More time and effort is being spent on trying to understand the needs of an increasingly elderly population, many millions of who have varing degrees of cognitive impairment. In the early stages of Alzheimer’s disease people experience some difficulties communicating, learning, thinking and reasoning. However, most can do a lot for themselves, still enjoy goal-directed activities and take an active role in their family life. They can also tell us how they feel and what they are experiencing. But Alzheimer’s is a degenerative disease and anxiety and fear are common emotions following diagnosis and as the disease progresses.
We can learn about what it is like to have Alzheimer’s from those with the disease. Knowing what to expect can help our understanding. This can be done by:
- Reading books by people who have Alzheimer's. Poetic imagination provides a more condensed and powerful linguistic form of expression. John Killick, has written a series of poems responding to the experiences of people with dementia. Themes of alienation, pain of abandonment, fear, futility and naked terror are expressed powerfully.
- By listening carefully and imaginatively to what people with dementia say. Communication difficulties can make this time consuming and you may need to interprete what is being said. What is said may be 'conveyed in a concrete, metaphorical or allusive way'. Studies point to recurring themes such as the importance of reassurance through the company and support of others. But the central message is that the voices of people with dementia need to be heard.
- Learning from the behavior and actions of people with dementia can help us understand their experiences and their world. Tom Kitwood, a British psychologist, suggests that people with Alzheimer's use whatever resources they have available to communicate. So if we lose the more sophisticated means of action people with dementia may fall back on more basic, more deeply learned ways of behaving. This can give meaning to behavior such as aggression. So an example would be that biting another person can be interpreted literally as 'leaving a mark'. Rocking, rubbing body parts etc. as self stimulatory actions, an important part of being a human being. Research has shown that people with dementia who demonstrate severe cognitive impairment, problems with thinking, problem solving, learning, judgement, in common with all people, have higher order needs such as social contact and sensory stimulation.
- Learning from people who have had illnesses with dementia-like features, for example meningitis or even major depression. We have probably all experienced some dementia like symptoms, even if they were only brief insights. Confusion, hypnogogic hallucinations, forgetfulness and fear in delerious illnesses. Our experiences of illnesses and other life events can be a valuable source of insight into some features of dementias such as Alzheimer's.
We look beyond the purely physical and adopt a more biopsychosocial model to understand dementia, one that seeks explanations of the person’s behaviour in their environment. One that sees behavior as an expression of an unmet need.
Reducing stress in early stage Alzheimer’s can help you cope better.
Published On: November 11, 2013