"It's like you're dead alive" : how do professional care staff construct challenging behaviour amongst residential and nursing home residents living with dementia : a discourse analysis approach

• Main Author: Day, Emma
• Published: University of Surrey 2013
• Subjects: 362.19683
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.600131

This study set out to acknowledge the voices of carers of people with dementia and to incorporate this into the present literature regarding dementia. The study therefore sought to ask: How do professional care staff construct challenging behaviour amongst residential and nursing home residents living with dementia? Interviews were conducted with twelve care staff working m residential and nursing homes and their transcripts were subjected to Foucauldian Discourse Analysis. Close examination of the data suggested four main discourses that were used interchangeably by all participants: The dualistic nature of dementia, causal explanations, challenging behaviour as a form of self-expression and the management of the disorder. It is thought that these discourses were drawn upon by participants to open and close the dialectical gap between 4healthy' staff and 'unhealthy' people with dementia. The researcher suggests that this may highlight the prevalence of 'othering' in care practices in addition to implications for identity formation and the management of blame and responsibility. It is argued, amongst other issues, that in order to achieve national dementia objectives (DoH, 2009; 2010), training of care staff should focus on the language and discourses drawn upon by staff Specifically, the use of 'distress reaction' should be considered as an alternative to 'challenging behaviour' to open up new opportunities for thinking and care practices. Furthermore, it is suggested that clinical psychologists have a leadership role to play in ensuring staff are reflecting on the influence their language may have on their clinical practice and in the constitution of an effective culture of care.