• Hans Ketil Normann, Nils Henriksen, Astrid Norberg, and Kenneth Asplund.
• Department of Nursing Science, University of Tromso, Breivika, Tromso, Norway. ketiln@fagmed.uit.no
• J Clin Nurs. 2005 Aug 1;14(7):891-6.

Aims And ObjectivesThe aim of this study was to explore the presence of lucidity in a woman with severe dementia during conversations and whether it occurred when conversational partners or the woman with severe dementia initiated the conversation topics about the present, past or future time and whether she was presented with support or demands during the conversation.BackgroundCommunication problems as well as episodes of lucidity in people with dementia are reported in the literature.DesignA researcher held 20 hours of conversation with a woman with severe dementia. A daughter participated for about three and a half hours. The conversation was tape-recorded and transcribed verbatim.MethodsThe text was divided into units of analysis. Each unit of analysis was then assessed separately and discussed among the authors. Chi-square tests and logistic regression analysis were performed. An ethics committee approved the study.ResultsThe woman as initiator of the conversation topic and support to the women during conversation from the conversation partner were found to be the most significant factors explaining lucidity, while conversation about the present or past time showed no connection with lucidity. Very few topics (n = 7) concerned future time and they were not used in the statistical analysis. The researcher initiated 41%, the woman 43% and the daughter 16% of the topics. Support was registered in 49%, demands in 15% and both support and demands in 16% of the units of analysis. There were 58% topics about present and 40% about the past time.ConclusionsThe presented study is a case study and the results cannot be generalized. For the woman with severe dementia, lucidity was promoted by the conversational parties carefully focusing on conversation topics initiated by the woman while supporting her during conversation.Relevance To Clinical PracticeTo share the same perception of reality, focusing on the topics initiated by the patient with severe dementia and a supporting attitude to what the patient tells, will hopefully give more episodes of lucidity in the patient. This approach in caring for patients with severe dementia might give more meaning and well-being to the conversational partners in daily care.

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