What happens when people develop dementia whilst working? An exploratory multiple case study.

PURPOSE: This study is an in-depth exploration of the unfolding experiences of five persons who developed dementia while still in paid work/employment, and of their significant others. Namely, we explore how they experienced the actions and decisions taken with respect to work, and what the consequences meant to them. METHODS: A qualitative longitudinal case study design with multiple cases was used, including five participants with dementia and significant others of their choice. Interviews were undertaken longitudinally and analysed with the Formal Data-Structure Analysis approach. RESULTS: The joint analysis resulted in two intertwined themes: 1) The significance and consequences of a dementia diagnosis: a double-edged trigger, and 2) Sensemaking and agency. The prevalent images of what dementia is, who can/cannot get it and what it will bring, were revealed as the critical aspects. Having the opportunity to make sense of what has happened and participate in decision-making, contributed decisively to the participants' experiences. CONCLUSIONS: Findings illustrate how a dementia diagnosis is alien in work-life, but once diagnosed, it may trigger self-fulfiling expectations based upon stereotypical understanding of dementia. A shift is needed from a deficit-focused perspective, to viewing people with dementia as citizens capable of agency.

Leaving homelessness and addiction: narratives of an occupational transition.

The aim of this exploratory study was to gain an understanding of occupational aspects of homelessness and of the transition from homelessness. Data were collected through narrative interviews of two formerly homeless women recovering from drug addiction. Data were analyzed using a constant comparative method followed by a narrative analysis. The findings first identified homelessness as a life of high intensity lived within a limited time perspective. Further, for these women homelessness was related to drug addiction, which was experienced at first as a solution to life situations that seemed impossible to handle. Second, the analysis showed how social relationships can strengthen or change the lived plots of the participants. Third, the transition out of homelessness was accomplished through the development and enactment of new lived plots. Finally the analysis showed that life as formerly homeless women was experienced as less intense and as a life that can only partly be controlled. This new life includes a broader time perspective. In the discussion, the relationship between time use and the meaning-making process and possible practical implications of this study are presented.