to AD were found in the
participants‟ view of life. Their view of life seemed to guide them
towards selecting mainly emotionally powerful and value-oriented
memories. The origins of their present central values and basic
emotional attitude were interpreted to have been established already
in early life. A sense of meaningfulness and continuity when looking
back on life was also expressed. Despite progressive memory loss
and cognitive deterioration, the participants‟ view of life was
interpreted as a vital aspect of their sense of identity.
The study implicates that knowledge of the view of life of persons
with AD is valuable for confirming and supporting their sense of
identity.

Keywords - Alzheimer‟s disease; identity; life story; view of life,
interview, phenomenological hermeneutics.

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ORIGINAL PAPERS

The thesis is based on two studies:

I. Westius, A., Andersson, L. & Kallenberg, K. 2009. View of life in
persons with dementia. Dementia 8, 4, 481-99.

II. Westius, A., Kallenberg, K. & Norberg, A. View of life and sense
of identity in persons with Alzheimer‟s disease. Ageing and Society.
Submitted.

Abbreviations
AD - Alzheimer‟s disease
FAST - Functional assessment staging scale
MMSE – Mini mental state examination

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