Turning towards the inevitable: How nursing home staff manage relatives' expectations of dementia progression

This article examines video recordings of care plan meetings between nursing home care staff and relatives of residents with dementia in Finland. Prominent in these meetings is the activity of updating the relatives about the resident’s condition. An associated practical task for the staff is to assist the relatives in making sense of the resident’s observed and reported deterioration. The staff employ inevitability claims whereby they state that the resident’s health will inevitably deteriorate further. This action normalizes deterioration by attributing it to dementia, and it enables the staff to account for the resident’s present, observed deterioration and to guide the relatives’ expectations for the future. In doing so, the staff attend to epistemic considerations by avoiding claiming that the relatives are unaware of the realities of dementia and rather invoking dementia as an already familiar reality. Data are in Finnish.