Contradictions of interaction for wives of elderly husbands with adult dementia

The researchers used a dialectical framework to examine interviews with wives whose elderly husbands experienced adult dementia from Alzheimer's disease and related disorders (ADRD), centering on how wives coped communicatively with their husbands' illness. These "married widows" experienced a primary contradiction between their husbands' physical presence and cognitive/emotional absence. Interwoven with the presence-absence contradiction were three additional contradictions: certainty-uncertainty, openness-closedness, and past-present. Results describe the ways these wives communicatively negotiated the web of contradictions as they interacted in the present with husbands they once knew. Applications for practitioners and caregivers working with ADRD patients and their wives, including formal and informal support, understanding, and managing contradictions, and ways to more effectively interpret ADRD patients' communication, are discussed.