title: Minimizing confusion and disorientation: cognitive support work in informal dementia caregiving.
abstract: Drawing from ethnographic fieldwork and in-depth interviews, I explain how informal dementia caregivers attempt to reduce the affected individual's moments of confusion and disorientation through cognitive support work. I identify three stages through which such support takes shape and then gradually declines in usage. In a first stage, family members collaborate with affected individuals to first identify and then to avoid "triggers" that elicit sudden bouts of confusion. In a second stage, caregivers lose the effective collaboration of the affected individual and begin unilateral attempts to minimize confused states through pre-emptive conversational techniques, third-party interactional support, and social-environment shifts. In a third stage, caregivers learn that the affected individual has reached a level of impairment that does not respond well to efforts at reduction and begin abandoning strategies. I identify the motivations driving cognitive support work and discuss the role of lay health knowledge in dementia caregiving. I conclude by considering the utility of cognitive support work as a concept within dementia caregiving.
authors.affiliation: Duke University, Center for the Study of Aging and Human Development, Duke University Medical Center, 201 Trent Drive, DUMC 3003, 3502 Blue Zone, Durham, NC 27710, United States. Electronic address: brandon.berry@ucdmc.ucdavis.edu.
authors.forename: Brandon
authors.initials: B
authors.lastname: Berry
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D003071:Cognition; D003221:Confusion; D003704:Dementia / Q000451:nursing / Q000523:psychology*; D005190:Family / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D012944:Social Support
keywords: Alzheimer's disease/dementia; Caregiving; Chronic illness; Cognitive support; Confusion/disorientation; Symptom management