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Keywords:

  • Alzheimer's disease;
  • dementia;
  • identity;
  • life story;
  • analysis of narratives;
  • nursing

Abstract

  1. Top of page
  2. Abstract
  3. Introduction
  4. The study
  5. Findings
  6. Discussion
  7. Conclusions
  8. Acknowledgements
  9. Funding
  10. Conflict of interest
  11. Author contributions
  12. References

Aim

To explore how people with Alzheimer's disease present their life story.

Background

Life story work is a key concept in a person-centred care. An important aspect in understanding the subjective experience and supporting the identity of people with dementia is to listen to their life stories.

Design

A narrative design with interviews was used.

Method

Nine participants with Alzheimer's disease were encouraged to tell about their lives from childhood, adult life, to present life and about their thoughts on the future. The interviews were conducted between September 2010–March 2011 in the participants' homes, with their spouses present and were analysed with a method for analysis of narratives.

Findings

Contentment, Connectedness, Self-reliance and Personal growth were identified as core dimensions in the participants' life stories and shown like threads throughout life, from childhood, adult life to present life. All participants expressed an overall contentment with life, and connectedness was related to their relation with significant persons and to be included in the local community. Self-reliance was expressed as a strong confidence in the own ability and an overall curiosity throughout life as a sustained quest for personal growth.

Conclusions

It is important for healthcare professionals, who work with people with dementia, to understand that people with Alzheimer's disease can maintain an overall trusting and hopeful approach to life. It is also important to use life story work to enhance feelings of being connected to the world and thereby support their identity and sense of self.

Why is this research needed?

  • It is important to further develop the knowledge about how people with AD present their life story, since life story work is a key concept in a person-centred care.

What are the key findings?

  • People with AD can reflect on their life and anticipate their future.
  • Life stories narrated by people with AD express a fundamental positive life tone.
  • People with AD maintain their quest for personal growth throughout the course of the disease.

How should the findings be used to influence practice?

  • When collecting life stories, the predefined areas, childhood, adult life and present life, where significant persons, places and events are included, can be used as framework to facilitate the storytelling.
  • Providing support to enhance feelings of contentment, connectedness, self-reliance and personal growth can facilitate people with AD to maintain their identity.

Introduction

  1. Top of page
  2. Abstract
  3. Introduction
  4. The study
  5. Findings
  6. Discussion
  7. Conclusions
  8. Acknowledgements
  9. Funding
  10. Conflict of interest
  11. Author contributions
  12. References

Previously, the understanding of living with dementia was built on a biomedical model based on symptoms and neurological explanations, and the subjective experience of the person with dementia was overshadowed by the concentration on identifying their cognitive and functional shortcomings (Hubbard et al. 2003). Often, information from proxies, as informal and professional caregivers was used to understand people with dementia (van der Roest et al. 2007), as it was assumed that information from those affected by the disease themselves was unreliable because of their cognitive and functional decline (Aggarwal et al. 2003). Gradually, there has been a change and today, there is an extensive field of research where people with mild-to-moderate dementia describe their subjective experiences of living with dementia (Gilmour & Huntington 2005, Langdon et al. 2007, Preston et al. 2007, Parsons-Suhl et al. 2008). An important aspect in understanding the subjective experience and supporting the identity of people with dementia is to listen to their life stories.

Background

Studies describe how people with dementia strive to balance adjusting to changes in life caused by the disease and maintaining their identity, while constructing new dimensions of self (Holst & Hallberg 2003, Steeman et al. 2007, MacRae 2008, Beard et al. 2009). Caddell and Clare (2011) describe this as the participants being in a state of flux, simultaneously experiencing both continuity and change in their senses of identity. This applies not only in the early stages of the disease, as studies have shown that even people with severe dementia can express persistence of identity and self (Tappen et al. 1999, Beard 2004).

The importance of maintaining a sense of self for people with dementia can be understood from a social constructionist theory, where language is of importance. Language skills can influence the organization of thoughts and experience, and thereby the creation of social reality (Gergen 1985). The sense of self and the concept of selfhood are closely linked to personal identity (Harre & Gillett 1994) and include the story of our lives and the multiple social identities constructed in cooperation with others (Sabat & Harré 1992, Sabat & Collins 1999). The identity itself takes the form of a story, with settings, scenes, characters, plots and themes. Life stories are psychological constructions, co-authored by the persons themselves and the cultural context wherein their life is embedded and given meaning. People select and interpret certain memories as self-defining, providing them with a privileged status in their life story, while others are found to be not as important. Given this process, identity can be seen as a product of choice. People choose the events that they consider most important for defining who they are and providing their life with meaning and purpose (McAdams 2001).

