Abstract
How do people react to and interpret the behaviors of an individual labeled a "dementia patient"? To answer this question, an in-depth analysis of one particular case of "the new century of dementia care" (Iguchi 2007) is presented in this paper. "The new century of dementia care" defines the current Japanese perspective on dementia care in which much importance is attached to communication between patients and their carers. This perspective recognizes that carers often try to "approach" patients in their current condition with the expectation that they may react. Moreover, carers regard such "approaching" as a "moral duty." What seems to be lacking is detailed analysis of the actual "approaching" or communication that occurs, the findings on which could lead to a reformation of present sociological frameworks on dementia care that emphasize the "self-fulfilling prophecy of impairment" (Lyman 1989). Data were gathered from participant observations within care settings, and this paper discusses in particular the interactions between Ms L (the patient) and her family. Data analysis revealed many elements of "the new century of dementia care," where Ms L's family was strongly oriented to "approach" (or communicate with) her with expectations of her reaction. Thus, their case was deemed a particular example of such care. Family carers almost always referred to Ms L's previous way of life before she was diagnosed with dementia. The study found a certain standard of "approaching" in dementia care, which I termed "life," after the geriatric psychiatrist Isao Ozawa's (2003) discussion. Further, a paradoxical conclusion was drawn: because carers respect the "life" of patients as a standard of care, carers must mobilize all their knowledge about patients in caring for them. While dementia care often centers on care settings, "what patients want/like/feel" and so on is highly dependent on interactions with carers.
