Autobiographical occasions in assessment meetings involving persons with dementia

Abstract

It has often been argued that identities have a strong connection to stories and storytelling and thus that life stories should be used to individualize care for people with dementia. A problem with this view is that storytellers are seen as individuals, freely reflecting on, composing, and telling life stories. This view becomes especially problematic when persons with dementia tell stories in institutional contexts where certain information is requested and necessary for decision-making. The aim of this study is to investigate how autobiographical stories are used and what functions they have in assessment meetings involving persons with dementia. Fifteen assessment meetings were audio-recorded and transcribed. Narratives were extracted and analyzed by coding who the narrator or narrators were, what the narrator(s) accomplished by telling this story, and what the consequences were for the ongoing meeting. It was found that all interlocutors told stories about the person with dementia. These stories were found to have three functions: (1) to justify why care services were needed; (2) to describe experiences about previous care; and (3) to provide a good working climate. Thus, not all autobiographical stories are the person’s story. For care managers in their everyday work it is important to be aware of this and not only be satisfied with a story that suits the organization’s needs. Furthermore, stories told in assessment meetings often positioned the person as dependent on others, which could undermine the identity and sense of self of the person with dementia.