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I becomes we, but where is me? The unity-division paradox when caring for a relative with dementia : a qualitative study

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Tierney, Stephanie, Tutton, Liz and Seers, Kate (2019) I becomes we, but where is me? The unity-division paradox when caring for a relative with dementia : a qualitative study. International Journal of Older People Nursing, 14 (4). e12263. doi:10.1111/opn.12263 ISSN 1748-3735.

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Official URL: https://doi.org/10.1111/opn.12263

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Abstract

Background
The number of older people living with dementia is increasing. Admiral Nurses work with these individuals and their families in the UK to manage challenges associated with the condition, providing guidance, advice and reassurance, alongside practical solutions.

Aim
To explore the input of Admiral Nurses as part of people's journey to becoming and being a carer for someone with dementia.

Design
A qualitative study was conducted to describe and understand how Admiral Nurses are experienced and encountered by carers as part of their narrative around supporting a relative with dementia.

Methods
Semi‐structured interviews were conducted with 19 carers between November 2017–April 2018. They lasted between 45 and 90 min. Thematic analysis was used to interpret data.

Findings
An overarching concept of “the unity–division paradox” was derived from the data. This highlights the complex interchange between the carer with (a) the person with dementia, (b) other individuals and (c) external services. Such interactions can make carers feel part of a larger network (unity) but also as if they are on their own, fighting on behalf of the person with dementia (division). This concept was underpinned by the following themes: (a) I becomes we; (b) My private world is encroached by dementia; (c) I’m left navigating an unwieldy system; (d) Are you with or against us?; and (e) Recreating boundaries to rediscover me.

Conclusion
The identity and unique characteristics and interests of those caring for a person with dementia may be lost as they encounter tensions associated with the unity–division paradox. Admiral Nurses can help carers feel less alone in managing internal and external struggles by supporting them to do their best for a loved one with dementia.

Implications for practice
Understanding carers’ experience and supporting their work may help to increase and sustain their capacity to provide care.

Item Type: Journal Article
Subjects: R Medicine > RA Public aspects of medicine
R Medicine > RC Internal medicine
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Warwick Research in Nursing > Royal College of Nursing Research Institute (RCN) (- July 2017)
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Dementia, Dementia -- Patients -- Care, Dementia -- Nursing, Caregivers, Caregivers -- Services for
Journal or Publication Title: International Journal of Older People Nursing
Publisher: Wiley-Blackwell Publishing, Inc
ISSN: 1748-3735
Official Date: December 2019
Dates:
DateEvent
December 2019Published
29 July 2019Available
1 July 2019Accepted
Volume: 14
Number: 4
Article Number: e12263
DOI: 10.1111/opn.12263
Status: Peer Reviewed
Publication Status: Published
Reuse Statement (publisher, data, author rights): "This is the peer reviewed version of the following article: Tierney, S, Tutton, E, Seers, K. I becomes we, but where is me? The unity–division paradox when caring for a relative with dementia: A qualitative study. Int J Older People Nurs. 2019; 00:e12263. which has been published in final form at https://doi.org/10.1111/opn.12263. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions."
Access rights to Published version: Restricted or Subscription Access
Date of first compliant deposit: 4 July 2019
Date of first compliant Open Access: 29 July 2020
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