Narrative identity and dementia : narrative and emotion in older people with dementia

Abstract

Little research has been carried out on the subject of memory, dementia and emotion. However, there is a growing literature on the relationship between cognition and emotion (Izard, 1991), and between emotion and memory (Williams et al, 1988). The importance of emotion has been identified within the study of ageing (Bromley, 1990), including that of dementia care (Kitwood, 1990a). Emotional memories in dementia, therefore, seem worthy of investigation. A small sample of moderately to severely demented elderly people who live in the community, and use psychogeriatric day services, were investigated to see if they could recall emotional memories with the help of interviewer counselling skills. Background information, including details of significant past life experiences and interests of informants, was given by relatives and staff in the settings. The investigation took place over a two year period. Informants were normally seen, individually, each week. Interviews were recorded and transcribed. The number of recorded and transcribed individual interviews with each informant were between thirteen and twenty five. The data is presented in the form of longitudinal case-studies, and methods, (Bromley, 1986), and a grounded analysed using quasi-judicial theory approach. Analysis of the data indicated that all informants recalled emotional autobiographical memories. Over time, it became apparent that these emotional memories formed fragmented pieces of the informant's personal narratives. The emotions associated with their narratives appeared to be a strong aid to recall. These partial narratives gradually cohered into whole stories and provided aH informants with a sense of narrative identity. This sense of narrative identity began to dissolve for some informants as their illness progressed and their stories faded from memory. For other informants, who were not so devastated by their illness, their stories and narrative identity remained with them. Although outcomes varied for all informants, all experienced varying levels of increased well-being through the recall of their narrative. Possible therapeutic benefits are suggested by this approach. Reminiscence work, combined with carer/interviewer counselling skills, may lead to the maintenance of the narrative in dementia and, thus, an increase in personhood. Topics of further investigation, suggested by this research, include premorbid personality traits and preventative counselling for those identified as at risk. Further studies should take into account the relationship between memory, dementia and emotion.

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