Sense of Self among Persons with Advanced Dementia

,; Norberg, Astrid; ,

doi:10.15586/alzheimersdisease.2019.ch13

Cited by 16 publications

(24 citation statements)

References 102 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The deterioration in cognition, emotion, behavior and functioning that occurs, in what is noted by the ICD-10 as a syndrome, usually of a chronic or progressive nature, is associated with an erosion of personhood and identity, and by extension, autonomy and competence in decision making. ( 15 ) The loss of identity—of a shared self, is recognized by some sociologists, including Brijnath and Cohen as a living death, or the first of the two deaths the person with dementia and their family must undergo ( 7 , 12 ).…”

Section: Identity End Of Life Care and Physician Assisted Deathmentioning

confidence: 99%

“…Of these stakeholders, however, the least autonomy (and associated decision making capacity) often rests with the person with dementia, sometimes contemporarous with late stage dementia and end of life care ( 11 ). The potential for erosion of autonomy may indeed be more so in dementia than other terminal illnesses due to the inevitable decline of decision making capacity with the progression of the disorder ( 15 ).…”

Section: Identity End Of Life Care and Physician Assisted Deathmentioning

confidence: 99%

“…While a large part of such an appreciation of the self-occur reflexively and often outside awareness, these nevertheless require a continuous utilization of cognitive resources. These cognitive resources also track the emotions, behavior and biological functions that the self-experience and constantly process and respond to them ( 15 ).…”

Section: The Self In Dementiamentioning

confidence: 99%

See 2 more Smart Citations

Does Alice Live Here Anymore? Autonomy and Identity in Persons Living and Dying With Dementia

D’cruz

2021

Front. Psychiatry

View full text Add to dashboard Cite

Conventional scientific definitions of dementia, or its newer proposed alternate—neurocognitive disorders place emphasis upon cognitive function, particularly memory. The changes in thought, emotion, behavior, personality, and biological function are usually considered only of secondary importance. At the core of the illness, however, lies a progressive loss of self, and by extension, of personhood, identity, autonomy, and agency. The identity of the person living with dementia, and the deterioration of a sense of self assumes significance in planning end of life care, including palliative care. A consideration of self and identity is also significant where physician assisted death, incorporating euthanasia, has legal sanctity. As dementia progresses, there is usually a progressive loss of personal decision making capacity and legal competence. Shared decision making, advance care directives and proxy representatives are options available to safeguard autonomy and agency in such cases. Advance care directives are often treated as static documents. The loss of self and deterioration of identity in persons with dementia means, that there is a psychological discontinuity across time and space, though biological continuity is retained. The discontinuity in self and identity however, imply that the person with dementia changes considerably and so too may values and beliefs. A document which best reflected the wishes of the person with dementia in the past, may not always do so now. Advance directives and proxy representatives may need to be dynamic and evolve over time, particularly where end of life care and physician assisted death is being invoked.

show abstract

Section: Identity End Of Life Care and Physician Assisted Deathmentioning

confidence: 99%

Section: Identity End Of Life Care and Physician Assisted Deathmentioning

confidence: 99%

Section: The Self In Dementiamentioning

confidence: 99%

See 1 more Smart Citation

Does Alice Live Here Anymore? Autonomy and Identity in Persons Living and Dying With Dementia

D’cruz

2021

Front. Psychiatry

View full text Add to dashboard Cite

show abstract

“…This may of course be extremely challenging as in the case of dementia, where there is a 'loss of self' and other parts of the person, when symptoms like amnesia, agnosia, aphasia and apraxia, etc., are present. However, research in the field, even in the case of advanced dementia, gleans qualitative reports of feeling "still the same" as before its onset, and for ensuring optimal care, strongly advocate that of "utmost importance is that other persons understand that persons with advanced dementia still are persons and support them to feel valuable" (Norberg 2019). Thus, the personal can be understood as relative individuation within the whole and is to be cultivated rather than conflated with the ego, as it implicitly is, in OAT's conventional interpretation.…”