According to Linde (1993), there are two criterions to be fulfilled in a life story. First, a life story should include some evaluative points, which communicate moral values of the narrator. Secondly, events included in a life story should have a special meaning and be of such significance to the narrator that it can be told and retold throughout life. Polkinghorne (1996) describes self-stories as a way of providing unifying identities to people's lives by gathering their past actions and events into a meaningful story. The life stories include material from a person's birth through the present and into their future. At any particular time, people are in the midst of their life story, which is also true for people with dementia. What has happened to them in the past cannot be changed, although future events may change the importance of certain events from the past and the imaginations of how the rest of their life will look like. Life story work is seen as an important part of a person-centred care and is a common intervention in the care of people with dementia. The work can be described as a way to collect significant aspects of a person's past and present life and should be seen as an ongoing process rather than something that is done once, to preserve identity and a sense of self among people with dementia (McKeown et al. 2006). Life stories of people with dementia are often collected through family members (Subramaniam et al. 2014) and is usually documented in a life story book, including the person's experiences and achievements, together with photographs and written stories about important events in the person's life (Webster & Fels 2013).

It is advantageous to start the life story work in an early stage of the disease, when people themselves can narrate their story (Clarke et al. 2003, Meininger 2005) as dementia can affect language (American Psychiatric Association 2000). People with dementia can experience difficulties in finding words and in following and participating in complex conversations with other people (Warchol 2006, Hydén & Örulv 2009). In addition, awareness and attention might fluctuate and they may experience lapses in concentration (Downs 2005). When people with dementia reach the stage where language and concentration is affected, this may impact their ability to narrate their life story. It is important to let people in an early stage of the disease narrate their story, as this increases the likelihood that it is the person's own life story that is reflected and not the story of their life as interpreted by family members or staff. This is even more important in a person-centred support. A deepened knowledge of how people with dementia view themselves and their life enhances the possibilities to support them to maintain a meaningful life.

The study

  1. Top of page
  2. Abstract
  3. Introduction
  4. The study
  5. Findings
  6. Discussion
  7. Conclusions
  8. Acknowledgements
  9. Funding
  10. Conflict of interest
  11. Author contributions
  12. References

Aim

To explore how people with Alzheimer's disease (AD) present their life story.

Design

In this study, narratives are used both as a theoretical concept and as a qualitative method to explore the stories that the participants tell about themselves and their life. Narratives are about creating coherence and make sense of experiences in life. The stories people tell about their lives are situated in a social, cultural and historical context (Holloway & Freshwater 2007).

Participants

The inclusion criteria were that the participants had a diagnosis of AD, were living in their own homes and were involved in the MemoryLane project (www.memorylane.nu). The participants were recruited through a geriatric clinic, healthcare centres and through advertisements in local newspapers. Five women and four men (= 9) aged between 60–81 participated and their score on the Mini-Mental State Examination (MMSE) (Folstein et al. 1975) ranged from 19–25. All participants lived in their homes in northern Sweden, together with a spouse, with the exception of one woman who was a widow and lived alone and they were all retired. Previous professions for the women were as follows: two teachers, an executive secretary, a postal teller and a utility worker. For the men, previous professions were as a physician, a salesman, an engine worker and a factory worker.

Data collection

Individual narrative interviews were collected between September 2010–March 2011 and conducted by the first author, who is a trained geriatric nurse and a PhD student. The interviews were conducted in the participants' homes (Hellström et al. 2007) and they were given time to narrate at their own pace (Bourgeois 2002) about their life in the predefined areas from childhood, adult life, to present life and include significant persons, places and events in their stories, as well as their thoughts on the future. To support and function as a vicarious storyteller, (Hydén & Antelius 2011) the spouse, and in one case, a daughter, was present during the interview and encouraged not to interfere in the storytelling, except when the participant needed help finding words or help with filling in forgotten details to continue their story. Each interview lasted an average of 1-hour and was audio-recorded. The interviews were transcribed verbatim and non-verbal expressions were also documented, such as laughter, sighs, hesitations, and utterances from the spouses and the daughter.

Ethical considerations

The study was approved by a Regional Ethical Review Board for research. To ensure that the participants understood the aim with the study, a terminology familiar to the participants was used (McKeown et al. 2010) and they were informed that they could withdraw from the study at any time. All participants gave their written informed consent to participate.

