Carers' interactions with patients suffering from severe dementia: a difficult balance to facilitate mutual...

1. A phenomenological-hermeneutic approach was used to illuminate carers' video-recorded interactions in connection with supervision for individualized nursing care. 2. In order to disclose any changes in the carers' interactions with patients suffering from severe dementia the video recordings were conducted before, during and after the intervention. 3. The content of the videos was transcribed as a text, mainly verbal communication. Due to the rich data the videos and text were kept together as a whole in every step of the analysis. 4. After an initial naïve understanding, different subthemes emerged in the structural analyses: promoting competence, struggling for co-operation, deep communication for communion, showing respect for the unique person, skills in balancing power, distance in a negative point of view, and fragmentary nursing situations. 5. The overall theme was 'Carers' balancing in their interactions, verbal as well as non-verbal, to promote a sense of mutual togetherness with the patient'. 6. The supervision intervention contributed to an improvement in carers' skills in balancing in their interactions. In the caring process carers' and patients' shared experiences and, due to patients' disabilities, interactions depended mainly on carers' qualities and capabilities for this confirming nursing care.