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Toward a Theory of Rhythmic Synergy in Caregiving for Older Adults Living with Dementia

Abstract

As family members and their loved one living with Alzheimer’s disease and other related dementias (ADRD) navigate their new reality as a family, understanding how they communicatively manage challenging interactions while also foster moments of joy and emotional co-presence is a pivotal concern for all stakeholders. Caregiving informally has been associated with poor physical and mental health outcomes, and the unique challenges inherent to an ADRD diagnosis present significant complexities. Given that the trajectory and symptomology associated with ADRD are highly unpredictable, this can create an overwhelming number of uncertainties for families. A hallmark of these conditions is the impact that cognitive changes have on communication ability, which can make fostering meaningful interactions and feeling confident about care-related decisions even more uncertainty-inducing. Previous research examining how family members and their loved ones living with ADRD communicate tend to focus on limited recommendations rather than the process that led to these strategies. In addition, previous research investigating the needs of family caregivers of loved ones living with ADRD suggest a deeper analysis on how exactly family members can better support each other that ultimately help them to work together to compassionately care for their loved one. The construct of rhythmic synergy emerged from the narratives of 31 adult family caregivers who were currently providing care (or had previously provided care) for a loved living with ADRD. The interviews were analyzed to understand how informal family caregivers navigate their experiences with regards to how they make sense of their caregiving experience, learn to communicate specifically with their loved one, and how the family navigates trying to come together to coordinate care. By focusing on the process of communication at both the dyadic level and family level, a more nuanced picture of communication in the family caregiving context became clearer. Rhythmic synergy conceptualizes the way people develop and continually evolve their communication patterns by being sensitively attuned to the abilities of someone who has differing communication abilities related to a cognitive condition. The goal of creating rhythmic synergy is that it not only eases certain aspects of caregiving but also becomes a way to promote social and emotional presence. Overall, the construct of rhythmic synergy bridges together multiple bodies of literature and offers several theoretical contributions, namely focusing specifically on the role of communication as a temporal process. As for practical contributions, rhythmic synergy helps conceptualize how family members and care partners can better perceive their communication patterns to ultimately nurture moments of connection and co-presence with the loved one and work together as an entire family to coordinate care.

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