Section: Personal Perspectival Awarenessmentioning

confidence: 99%

The Significance of ‘the Person’ in Addiction

Hurley

2021

Religions

View full text Add to dashboard Cite

Van Gordon et al. outline the classification of their Ontological Addiction Theory (OAT), including its aetiology and treatment. In this review article I will from an appreciative perspective question some of its fundamental assumptions by presenting an alternative view on the ontology of ‘the person’, as distinct from its presently assumed conventional conflation with a contracted separate egoic self. I will propose this view as structurally and ethically significant for the ‘embodied’ experience of a reconstructed “dynamic and non-dual self”, as cultivated in their treatment. Rather than this reconstructed self simply being socially desirable for functional purposes, I will underscore the meaning-generative case for ontological status, in the absence of which, a pervasive ‘sense of lack’ is evident, with all attendant individual, psychological, social, ecological and ethical implications. This article brings a developmental psychology perspective to bear in appreciating ‘personhood’ as an emergent, progressively realised and is thus similarly aligned with the intent of OAT in overcoming egoic addictive suffering. This mapping of the territory however populates a blind spot in OAT’s diagnosis by affirming unique personhood, a quality of ‘integrative presence’, meaningfully understood as a psycho-spiritual ontological reality. It offers, as with OAT’s stated intent, the merit of avoiding attendant mental health and developmental pitfalls, which can beset what we may discern as an implicit transcendental reductionist assumption operative in OAT, where ‘the many’ are reduced to ‘the One’ and there are, it is assumed, no real many. This framing is resonant with the lived experience of healthy ‘individuation’, a process distinct from the problematic phenomenon of ‘individualism’, evidenced by the empirical data on post-conventional human development, which potentially provides diagnostic markers for any optimal treatment discernment. It is also attuned to what many recognise as a contemporary Fourth Turning in Buddhism, in its conscious evolutionary recognition of the emergence in non-dual states of a ‘unique personal perspective’, and/or a relative individuation within the whole. This differentiation has formerly been interpreted through an ‘impersonal’ lens as an egoic holdover, and potentially inhibits ethical action in the world, as distinct from the ethical import and potential fruits stemming from the ontological affirmation of the person.

show abstract

“…Osobná identita je v ich predstave tripartitná, pozostáva z troch na sebe navrstvených súčastí. Rovnaký teoretický základ vyuţívajú viaceré štúdie osobnosti ľudí s demenciou, ktoré boli publikované v poslednom čase (Hampson -Morris 2016;Hedman et al 2013;Kristiansen et al 2017;Norberg 2019;Skaalvik et al 2016). Ich zistenia ukazujú, ţe u ľudí s miernym aţ stredným kognitívnym narušením zostáva najhlbšia z vrstiev identity zachovaná, zatiaľ čo ostatné môţu byť progresívne narušené.…”

Section: Sociálne Vytváraná Osobná Identitaunclassified

Harrého identita u ľudí s Alzheimerovou chorobou: spomienky na miesta a vzťahy

Chlebišová¹,

Ondoš²,

šušaníková³

et al. 2020

sociologia

View full text Add to dashboard Cite

Rochovská Katedra ekonomickej a sociálnej geografie, demografie a územného rozvoja, PriF UK; Katedra farmakognózie a botaniky, FaF UK, Bratislava Harré's Selfhood in People with Alzheimer's Disease: Memories of Places and Relationships. Increasing share of elderly people in aging population affects all categories of age and social sectors. Society responds to the situation through a necessary change in social area and growing importance of social care for the elderly people. Number of factors determine quality of life in older age, including how they succeed in construction of the new self. Decreased frequency, intensity and diversity of personal interactions often lead to social exclusion. Loneliness is among the most serious concerns in older generation. Deeper levels of a multi-layered selfhood are less affected by the disrupted social construction, which one observes among the older people. It seems that the anchoring of personal identity in place and relationships grows in significance as people age. We investigate construction of selfhood from fragmented memories of people with Alzheimer's disease. Even in conditions of severely affected independence in everyday life we are finding a rich memory, which reflects their personal relationships linked to the places of past. Source observations use a qualitative probe of five clients in a specialized facility for the people living with Alzheimer's disease. We discuss our findings in the context of research focusing on social aspects of aging and the changing meaning of gradually lost memory.

show abstract

Sense of Self among Persons with Advanced Dementia

Cited by 16 publications

References 102 publications

Does Alice Live Here Anymore? Autonomy and Identity in Persons Living and Dying With Dementia

Does Alice Live Here Anymore? Autonomy and Identity in Persons Living and Dying With Dementia

The Significance of ‘the Person’ in Addiction

Harrého identita u ľudí s Alzheimerovou chorobou: spomienky na miesta a vzťahy

Contact Info

Product

Resources

About