The enrichment process for family caregivers of persons living with dementia: A grounded theory approach

Aim: Many persons living with dementia (PLWD) reside in the community and are cared for by family members. The aim of this qualitative study was to gain an understanding the enrichment process for family caregivers of PLWD in Taiwan.Design: A grounded theory approach with face-to-face semi-structured interviews was conducted with family caregivers of PLWD in Taiwan.Methods: Interview data from 30 family caregivers of PLWD recruited from dementia clinics or support groups in Taiwan were obtained from the first wave of a larger study conducted from January 2018 to September 2021. Glaser's grounded theory approach with theoretical sampling was used to understand the enrichment process of family caregivers of PLWD.Results: Analysis indicated the core category that characterized the process of enrichment was 'holding together'. Caregivers were able to maintain their connection to the person with dementia through activities that deepened their relationship and strengthened their bond. 'Holding together' included four components: maintaining continuity, creative interactions, interacting with humour and sharing pleasurable activities. Through these components, family caregivers generated positive interactions and relationships with the person living with dementia and sustained their motivation for caregiving. Three modifying elements facilitated or impeded the process of holding together: 'previous daily interactions', 'caregiving beliefs' and 'filial piety'.Conclusion: Through the enrichment process of 'holding together', family caregivers used different strategies to conduct pleasurable and meaningful activities with the person living with dementia to maintain and improve their relationship and enhance their happiness in life.Impact: To facilitate the enrichment process, health care providers should encourage activities between family caregivers and PLWD that promote continuity, increase interactions, provide humour and foster pleasurable activities.Reporting Method: This study adhered to the COREQ guideline checklist.Patient or Public Contribution: No patient or public contribution.