Abstract
Adequate and mutual interaction is a key factor for a good and stable relationship between people with dementia and their carers and a prerequisite for living well with dementia. The dominant features of dementia include cognitive impairment and behavioral changes in people with dementia, often referred to as “challenging”. Whether communication is successful or not depends, on the one hand, on the type and degree of cognitive impairment and the skills and resources available to people with dementia and, on the other hand, on the ability of the environment to interpret and understand the utterances and the meaning of the behavior.
In the first part of this essay we begin with a description of the different concepts of challenging behavior and their theoretical assumptions and backgrounds. We then describe the particularities of the nursing perspective and show the state of the art in caring for people with dementia with challenging behavior. We will also consider current evidence on the different views on the phenomenon facing the perspective of professionals, family carers and people with dementia themselves.
In the second part, we alternately describe and reflect on a very short sequence of a micro interaction of a couple at home during a meal. With regard to current theoretical discussions, the example gives a first impression of the tiny, situational and complex interactional attunements and underlines the need for sensitive communication skills of people caring for people with dementia.