Teaching, teasing, flirting and fighting

Interactions between six participants with a dementia syndrome were observed and recorded across an eight-week therapeutic group, using audio and video equipment. Sessions were analysed using ‘template analysis’ methodology. Three codes were used to describe participants' behaviour and discussion in the group. These described discussion of participants' experience of dementia, their responses to the group itself and ways in which participants used the group to fulfil their own needs. Subordinate codes illustrated these levels of participation. Participants offered practical and emotional support and listened, reflected and responded to others, whilst also using the group to meet their own needs. Group development was generally consistent with that of small groups for people without a dementia. The findings raise questions about the abilities that may be retained by people with a mild or moderate degree of dementia and challenge assumptions about ‘lack of insight’, and the positioning of people with a dementia as passive. The importance of providing contexts in which people with a dementia can express their abilities and reciprocate within relationships is discussed. Arguments for the efficacy of psychotherapeutic support for people with a dementia, and the inclusion of their perspectives in both research and practice are also considered.