Posted: September 4th, 2013
Social Context of Dementia
Social Context of Dementia
Dementia refers to a decline in a person’s mental abilities such as memory and thinking capacity. It occurs because of the physical changes that occur on the brain due to damaged brain cells. This affects the person’s ability to perform their daily tasks. Dementia also affects communication and language, ability to pay attention, visual perception, judgment, and reasoning (Duggleby et al, 2009). One of the most common types of dementia is Alzheimer’s, which accounts for 60-80% of dementia cases. Alzheimer’s affects a person’s behavior, and this has a negative effect on the person’s health and social relationships. People suffering from dementia have problems remembering things, and this makes it especially hard for those living with them. Symptoms often develop slowly, and they continue to worsen. In this review I will discuss how dementia does not only affect a person’s identity, but it also affects family, friends and the community in different ways.
People suffering from Alzheimer’s are not able to take care of themselves properly because of the limitations of their cognitive abilities. This places a huge burden on the people who take care of them. The caregivers have to ensure that patients are okay, and they cannot leave the patients alone (La Fountaine et al, 2007). Caregivers experience physical, mental, psychosocial, and spiritual stress. Some of the physical problems caused by Alzheimer’s include a decrease in the response of the immune system, high risks of developing high blood pressure and cardiovascular diseases, high rates of depression and anxiety symptoms and sleep interruptions.
Patients depend on their family members to take care of them, although some of them are institutionalized. Family members are saddened when the patient does not recognize them. Caregivers are often stressed and exhausted when taking care of patients. Some of them are in a dilemma, and do not know what to do since they have to take care of patients. This makes them feel trapped and helpless because they cannot find a solution to their problems. They have to alter their lives, and their social life changes. They do not have as much freedom as they used to since they have to take constant care of the patient (Duggleby et al., 2009).
Spouses have a hard time dealing with their partners who have dementia, especially when patients have not been diagnosed. Patients forget their partners and they forget their responsibilities. The period before diagnosis is especially challenging and trying for families. It is a period of misunderstanding, irritation, conflict, and tension in the home. Spouses do not understand why their partners have to keep forgetting things, and the patients do not understand why their partners keep blaming everything on them. Memory loss is a big problem, and the person who forgets often feels frustrated (Duggleby et al., 2009).
They have a hard time doing basic things around the house because they cannot remember. Before diagnosis, children are often irritated with the parent who has dementia and they resent them for the negative behavioral changes. Parents with dementia do not pay attention to their children. It is especially hard for children if their parents do not remember them. They do not understand why their parents have to behave the way they do, and this causes conflict in the home. It becomes worse when patients become inconsistent with their thoughts or how they talk. This inconsistent behavior is a good sign of suspecting dementia (Deliane et al., 2011).
Caregivers have a hard time taking care of patients. Despite this, many caregivers find meaning and joy when taking care of their family members. They feel devoted to them, and they feel that they have to keep hope alive. Hope is important for caregivers who are taking care of their families. This is not only the case with caregivers who are taking care of patients with dementia, but also to the caregivers taking care of patients with terminal diseases. It balances the stress the caregivers experience and maintaining their well-being. It gives them an inner strength, and they feel motivated to keep on taking care of patients. It gives them the physical and mental strength they need to continue taking care of their patients. Caregivers hope that the patient’s condition will not get worse rather than hoping that it will improve (Deliane et al., 2011).
The hope that caregivers have is more for themselves rather than for the patients. They are, therefore, concerned when this hope starts fading. They worry that they will not be able to go on, and they will not find the encouragement they need to continue. Caregivers have to find ways of renewing their hope. They talk to other family members, friends, and people who are going through the same things that they are experiencing. Caregivers learn from one another and encourage each other. Caregivers renew their hope by coming to terms with the situation. They learn more about the condition and understand it better. They learn things such as maintenance and treatment of the condition. This helps them to have a realistic view of the situation. They know what is possible, and how they can improve the patient’s condition.
Caregivers get encouraged when they know that they are doing their best to take care of patients. Once they face the situation, they begin finding positive things. Some patients are happy when they observe small changes in the patient’s condition. Any instance of positive change from the patient encourages them. They are happy when the patient’s heath does not worsen. The caregivers set short-term goals as a way of renewing their hope (Duggleby et al., 2009). Families are important, and in most cases, they provide better care giving than institutions. Having a positive relationship with their children provides patients with attachment, recognition and positive outlook (Surr, 2006).
Dementia affects a person’s identity and personality, mostly in negative ways (Surr, 2006). Before diagnosis, patients go through periods of denial, and they might convince themselves that they are not suffering from the condition. Some patients feel the need to cover up their condition, and they end up lying to their families. It may take considerable time before the patients agree to seek medical help. Caregivers may have different explanations concerning the patient’s condition. They give reasons such as stress, depression, change of environment, and old age among others. In most cases, the caregivers are the ones who seek for medical intervention, rather than the patients.
The patients do not think that there is anything wrong with them, and they may refuse to seek any medical help. The patients do not remember their actions, and they do not think that they have done anything wrong. Some of them live in denial as a way of protecting themselves. They think that everyone is against them, when people tell them things that they cannot remember. Therefore, they choose to hide their problem to avoid any negative attention for their symptoms. This affects the person’s personality because the person will find ways of lying and deceiving their families, friends, and colleagues at work (Deliane et al., 2011).
