title: Progressive compensatory symbiosis: spouse caregiver experiences of caring for persons with dementia in Taiwan.
abstract: Spouse caregivers have been the predominant family members who care for persons with dementia in Taiwan. Although studies in western countries have described the caregiving experiences and changes in the marital relationship for these spouse caregivers, this information is lacking in Taiwan. This study explored the experiences of spouse caregivers caring for persons with dementia in Taiwan.
  
  
  
  A grounded theory approach was used for this qualitative descriptive study. Data were collected through recorded in-depth interviews and observations with 15 spouse caregivers of persons with dementia. Constant comparative analysis was used to analyse the transcripts and field notes.
  
  
  
  Analysis of interview transcripts revealed that the experiences of caregiving for spouse caregivers who lived with persons with dementia could be described as 'progressive compensatory symbiosis.' This core category included three components: awareness of unbalanced intimacy, making a commitment and implementing a compensatory scheme. These experiences could be either mutually beneficial or unbalanced and fluctuated as the disease progressed through the phases of 'subtle,' 'revealed' and 'confirmed,' which also influence the pace, transition and evolution of the compensatory symbiosis.
  
  
  
  This exploratory study describes the family caregiving experiences for 15 spouse caregivers of persons with dementia in Taiwan. These results can provide guidance for developing interventions to prepare, facilitate and promote a mutually beneficial adjustment for spousal caregivers and their spouses as dementia progresses. The findings are worthy of further investigation with a larger sample and a prospective design.
authors.affiliation: a School of Nursing, College of Medicine, Chang Gung University , Taoyuan City , Taiwan.|b Department of Nursing , Tzu Hui Institute of Technology , Pingtung County , Taiwan.
authors.forename: Ching-Lin
authors.initials: CL
authors.lastname: Wang
authors.affiliation: a School of Nursing, College of Medicine, Chang Gung University , Taoyuan City , Taiwan.|c Healthy Aging Research Center , Chang Gung University , Taoyuan City , Taiwan.
authors.forename: Yea-Ing Lotus
authors.initials: YL
authors.lastname: Shyu
authors.affiliation: d Department of Nursing , Yuh-Ing Junior College of Health Care & Management , Kaohsiung City , Taiwan.
authors.forename: Jing-Yun
authors.initials: JY
authors.lastname: Wang
authors.affiliation: e Department of Neurology , Chang Gung Memorial Hospital , Kaohsiung City , Taiwan.
authors.forename: Cheng-Hsien
authors.initials: CH
authors.lastname: Lu
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D017028:Caregivers / Q000523:psychology*; D003704:Dementia / Q000451:nursing*; D004645:Empathy; D005260:Female; D066296:Grounded Theory; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D018454:Spouses / Q000523:psychology*; D013315:Stress, Psychological / Q000523:psychology; D013624:Taiwan
keywords: Taiwanese; dementia; grounded theory; spouse caregiver