Brains, minds and selves: Changing conceptions of the losses involved in dementia

Abstract

Until the last 10 years or so, dementia research had been dominated by the psychiatric or medical approach to dementia. However, increasing numbers of new psychological and social psychological approaches to dementia have begun to emerge. Consequently, there has been a significant change in the descriptions of the losses involved in the dementing process: from being represented in terms of brain functioning, they have become repositioned as occurring within both personal and social contexts. We elaborate these frameworks and apply them to three phenomena associated with dementia--depressions, delusions and denial. While these conceptualizations are limited by a number of difficulties, they nevertheless represent a significant change in approaches to dementia care and allow the potential for positive change through psychological as well as chemical means. The emergence of these new accounts of the losses involved in dementia needs to be matched by the equivalent development of effective psychosocial interventions to maintain individuals within their own homes.

How to evaluate quality of care from the perspective of people with dementia: An overview of the literature

“…Use of a proxy in measuring quality of care from the perspective of a person with dementia can be legalized when the person with dementia, due to severe cognitive deficits, cannot reliably report on internal states and lacks 'insight' (Cheston & Bender, 1999). However, Continue to show interest in the person with dementia after the more formal part of the interview has finished if a lasting positive impression is to be created, and a 'hit and run' approach should be avoided at all costs (Clarke & Keady, 2002).…”

Computerized Structured Cognitive Training in Patients Affected by Early-Stage Alzheimer's Disease is Feasible and Effective: A Randomized Controlled Study

“…Amongst them, Alzheimer's disease (AD) is the most common form of dementia, and it accounts for an estimated 60-80% of all cases. AD affects the patient, their family and their wider social network through its deep impacts at cognitive, behavioural and social levels (Cheston & Bender, 1999;Dourado et al, 2014). Clinical manifestation of AD typically includes significant neuropsychological deficits such as memory problems, frequently associated to other cognitive deficits such as aphasia, apraxia and/or agnosia, that significantly interfere with everyday life (McKhann et al, 1984;.…”

Psychotherapeutic work with dementia sufferers

“…It is now widely understood that the view of dementia as a disease of the brain is only one, partial representation of this condition (Cheston & Bender, 1998). This shift away from seeing dementia simply as an organic illness has raised the possibility of engaging with people with dementia on a psychotherapeutic basis.…”

“…Much of the reported formal psychotherapeutic work with both individuals and groups has been reviewed elsewhere (e.g. Cheston, 1998). Counselling skills can be employed as part of an individualised care plan, either within a hospital ward or in the community involving carers.…”