Dementia and identity

Excerpts from an essay at Aeon:

Memory becomes like a flickering signal from a faraway shortwave radio station: people can do and say things, then promptly forget them, and then do and say them again. They can no longer read obvious social cues. They become easily distressed as a thickening fog descends upon them, causing them to lose track of everything. As the disease progresses, only fleeting glimpses of the once capable person can be seen; for the rest of the time, everyone is stuck with an uninvited guest. Eventually, the sufferer fails to recognise even loved ones.

Dementia raises deeply troubling issues about our obligations to care for people whose identity might have changed in the most disturbing ways...

It’s no wonder that carers feel everything from mild annoyance to profound grief as they take on ever more onerous responsibilities of shoring up someone’s fading sense of self. ... ‘The person I’m dealing with, the person I’m yelling at, the person who’s making me weep with frustration, is like a stranger. He looks like my husband, but Howard’s gone.’

...highlights the significance of physical routines, which, like recalling the steps in a dance, become more important as the ability to follow written instructions dwindles. Even the simple act of walking can restore a dementia sufferer to feeling fit, healthy and capable...

If the environment is cognitively overloaded, with bewildering signs, forms and instructions, not to mention smart devices, then it will make someone with dementia feel less capable and more distressed...

People with dementia need environments that are constant and reliable, and so require little new learning. Living with such people entails embracing the pleasures of patient repetition rather than constant novelty.