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Mixed Friendships: Examining the friendships of persons with Alzheimer’s disease and cognitively intact individuals. Brandi M. McCullough The University of North Carolina at Greensboro NCCOA 2007. Vision. Friendships important in older adults’ lives
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Mixed Friendships:Examining the friendships of persons with Alzheimer’s disease and cognitively intact individuals Brandi M. McCullough The University of North Carolina at Greensboro NCCOA 2007
Vision • Friendships important in older adults’ lives • Facilitates self-esteem, well-being & selfhood • Research on friendships of persons with Alzheimer’s (PWAs) lacking • Shift toward person-centered research • Pursuing firsthand accounts of the experience of AD
Vision • Want to get firsthand accounts of what it’s like to have AD, and what happens in PWA’s friendships • RQ: What are the patterns that characterize the friendships of persons with Alzheimer’s?
Stigma Excess disability Person-turned-patient mentality Lack of relational reciprocity Shrinkage of network for PWA Social isolation Possibility of new friendships PWA’s desire to sustain friendships What we know
Population • Caucasian women living in NC • Community-dwelling • Age 65 and older • Early enough stages to provide informed consent • Inclusion criteria is very limiting…
Recruitment Agencies • Eastern NC Alzheimer’s Association • UNC’s Memory Impairment Clinic • MARS Center • Geriatric Care Managers • If you know anyone who would be interested in participating in this study, please let me know!
Method • N =15 • In-depth, conversational interviews • Last between 1-2 hours in participants’ homes • Using interview guide • Ask participants about AD & friendships pre & post-diagnosis
Results (so far…) • 1st respondent • Pre-diagnosis friendship patterns • Not a part of community’s in-group • Private person who preferred listening • Good friend had been present for 20+ years
Results… • Post-diagnosis friendship patterns • Strong desire to disengage • Difficulties following conversations, remembering names • Very embarrassed because “I’m different.” • No open dialogue about diagnosis/illness • Good friend accepted her as she was
Results… • Experience of AD • Got aggravated with herself • Does her best • Advice to other PWAs; “Don’t feel sorry for yourself.” • Sense of guilt for husband’s lifestyle change • Not open with friends about illness
Results… • Role of husband • Very positive attitude • Life was as though it always had been • Interrupted & talked over his wife many times • Very affirming of situation • Facilitator of friendships for wife
Results… • 2nd respondent • Pre-diagnosis friendship patterns • Had lived in community all her life • Was very social, with many friends • Post-diagnosis friendship patterns • Moved in with daughter in another state • Move & age has prevented against large friendship networks • Good friend had been in life 3-4 years until death • Still had desire to remain engaged, “I like people. I like being out with people…”
Results… • Post-diagnosis friendship patterns • Good friend was introduced post-AD • Source of great pleasure for respondent • AD seemed to not be an issue in this friendship • Open dialogue about diagnosis/illness • Experience of AD • No shame about disease; “It is what it is.” • Acceptance of her disease • Advice to other PWAs; “Continue what you’re doing…Don’t change your life; you’ll know when you need to.” • Very open with others
Results… • Role of daughter • Feels guilty about moving mother away from large social network • Very open about illness with mother • Facilitator of friendship for mother
Respondent 1 Stigma Closed dialogue Desire to disengage Lack of new friendships post-AD Lower self-esteem? Guarded with friend Wife’s guilt regarding husband Respondent 2 Lack of stigma Open dialogue Desire to stay engaged New friendship post-diagnosis Higher self-esteem? Vulnerable with friend Daughter’s guilt regarding mother Discussion
Discussion • Both respondents • Communication challenges • Equitable social exchange with friend • Continued in friendship patterns held prior to AD • R1 was private woman & desired to disengage • R2 was very open & desired to remain engaged
Discussion • Encouraging finding… • For R2, Alzheimer’s did not prevent her from developing a meaningful friendship. Her age & geographic location seemed to have more of an impact on her friendship network than did her diagnosis.
Tentative Conclusions • Meaningful friendships can develop after an individual has developed AD. • The friendship patterns that these PWAs held prior to developing AD have continued throughout the disease process.
Tentative Conclusions • Important for friends of PWAs to accept them as they are. • Caregivers & significant others can be friendship facilitators.
Need help with recruitment!!!If you know of anyone who mightqualify, please contact me! Caucasian, community-dwelling women, 65 & older, diagnosed with AD
Thank You! Brandi McCullough The University of North Carolina at Greensboro bmmccull@uncg.edu