Turning Toward the Inevitable: How Nursing Home Staff Manage Relatives’ Expectations of Dementia Progression

Abstract

<p> This article examines video recordings of care plan meetings between nursing home care staff and relatives of residents with dementia in Finland. Prominent in these meetings is the activity of updating relatives about a resident’s condition. An associated practical task for the staff is to assist relatives in making sense of a resident’s observed and reported deterioration. The staff employ <em>inevitability claims</em>, whereby they state that a resident’s health will inevitably deteriorate further. This action normalizes deterioration by attributing it to dementia, and it enables the staff to account for a resident’s present, observed deterioration and to guide relatives’ expectations for the future. In doing so, the staff attend to epistemic considerations by avoiding claiming that relatives are unaware of the realities of dementia and, rather, invoking dementia as an already familiar reality. Data are in Finnish.<br></p>