Living with early-stage dementia: a review of qualitative studies.
OBJECTIVE
This paper presents a literature review whose aim was to provide better understanding of living with early-stage dementia.


BACKGROUND
Even in the early stages, dementia may challenge quality of life. Research on early-stage dementia is mainly in the domain of biomedical aetiology and pathology, providing little understanding of what it means to live with dementia. Knowledge of the lived experience of having dementia is important in order to focus pro-active care towards enhancing quality of life. Qualitative research is fundamentally well suited to obtaining an insider's view of living with early-stage dementia.


METHODS
We performed a meta-synthesis of qualitative research findings. We searched MEDLINE, CINAHL, and PsycINFO and reviewed the papers cited in the references of pertinent articles, the references cited in a recently published book on the subjective experience of dementia, one thesis, and the journal Dementia. Thirty-three pertinent articles were identified, representing 28 separate studies and 21 different research samples. Findings were coded, grouped, compared and integrated.


RESULTS
Living with dementia is described from the stage a person discovers the memory impairment, through the stage of being diagnosed with dementia, to that of the person's attempts to integrate the impairment into everyday life. Memory loss often threatens perceptions of security, autonomy and being a meaningful member of society. At early stages of memory loss, individuals use self-protecting and self-adjusting strategies to deal with perceived changes and threats. However, the memory impairment itself may make it difficult for an individual to deal with these changes, thereby causing frustration, uncertainty and fear.


CONCLUSIONS
Our analysis supports the integration of proactive care into the diagnostic process, because even early-stage dementia may challenge quality of life. Moreover, this care should actively involve both the individual with dementia and their family so that both parties can adjust positively to living with dementia.
Steeman
Els
E
Center for Health Services and Nursing Research, Faculty of Medicine, Katholieke Universiteit Leuven, Leuven, Belgium. els.steeman@ugent.be
de Casterlé
Bernadette Dierckx
BD
Godderis
Jan
J
Grypdonck
Mieke
M
D000223:Adaptation, Psychological; D003704:Dementia / Q000150:complications / Q000523:psychology / Q000534:rehabilitation*; D004644:Emotions; D005239:Fear; D006801:Humans; D007398:Interpersonal Relations; D008569:Memory Disorders / Q000209:etiology / Q000523:psychology / Q000534:rehabilitation; D026684:Personal Autonomy; D011788:Quality of Life; D012649:Self Concept; D013315:Stress, Psychological / Q000523:psychology