The conceptual framework of biographical disruption has dominated studies into the everyday experience of chronic illness. Biographical disruption assumes that the illness presents the person with an intense crisis, regardless of other mitigating factors. However, our data suggests that the lives of people who have a particular illness that is notably marked by sudden onset are not inevitably disrupted. Extensive qualitative interviews were conducted with a sample of veteran non-Hispanic white, African-American, and Puerto Rican Hispanic stroke survivors, at one month, six months and twelve months after being discharged home from hospital. Narrative excerpts are presented to describe specific discursive resources these people use that offset the disrupting connotations of stroke. Our findings suggest a biographical flow more than a biographical disruption to specific chronic illnesses once certain social indicators such as age, other health concerns and previous knowledge of the illness experience, are taken into account. This difference in biographical construction of the lived self has been largely ignored in the literature. Treating all survivor experiences as universal glosses over some important aspects of the survival experience, resulting in poorly designed interventions, and in turn, low outcomes for particular people.

No abstract

This study examines how people caring for a spouse with Alzheimer's disease reconstruct the meaning of closeness within their marriage. In-depth interviews were conducted with 13 men and 15 women. The authors discovered that significant changes in the social identity of the impaired spouse may have important implications for how caregivers view their marriage and their ability to reestablish a sense of marital closeness. The majority of caregivers experienced significant disruptions in their marriage as a result of their respective spouse's dementia. The authors further discovered that the caregiver wives in the study sample were more likely than caregiver husbands to report that perceived changes in the spouses' identity altered how they identified themselves within their marriage, leading to longer term disruption of marital closeness. The findings suggest that retaining a sense of marital closeness is often quite difficult for caregiving spouses, pointing to the need for specific types of caregiver education and support.

Findings indicate that changes in sense of self, connectedness with others, and community integration presented the major challenges.

No abstract

In this article, the authors explore the narrative production of stroke from the perspectives of survivors, that is, the stroke itself, not its implications for the individual poststroke. In the vast amount of literature on both sudden onset and chronic illness, the narrative construction of the onset of the illness, for the most part, has been ignored by social scientists, most notably in qualitative research. This is certainly true of stroke. Drawing on existing literature in both chronic illness and the body, the authors extend this to explore the phenomenological construction of stroke onset. Using data gathered from in-depth interviews with 111 stroke survivors postdischarge, they suggest three narrative mechanisms are used in the construct of the sudden-onset event itself: the use of typifications to construct the body during stroke, stroke as an internal communicative act, and stroke as a physical sensation and the mechanisms used to minimize bodily concerns.

In this article, we analyze the process of redefining marital relations within the context of couples dealing with Alzheimer's disease and related disorders (ADRDs), drawing on intensive interviews with 13 caregiver husbands and 15 caregiver wives. Men were slower to recognize the symptoms of ADRDs, with social others usually bringing the problems to their attention. They often attributed symptoms to a less-problematic cause and engaged in extended normalization of their wife's condition. Women were quicker to recognize symptoms and often noticed subtle changes in their husbands but failed to take action quickly. They were reluctant to disclose their concerns to their impaired husbands, which might have protected the husband's masculine identity and served to maintain the wife's own sense of self in relation to him. We suggest that husbands were able to normalize because the wife's symptoms did not change marital authority dynamics, but authority relations were reversed by the illness for caregiver wives.

The lessons provided by everyday functional assessment for understanding the stroke experience, as well as directions for further study, are discussed in the conclusion.