Data analysis

The interviews were analysed by the first and last author with a method for analysis of narratives (Polkinghorne 1995). In line with the methodology, the analysis focused on what the stories communicated. Events, happenings and actions were drawn together and integrated into a temporally organized whole, a process which Polkinghorne (1995) refers to as a narrative configuration. A paradigmatic analysis of the narratives was conducted where common themes and conceptual manifestations among the individual stories were identified (Polkinghorne 1995). The interviews were transcribed verbatim and thoroughly read to provide a sense of what the individual life stories were about. In this process, significant content in the stories was identified in the areas of how the participants presented themselves, how they narrated about their childhood, adult life and present life, and their thoughts on the future. In the aggregated analyses, where all stories were considered as one text, themes were identified, which were compared, revised and interpreted. Thereafter, all the individual stories were reviewed to determine if they included these themes. The aggregated analysis resulted in four themes, which were considered as core dimensions in life and were shown like threads throughout life in all the participants' life stories.

Rigour

The interviews were conducted by a Registered Nurse and doctoral student with prior experience of interviewing people with AD. The initial data analysis was made independently by the first and last author, and in this process, the interpretation was checked with the original text. Findings were then compared and discussed until agreement on the interpreted dimensions was mutual. Regular discussions were also held in the whole research group to review and agree on the interpretations. These strategies support the credibility and dependability of the study. Throughout the study, an audit trail was undertaken including reflective notes, which further increased the trustworthiness of the study (Polit & Beck 2012).

Findings

  1. Top of page
  2. Abstract
  3. Introduction
  4. The study
  5. Findings
  6. Discussion
  7. Conclusions
  8. Acknowledgements
  9. Funding
  10. Conflict of interest
  11. Author contributions
  12. References

The nine participants could easily narrate the story of their life, although some of them found it difficult to include certain details due to memory loss. Their stories from childhood, adult life, to present life included four core dimensions that emerged as threads in all the stories, which were identified as Contentment, Connectedness, Self-reliance and Personal growth.

Contentment

One core dimension throughout life was an overall contentment with life and the way life had unfolded, which overshadowed stories about despondency and grief. When the participants looked back on their life, they all seemed to have come to a sense of reconciliation where their enduring feeling was an overall gratitude to life. Many of them had grown up under poor conditions, but when they talked about their childhood, their voices were filled with tenderness and they described this part of their life as a time filled with joy and happiness: ‘I think we had a very nice childhood… It was an idyllic setting… Now when I look back I think it was fantastic. We were 10 siblings… three of my brothers had to share the mattress… but I never felt that we were poor… there was nothing to compare with….’ With reverence and respect, one woman told about her mother's skill in making ‘the most out of nothing’ to make the poverty of the family less obvious.

The overall sense of contentment seemed to be associated with how well the participants had accepted prevailing circumstances and adjusted their own desires and expectations of life to the expectations and requests from others. An example was the choice of profession that for some was not much of a choice, but rather an acceptance of what was available at the time. One man told of how he had a decent job, which he mostly enjoyed, even if it not was what he had dreamt of or hoped for. For others, having a professional career of their own had been a strong desire. One woman said: ‘I worked when we were newly married… but after we had our children my husband wanted me to be at home… even if I wanted to continue to work I also knew that I was needed at home… and then it became so….’ This was a recurrent theme in her story and accepting her fate seemed to have left a string of disenchantment in her.

Despite the overarching feeling of contentment, there were, in all stories, also signs of both grief and sadness deriving from emotionally stressful situations in the participants' lives. They told about how they had been exposed to traumatic events, such as unexpected losses of family members or other tumultuous incidents. One woman returned several times to a trauma she had experienced as a child, which seemed connected to feelings of both guilt and grief, feelings she seemed have harboured throughout life.

When the participants were encouraged to talk about how they experienced their present situation, there were expressions of both sadness and despondency. A sense of living in another world, that life was tough and many blue feelings. One man narrated: ‘Well… life is fine but…. I know that I am annoying my wife a bit because… I'm like a child I suppose… I do not know what I shall occupy myself with … so now and then I get on the bike for a while so she can have some respite…’

Two of the participants had to accept an early retirement due to the disease, and to both of them, this seemed to have brought feelings of disappointment and sadness into their lives. They were disappointed not only by the lack of support from their employer but also by their former colleagues, whom they felt had abandoned them.

