“The self in dementia is not lost, and can be reached with care”

Muireann Irish

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Memorable excerpts:

Many people see memory as providing the foundation upon which a stable sense of self is constructed.

 Our autobiographical memory, in particular, seems crucial to weaving a life story that bridges past and present, and permits us to extrapolate how the future might unfold, all within a meaningful and coherent narrative.

The view that without our memories we are no longer ourselves is pervasive, and has led to the use of stigmatising language, even within the dementia-care setting, such as 

‘Loss’,

 ‘disintegration’ and

 ‘unbecoming’. 

There remains a recalcitrant perception that in parallel with the progressive pathological onslaught in the brain is the inevitable demise of personhood, akin to a ‘living death’.

Of course, people with dementia experience significant changes in their 

1-self-concept,

2- self-knowledge,

3- social relationships,

4- perception of their own capacity, and

5- even their physical appearance

. Yet the essence of the person endures

While the illness is devastating, not all memories are obliterated by Alzheimer’s, and much of the person’s general knowledge and recollection of the distant past is retained. 

There remains 

As the disease progresses and their self-concept becomes more rooted in their past,

Relatives’ knee-jerk reaction is often to ‘reorient’ the family member who has dementia, to help reconnect that person with the present.

 A classic example of this is when the person with dementia enquires where their deceased spouse is, only to be told that they have passed away and that the family home has been sold.

 While factually accurate, these efforts to correct more often than not result in extreme emotional distress, which persists long after the information itself has faded.