Unyielding selflessness: Relational negotiations, dementia and care

This article addresses how couples within care relationships engage in negotiations when mutual selflessness is the relational starting point. Evaluation of hypothetical dementia care scenarios offers insights into pressures upon joint decision-making. Strategic interaction models such as ‘the prisoner’s dilemma’ focus on how a person’s pursuit of self-interested preferences might be impeded by the self-interest of another person. Scrutiny of negotiations within care relationships demonstrates that selflessness can also present significant challenges, as combined strategies of altruistic intent mean that neither party is able to prioritise the other person successfully. Moreover, sociocultural pressures associated with illness and care mean that alternative strategic options are difficult to pursue. Care deliberations, predicated on mutual selflessness, can therefore present a static and unyielding interactional context for both parties to endure. The exploration of relational negotiations highlights the requirement to understand the complex breadth of factors that shape experience. This can accordingly enhance academic understandings of the relational basis of dementia and care, as well as informing the approaches of policymakers.