Opposing orientations in interactions with individuals with Frontotemporal Dementia

Abstract

Clinically, frontotemporal dementia (FTD) is described as primarily affecting personality and interpersonal conduct and resulting in social behavioral disruptions, thus often giving rise to interpersonal conflict. Conflict behavior in both typical and dementia populations is frequently identified as explicit physical and verbal acts such as assault, yelling or insulting, and research often situates conflict and collaboration as opposing dimensions. The premise of this article is to examine the unfolding of moments in which individuals diagnosed with FTD and their carers demonstrate opposing orientations towards an activity in real time interaction: A home nurse needing to fulfill an institutional agenda — taking sitting blood pressure — seeks the cooperation from an individual who, in attempting to lie down, interferes with this agenda. These moments constitute sources of interactional conflict that carers attempt to resolve. However, often conflict behavior and cooperative behavior are not neatly teased apart; for instance, individuals often display conflicting orientations towards an overarching or guiding activity while cooperating in more immediate and discrete interactional tasks. These verbal/nonverbal conflicts are not large acts of aggression; rather, they may be viewed as arising within the mundane moments of life that individuals face in everyday contexts and frequently.