The nurses' process of recognizing the demented elderly patients' wills

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The purpose of this study was to investigate the nurse's process of recognizing the demented elderly patients' wills. The data was collected by observing the interaction between six demented elderly patients and seventeen nurses in daily care and interviewing the nurses after the observation for about 30 minutes. The qualitative approach was used to analyze the data. For the nurses, main theme in interacting with the patients in daily care was [accommodation with the will] included <ascertainment of the will> and three dimensions. In <ascertainment of the will>, the nurses focused on the changes of the patients' expressions (focusing the change), made inference by asking the patients their questions about the meaning of the changes (infering the will), and then confirmed the inference by taking other informations (confirming the will). Through this process, the nurses made a decision about the patients' care based on their wills (making decision based on the will). [An accomodation with the will] had three dimensions ; 1) <ascertaining negative responses to instructions> was the dimension of the nurses' making sure of the patients' negative responses to the instructions in daily care 2) <appraising discomfort> was the dimension of the nurses' assessing the presence of the patients' discomfort as pain, 3) <ascertaining the unacceptable complaints> was the dimension of the nurses' making sure of patients' unacceptable complaints. In the each demension, there were three approaches ; 1) <accepting the will> was the approach of the nurses' accepting the patinets' will, 2) <compromisng with the will> was the approach of the nurses' comproming with the patients' will, 3) <controling the will> was the approach of nurses' controling the patients' will.