Even if feelings of disenchantment and sadness derived from personal experiences throughout life were abundantly present in the stories, they did not let these feelings overshadow their overall approach to life. Statements like: ‘I have nothing to complain about’ were common and despite her present problems, one woman said that for the moment she was experiencing the best time of her life: ‘…I feel that it has been a good life and positive and everything… of course I have had my bruises in life… haven't we all… but that is nothing… It is the best life I ever had… it is just that obvious that there is nothing else to say….’ Other expressions, such as: ‘I have always felt harmonious and grateful to everything life has given me’ and ‘thanks rich life’ can be seen as reflecting an overall gratitude and contentment with life.

Connectedness

The core dimension connectedness seemed to bring a special dimension into the participants' lives. The sense of being part of a larger community of people seemed to counteract feelings of estrangement, while the connectedness with family and significant persons provided a great source of joy. Many expressed a deep gratitude for being loved by parents as a child and one woman described how much joy and happiness her children and grandchildren brought her: ‘I live for and want to be there for my children and grandchildren.’ Another spoke warmly about his grandmother, with whom he spent most of his summer during childhood. To one woman, the people in her home village had a special place in her heart: ‘… there is a great solidarity here in the village… there is never anyone who are foes… everyone is so kind… I find a great consolation in having these people around me….’

The dimension of being a social person in the community was another important aspect of connectedness. All participants were engaged in creative activities that brought a sense of connectedness, such as choir singing, playing music and dancing: ‘… I don't know them all but there are very nice people who are participating [in the choir] and that's why I enjoy being there… it doesn't have to be that extraordinary or so… it can just be simple and you just say hallo to each other….’ One woman was well known and very appreciated and respected in the village, both due to her former profession and through her adventurous life. She said: ‘I like it here. I feel that I am familiar with many people… anyone I meet says ‘but hi there’ and wants to chat with me… so I think I am cherished by most of them… definitely… such things I notice….’

Nature was another source of a sense of connectedness. Many of the participants had interests that gave them close encounters with nature. One man narrated: ‘…there is a place famous for its great fishing … it is incredibly beautiful … it has a special meaning to us… we never bring any fishing equipment… [laughs]… we just enjoy ourselves and relax… light a fire and have a beer…’ Another expressed her experience of and desire to be close to nature: ‘…In the case of mountain trips… I have done a lot of skiing in the mountains…I almost forgot… and I have slept in teepees… and… I am an outdoor woman… I am nearly almost outside…’

The significance of the place where the participants were born was manifested in different ways in their stories. One woman described her home village as the best place on earth: ‘Even if I have been travelling all around the world… it is the place where you [are born]…this is home to me…’ For others, it was expressed as nostalgia for the place they were born and have grown up and seemed connected to joyful memories from their childhood: ‘…My home village is close to my heart and I often wish I was there… you know I would really like to move back there where I am familiar with the church and the people…’

Self-reliance

The stories revealed that the participants seemed to have managed to cope with life in both prosperity and adversity. All participants expressed a strong confidence in their own ability and a perception of being able to handle most situations. They all talked about properties and areas of their life they were proud of. Some told about how they were good at school and learned easily: ‘I actually had good grades in school, if I may say so myself … but sometimes I got a bit bored because I already knew everything…’ Others talked about how they succeeded in their career. With pride in her voice, one woman described how she felt that she had done a good job as a teacher and that she never had any problems with pupils. A former salesman, to whom his work had been an important part of his life, said: ‘You had all the responsibility to make the best of the situation… and I think I have succeeded in every way …and the most important was that you had to never forget a costumer….’ Self-reliance was also expressed when the participants talked about their current situation. Memory loss due to AD did not seem to be a problem to one woman: ‘Actually… I must say I remember everything quiet well, what we have done my husband and I… so that is not a problem.’

To have the ability to continue doing things as before seemed to be taken for granted and nothing the participants reflected much on. In their stories, self-reliance seemed connected to a sense of independence. Some expressed a strong self-confidence and narrated that they were able to do whatever they wanted. With strong conviction, one woman stated: ‘There is nothing stopping me.’ Even if the participants had a strong belief in their own abilities, they were also aware about life's unpredictability and that life is not infinite: ‘You just wait and see… you never know how long you can be… fairly it is just that…. I just think that… it is not much time left… you have to seize the day while you can…’ Another emphasized her own responsibility to make the best of what it was left of life: ‘no one else can fix my future.’ Along with a strong belief in their own ability and an insight that life is not infinite, there were also narrations about how the disease had a major impact on the participants’ daily lives. Some spoke about their dependency on their partner, as the woman who talked about how her husband had become her vicarious memory: ‘I am at the mercy of my husband [laughs]… more and more… even my memory he takes care of nowadays … he knows me better than I know myself after all our … 56 years together… [laughs]….’ To others, the disease contributed to feelings of insecurity and limitations in their daily activities. One man was advised by his doctor not to drive, which he experienced as a great loss and a threat to his independence. But, he was aware of the risks of not obeying the physician's advice: ‘It has been a year and half now… I would really like to [drive] and you have to take it damn careful… but if anything happens you stand right there….’ Awareness was also shown in relation to forward planning. One woman explained how holidays during the summer were no longer an option for her and her husband, since she then had to arrange for someone to look after their garden.

