Abstract

The study focuses on the transformation of identity attributes of two members in a dyadic relationship where one person has Alzheimer's disease and the other assumes the moral responsibility for providing care. Of special significance are the social interactions among family members which led to one person assuming primary responsibility. How the caregiving relative existentially defined the caregiving situation and its consequences is also examined. Finally, the study looks at strategies used by caregiving relatives to maintain identity attributes as long as possible and the ways in which identity loss in the Alzheimer's person was perceived. ;The study draws on in-depth interviews of thirteen persons who assumed the moral responsibility for providing care for a relative with Alzheimer's disease in the early to late 1970s. Respondents ranged from thirty-four years to seventy-four, and the number of spouses and adult children was even. Ten were white females; two were black females; and one was a white male. Other members of the families were also interviewed, when possible. In addition to the interviews, data were gathered during two separate internships at local adult day health care centers and participation in weekly case conferences at the University of California, San Francisco, Memory Clinic. Methodology is informed by the Symbolic Interactionist perspective and Grounded Theory was used operationally. Open-ended interviews lasted from two to four hours each. ;Findings confirm that social relations of a caregiver significantly influence not only the entry into the caregiving role but the caregiving experience as well. Memories, as a social construction of a past reality, are critical components of the caregiving experience, typically used as strategies for the maintenance of the identity attributes of the Alzheimer's person. The concept of 'burden' is expanded to include the cumulative effects of re-commitment to the moral obligation which caregiving relatives face on a daily basis. Finally, quality of care provided is, in large measure, dependent on how the caregiving relative defines the situation vis a vis his/her own moral values