Guiding People With Korsakoff’s Syndrome and Other Alcohol Related Cognitive Disorders in Long Term Care – An Ethnographic Study

Korsakoff's syndrome (KS) is a neurocognitive disorder characterized by executive dysfunction, behavioral symptoms, and impaired awareness. In the Netherlands, people with KS and other alcohol-related brain disorders are cared for in specialized long-term care facilities (LTCFs). However, little is known about how formal caregivers working with people with KS in LTCF guide residents in daily practice. An ethnographic study was conducted over six months in two LTCFs. Using an apprenticeship-inspired approach, a partially participating researcher observed caregivers (nursing assistants, nurses and social workers) during work shifts, with informal interviews complementing observations. Through thematic analysis conducted by three researchers, three guiding patterns were identified. Behavior-centered guidance (1) aims to promote desired behavior through clear rules and direct communication. Caregivers following this approach value being firm and consistent as a way to support residents' independence and overall quality of life. Person-centered guidance (2) focuses on building connections through care by getting to know residents and working together with them. Caregivers in this pattern value attending to and understanding residents, treating them as individuals rather than defining them by their disease. Care-task-centered guidance (3) aims to keep things on track by prioritizing the completion of household and care tasks. Caregivers following this approach are practical and rational, adjusting their methods to prioritize task flow rather than resident interaction. Although caregivers had a preferred guiding pattern, they shifted between patterns depending on the resident and varying circumstances. These findings contribute to a deeper understanding of caregiving dynamics and offers opportunities for reflection and team development within LTCFs.