Some patients tend to contradict what they. They confuse statements since they cannot remember what they previously said. A wife may not recognize her husband. He or she may talk about past events and make them look like they are currently happening. If they are corrected and anyone suggests they are unwell, they might become violent. Some of them have to be taken to hospital under coercion. All these changes make these people look different and it changes their personality (Surr, 2006). Sometimes it becomes hard for families to accept the changes.
Patients tend to deny any mistakes they have done, cover up any deficits in their cognitive abilities, and undermine any difficulties they may be experiencing (Deliane et al., 2011). Some of the patients suffering from dementia may also become aggressive because they do not remember the people around them. They might think that the people are taking advantage of them, or that they want to harm them. Memory loss leads to behavior change, and this affects the person’s personality. He or she cannot remember the most obvious things. For instance, a mother will have a hard time in recognizing their children.
Alzheimer’s affects the community in different ways (Deliane et al., 2011). These effects may be economic loss realized from the loss of jobs once a person is diagnosed with the condition. Patients become less productive in their work. They are unable to perform the simple and routine tasks they used to, since they cannot remember the processes. They have more conflicts with their colleagues because they develop short-term memory loss. They will therefore do something, and then forget that they are the ones who had done it. This affects the work environment. The situation worsens if the management or the colleagues at work do not know of the patient’s problems. Some patient’s end up becoming stressed and depressed because of the conditions at work, and this worsens their conditions further (Deliane et al., 2011).
People in different cultures have different perception of Alzheimer’s. Some societies view dementia in a negative way. They are more likely to stigmatize people with dementia and develop negative stereotypes because they do not understand the condition (Surr, 2006). This negative perception is not good for people with dementia, and it worsens their condition. When the patients experience negative stereotypes, they tend to age more quickly, and their memory performance worsens. This is because they become upset and frustrated with their environment and treatment from people (Surr, 2006).
The stigmatization happens because people in the community find it hard to cope with dementia patients. The community isolates the patients and their caregivers. Due to the embarrassment of these patients and their caregivers, they are unable to seek formal services for help. Many patients are at home using informal treatment instead of seeking professional help. The notion of assuming it is normal for old people to have dementia is another reason for using informal treatments. A large number of these patients are dying quickly because they do not seek professional help when dealing with the condition.
The Western culture has some understanding of dementia. They know it is a medical condition brought by a number of diseases. People are also aware of services offered to dementia patients and their caregivers. The best way to begin to handle this condition is accepting the situation and to seek help. Different health institutions have helped patients and others who have sought their help. They help patients to deal with their social life and advice the caregivers on how to adjust smoothly. Some of the services relevant to dementia patients are nursing homes for old people. They are good caregivers to patients suffering from Alzheimer’s and other dementia patients. Family and friends can visit them in the nursing homes (Surr, 2006).
Some cultures mostly consider dementia as normal stage of old age (La Fontaine et al., 2007). Others view it as mental disability. Different communities have varied definitions of dementia. Generally, it is a shame to have a dementia and it is not easily accepted. This is why patients are stigmatized and some are even neglected. There is need to create awareness of this condition to educate people about it. People might change their attitude when they understand better about dementia. Some have developed negative attitudes because they just adopted the beliefs they found in the community.
The Indian communities, dementia problems are contributed by negligence of the patient and the family. It is advised that such communities should deal with family problems and overcome them. There is inadequate knowledge of dementia illness. Other physical and emotional problems are understood but there is little knowledge about dementia. This is why these communities isolate and discriminate dementia patients. Old people withdraw themselves from the rest of the community. This is why it seems acceptable to stigmatize dementia patients (La Fontaine et al., 2007).
The community should take time to understand dementia conditions and change any negative attitude towards these patients. They are part of the community and they should not be isolated. It is unacceptable for children to abandon their parents or any relative because they think they are mentally ill. Dementia should be approached with a lot of understand and support to the patients. Regardless of lack of treatment to some conditions like Alzheimer’s disease, patients can live longer. This will happen if they are given enough care by those who are with them (La Fontaine et al, 2007).
Around the world, more people that are elderly are reporting cases of dementia. People who are forty years of age are still prone but their chances are minimal compared to those who are more than sixty-five. Families with the elderly should learn more about dementia and prepare in case one of the members become affected. All people within these ages prone to this condition should also be aware of it and accept th3e changes in case they become affected. Dementia is hereditary and most probable in families, which has a history of it. People should stop viewing dementia as mental illness. This will help them eliminate the attitude of stigmatization towards the affected people (La Fontaine, 2007).
It has been observed that dementia patients lose close relationship with people. This is a common characteristic of how communities treat these patients. It is recommended that people should maintain these relationships for the welfare of the patient. He or she should continue experiencing the same kind of environment as before. However, it is difficult to maintain the environment as it was, since the rest of the family and friends become affected by the change. A family with dementia patient should seek counseling to help them cope with the changes.
Deliane, V., Vugt, E. M., Bakker, C., Koopmans, R. T. et al. (2011). Caregivers’ perspectives on the pre-diagnostic period in early onset dementia: A long and winding road. International Psychogeriatrics 23, (9), 1393-1404
Duggleby, W., Williams, A., Wright, K., Bollinger, S. (2009). Renewing everyday hop: The hope experience of family caregivers of persons with dementia. Issues in Mental Health Nursing 30, 518-521
Surr, A. C. (2006). Preservation of self in people with dementia living in residential care: A socio-biographical approach. Social Science & Medicine 62, 1720-1730.
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