Integrity promoting care of demented patients: patterns of interaction during morning care

Video-recorded morning care sessions (n = 49) of demented nursing home patients (n = 5), were analyzed before, as well as after, training of the staff in integrity promoting care. A phenomenological-hermeneutic analysis was performed based on the Erikson theory of "eight stages of man" and musical notations were used for the analysis of courses of events. The analysis revealed five main patterns of interaction; positive, negative, intermediate, negative/intermediate turned into positive by the patient, and negative/intermediate turned into positive by the caregiver. Before the training, negative and intermediate patterns dominated (58%), while positive patterns dominated (84%) after the training. The positive patterns of interaction were characterized by the caregiver communicating with the patient as a competent partner, showing humanity, respect and support. The activity was carried out in intimacy. This led to the patient displaying more and more ability.