To one woman, the disease contributed to self-accusation, when she realized that she could not remember as before or had difficulties with finding the right words: ‘I am bad… at talking properly… maybe it follows with the disease… before I used to talk and got it out what I wanted to say but… now it is irritating… it does not sound good what I am saying…’ The participants’ self-reliance seemed to have persisted throughout life and contributed to a sustained faith in themselves despite adversity and the impact of the disease.

Personal growth

The quest for personal growth seemed connected to a persistent curiosity throughout life and connected to the fundamental human quest for development. Some participants talked about how they had enjoyed their time in school and the privilege to learn. One woman said: ‘…Ever since I was a child I have been curious…’ and another commented on her overloaded bookshelf by saying ‘Well… since I have been curious all my life I have to buy books now and then… maybe I get something more into my head….’

The privilege of having interesting and fulfilling work seemed to be an important aspect of personal growth for some participants, and their stories were filled with expressions on how they appreciated their work and how much it had meant to them.

The participants also mentioned how they held on to daily routines and continued to do activities they enjoyed. For instance, all of them had different leisure activities they were practising and engaged in, which seemed to bring meaning and satisfaction into their lives. Many appreciated spending time with nature; some found great pleasure in handicrafts, such as knitting and carpentry, and one was exercising regularly at the gym. To continue life as usual seemed to be a way to fight the disease and an opportunity to continue to experience personal growth through new experiences.

Visiting foreign countries and exploring unknown places were common interests among the participants and can also be seen as an expression of curiosity and a quest for personal growth. Some had travelled extensively through life, such as the woman who narrated: ‘I've been out in the world… in various places… I have been in Tanzania, Kenya… I can list a bunch of places… it was absolutely amazing to be with the animals and all the beautiful flowers… and it was exciting when animals came up that you do not really want to see up close…’

Others preferred to make trips in the local area and the willingness and desire to discover new places was still pronounced. One woman revealed her lifelong dream of visiting America: ‘Surely it would be fun to go there, but at the same time… no… I do not know if I want to go that far… it might wake up my wanderlust…’ The ongoing quest for personal growth seemed to contribute to a never-ending desire to gain new experiences.

Discussion

  1. Top of page
  2. Abstract
  3. Introduction
  4. The study
  5. Findings
  6. Discussion
  7. Conclusions
  8. Acknowledgements
  9. Funding
  10. Conflict of interest
  11. Author contributions
  12. References

The aim of this study was to explore how people with AD present their life story. The core dimensions Contentment, Connectedness, Self-reliance and Personal growth appeared as threads throughout life, from childhood to present life.

In the stories, the participants talked about significant episodes that forever had coloured their lives. This is similar to the findings of Westius et al. (2009), who found that the view of life among persons with dementia influenced which memories they included in their life story and how these memories were interpreted. The stories people construct to make sense of their lives are described by McAdams (2008, pp. 242–243) as: ‘a struggle between reconciling who they were, who they are and who they might become in their head and bodies, with who they were, are and might be in the social contexts of family, community, the workplace, ethnicity, religion, gender, social class and culture’.

The core dimensions Contentment, Connectedness, Self-reliance and Personal growth found in this study reflected an overall trusting and hopeful approach to life. It can be seen as the participants having an optimistic life tone, as described by McAdams (1993). The participants' stories contained both positive and negative memories, but it seemed like they had transposed their negative memories into themselves and managed to maintain a trusting and hopeful approach to life. According to McAdams (1993), our narrative tone is developed in early childhood, while our narrative identity and approach to life is developed throughout life. Thereby people develop a life tone that prevails in their life stories, which means that the stories can reflect either optimism and hope, or mistrust and resignation (McAdams 1993). Even if a person's narrative tone originates from early childhood, an underlying positive or negative belief in the possibilities of human intention and behaviour can be altered. Maturation, major life events and social interactions may have an impact on the extent to which the traces of a relatively hopeful or hopeless perspective on life are maintained (Polkinghorne 1996).

