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COPYRIGHT 2000 JAI Press, Inc.
INTRODUCTION
Gerontological research on family caregivers has largely focused on the role of wives giving care to their demented husbands. It is only recently that the caregiving role of men, and husbands in particular, has begun to receive more attention in the gerontological literature (Barusch and Spaid 1989; Fitting et al. 1986; Harris 1993; Miller and Cafasso 1992; Pruchno and Resch 1989). However, the findings on male caregivers are fragmentary and contradictory. This is due to both the limited amount of systematic knowledge available about men's action as caregivers and to methodological problems (Harris 1993:551-552). In the family caregiving literature there is a relative absence of qualitative research (Farran et al. 1991:438; Lyman 1989:603), and a more in-depth understanding is needed, especially of the male caregiver world (Gubrium and Sankar 1990). The study on which this article reports is one attempt to respond to this need.
MATERIAL
Our research material is drawn from a corpus of 159 stories written by Finnish women and men who were giving or who had given care to their demented close ones. These stories were received in reply to a request by Antti Hervonen, Professor of Gerontology at the University of Tampere School of Public Health. The request was sent out to 1,240 members of local associations of the Central Union of Alzheimer's Disease in Finland. The letter of request appealed for "a story of your close one, mother, father, spouse, neighbour, who suffers or suffered from dementia; the whole story with all its twists and turns, authentically and in detail without hiding your feelings" (Jylha et al. 1996:22).
The biggest writer groups in the data were wives (n = 58), daughters (n = 47) and other female close ones (sister, friend, daughter-in-law, etc., n = 36). The 18 male writers included 3 sons and 15 husbands. Our study consisted of the 15 stories written by husbands.
The average length of the husbands' stories, adding up to 30 double-spaced pages, is two pages, ranging from one to six pages. The shortest stories are factual accounts(1) with few personal notes and comments. Most stories are from one to three pages in length and describe, in varying detail, life before the onset of dementia, the patient's symptoms and behavior as well as the writer's experiences of caregiving. In five stories, the patient was in a relatively early stage of the disease; in six stories, a late stage; in four stories, the patient had died.
THE PURPOSE AND PROCESS OF THE STUDY
The purpose of the study was to find out how husbands experience their position and themselves as caregivers to their demented wives. Our aim was not to compare the husbands' stories with those written by wives or other groups of writers, but to interpret them as texts in their own right. The main questions we asked of the material were these: How do husbands assign meanings to and how do they make sense of their actions and their lives as caregivers?
We had no specific hypotheses that we set out to test in the material. Our intention was to proceed on an inductive basis and carefully listen to what the texts, in themselves, had to tell us. We started the analysis by noting similarities and differences in the stories and between their tellers. This process of reading and rereading the texts provided us with some themes and categorizations of the writers. These categories did not, however, seem to do justice to the diversity of the husbands' narration. In some stories, certain themes predominated; in others, they appeared as minor sidelines; the writers portrayed themselves in varied, and even contradictory, ways. We therefore needed a conceptual framework to be able to interpret the ambiguities in the husbands' narration.
THE DISCOURSE ANALYTIC APPROACH
We based our data interpretation on a discourse analytic perspective that draws from the theoretical insights of Jonathan Potter and Margaret Wetherell (1994) and Ian Parker (1992). In the discourse analytic approach, the basic research unit is not an individual, but a culture and its representations in people's language use. Language is seen not only as a reflection of reality, but also as a constitutive element of reality. People use language for purposes of intermediating meanings. In doing so, they adopt vocabularies of different culturally available linguistic practices. Parker defines these practices as coherent systems of meanings and calls them discourses (1992:6). Potter and Wetherell use the term "interpretative repertoires" much in the same sense for "currently used systems of terms used for characterizing and evaluating actions, events and other phenomena" (1994:149).
Meanings are transindividual and contextual. They have different functions and consequences in speech, which is demonstrated by language variation (Potter and Wetherell 1994:32-37). Discourses provide actors with different subject positions with respective rights, duties, and obligations, and draw them in to adopting certain identities (Parker 1992:6, 9-10). Applying this conceptual framework in our analysis, we were not interested in the writers' personal traits and characteristics, but in how the writers talked about themselves and constructed their identities through the linguistic practices that they used in their narration.
The patients have no voice of their own in our data: they only appear in the texts as portrayed by the writer. In addition to "I" (the writer) and "she" (the patient), the texts may also involve the joint subject position of "we" (the writer and the patient) and a reference position of "those." A story is always told to someone. Even when the story is not based on a specific request, the teller has in mind an ideal reader or an audience, "a generalized other" (Mead 1964). In this case, the immediate audience--"you" for the writers--is the requester (and receiver and first reader) of the stories.
The Variation of Speech
To demonstrate the variation in the ways that the husbands speak about their experiences of care, we start the presentation of our material by considering extracts from a story in which the patient is in the early stage of dementia:
*061; early stage. My wife's father's brother was probably demented because he got lost in a small wood near his home. My wife's mother became demented when she was 68.... My wife's memory began to decline around 1984 when she was 60.... In 1987 we went to see a neurologist who concluded that "the patient is oriented" ... and recommended that we go to see a psychiatrist. The psychiatrist tried various different drugs and eventually decided on two drugs called Doxal and Haloperin. My wife has been taking them for three years or so until recently another doctor said that he only recommends Haloperin for patients who have clear delusions. So I reduced the dosage and then stopped it altogether. I do not think stopping has done any harm. I suppose really I should tell you about my day-to-day life: depression, exhaustion, quarelling [sic] and feelings of guilt. The...
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