How friends can enhance the wellbeing of people in early-stage dementia : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University, Auckland, New Zealand

Abstract

Dementia prevalence is widespread globally and in Aotearoa New Zealand. It has significant economic, human, psychological and social impacts. Evidence shows that how the person experiences dementia is largely driven through social processes, interactions, and social positioning, rather than neurogenic processes. How friends and communities treat people with dementia impacts their sense of self, quality of life and wellbeing. The objective of this study was to explore how friends can enhance the wellbeing of people in early stage dementia. Using Interpretative Phenomenological Analysis (IPA) and Appreciative Inquiry (AI) methodologies, four women living in the community with early stage dementia were interviewed in their homes to understand their lived friendship experiences, and those factors that impact their wellbeing. Data were analysed using IPA and four overarching themes were identified: 1) accept me as I am; 2) be there for me; 3) help me stay in the world; 4) show me I am worthy. Findings revealed crucial roles friends play and specific friendship behaviours that impact wellbeing. Findings showed that accepting the women’s limitations and acknowledging their needs and wishes was important to counter internalised stigma, and to help them adjust to a changing conceptualisation of self. Acceptance, together with social support, enabled them to participate in activities that kept them engaged in the world. These factors contributed to their sense of self-worth, and all four factors were interrelated. This study provides insight into why these factors are significant for people in early stage dementia and how they might impact wellbeing. Based on the findings, a simple strengths-based framework and pragmatic tool is provided as a guide to having positive social interactions with people with dementia. This study adds to, and strengthens, the literature on critical wellbeing and social relationship factors for people in early stage dementia, and demonstrates the relevance and applicability of these factors within a New Zealand context. It shows people in early stage dementia have unique insights to what is important to them for their own wellbeing and highlights the critical role of friends.