The findings in this study can also be viewed in the perspective of Erikson's (1982) life span model of human development. The model includes eight stages, where each stage is associated with an inherent conflict that the person must encounter and resolve to proceed with development. To attain wisdom, the conflict between integrity and despair in the last stage of the life span model must be solved. This stage includes the acceptance of oneself in the past, present and future. The participants presented their life stories from the perspective of being older, reflective and mature. From childhood to an anticipated future, personal growth and development was one of the core dimensions that characterized their storytelling.

Life story work has been used in different ways and with different purposes, but is mainly seen as part of normal ageing and a way for older people to look back and get perspective on their life. It provides an opportunity to process previous conflicts, grief and losses, forgiveness for themselves and others, to celebrate success and reach a stage of reconciliation (Kunz & Gray Soltys 2007). Narrating the story of our life can be seen as a way to sustain a sense of self and define our own identity (Hydén & Antelius 2011), which are assumptions in line with the findings in this study.

The participants in this study had memory losses, communication problems and other symptoms related to AD, but the stories they told about their lives were characterized by a mature and reflective perspective. Storytelling about life is a way for people with dementia to construct and express meaning in their lives and has an important impact in helping people identify themselves (Angus & Bowen 2011) and sustain identity over time (Hydén & Örulv 2009, Westius et al. 2010). Viewed from an existential perspective, dementia can pose a threat to a person's sense of self, as the progress of the disease might gradually affect a person's ability to maintain connection not only to the self but also to significant persons, places and events, which might lead to feelings of homelessness and not being connected to the world (Zingmark 2000).

Limitations

The findings in this study reflect core dimensions in life expressed in the unique life stories of nine persons and might therefore not represent core dimensions in life among people with AD in general. The predefined areas in the interview could have led to important areas in the participants' life stories being left out and the partners present might have prevented them from narrating as freely as they wanted. However, the narrations were rich and the impression was that both the structure of the interviews and the presence of the partners were more of a support than a hindrance.

Conclusions

  1. Top of page
  2. Abstract
  3. Introduction
  4. The study
  5. Findings
  6. Discussion
  7. Conclusions
  8. Acknowledgements
  9. Funding
  10. Conflict of interest
  11. Author contributions
  12. References

The findings in this study indicate that stories about life told by people with communications problems and other symptoms related to AD reflect an overall trusting and hopeful approach to life. Their narrations were characterized by a mature and reflective perspective on life, and a conclusion that can be drawn from these findings is that it is important to support people with AD to maintain this perspective on life as far as possible. Life story work, where people with AD are encouraged to include significant persons, places and events in their stories can be an important way to maintain a positive view on life. This can enhance feelings of being connected to the world and thereby support their identity and sense of self.

Acknowledgements

  1. Top of page
  2. Abstract
  3. Introduction
  4. The study
  5. Findings
  6. Discussion
  7. Conclusions
  8. Acknowledgements
  9. Funding
  10. Conflict of interest
  11. Author contributions
  12. References

We sincerely thank all the participants for having the privilege to listen to the story of their life. We also thank the spouses and the daughter, which by their presence and humble way contributed to a relaxed and friendly atmosphere during the interview and thereby facilitated the storytelling.

Funding

  1. Top of page
  2. Abstract
  3. Introduction
  4. The study
  5. Findings
  6. Discussion
  7. Conclusions
  8. Acknowledgements
  9. Funding
  10. Conflict of interest
  11. Author contributions
  12. References

The MemoryLane project was partially funded by the e-Health Innovations Centre at Luleå University of Technology and by the European Regional Development Funds (Mål-2). The Dem@Care project is partially funded from the European Union Seventh Framework Programme (FP7/2007-2013) under grant agreement no. 288199.

Author contributions

  1. Top of page
  2. Abstract
  3. Introduction
  4. The study
  5. Findings
  6. Discussion
  7. Conclusions
  8. Acknowledgements
  9. Funding
  10. Conflict of interest
  11. Author contributions
  12. References

All authors have agreed on the final version and meet at least one of the following criteria [recommended by the ICMJE (http://www.icmje.org/ethical_1author.html)]:

  • substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data;
  • drafting the article or revising it critically for important intellectual content.

References

  1. Top of page
  2. Abstract
  3. Introduction
  4. The study
  5. Findings
  6. Discussion
  7. Conclusions
  8. Acknowledgements
  9. Funding
  10. Conflict of interest
  11. Author contributions
  12. References