Nurses' reflections about dementia care, the patients, the care and themselves in their daily caregiving

In this study the aim was, through interviews, to disclose 13 nurses' personal knowledge about the patients, themselves, and care provision, using a phenomenological hermeneutic analysing method. Caring-for people with severe dementia meant an intertwined life would emanating fi om making and doing together and the delicate interpretative work that the care provision required. The intertwined life world consisted of the interaction between the nurses' and the patients' separate lives, their common life and the environment, culminating in mutual dependency, Making together signifies the relationship being based on the nurses' knowledge and skills as nurses i.e. the task they had to perform. Doing together signifies the relationship being based on the oneness:of the nurses and the patients with severe dementia as ordinary human beings. The delicate interpretation process required, to adapt care to the individual patient, was based on knowledge about the patient's personality,life history and disease progression in combination with the nurses' interpretation of the current situation. The nurses searched for meaning and that,,in turn, meant that the patient's inner world was determined by the nurses and thus the patient was seen as being in their hands. It seems important to further understand the human aspects of both the nurse and the patient and to examine this dynamic, ongoing, vulnerable interpretation process, critically, in order to achieve high quality nursing care for the patients with severe dementia, and an experience of well-being in nurses everyday working lives. (C) 1998 Elsevier Science Ltd. All rights reserved.