Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-26T00:49:44.437Z Has data issue: false hasContentIssue false
  • English
  • Français

Mild Dementia: Perceptions and Problems

Published online by Cambridge University Press:  14 November 2008

P. A. Pollitt ,
D. W. O'Connor  and
I. Anderson
P. A. Pollitt
Affiliation:
Hughes Hall, Cambridge CB1 2EW, England.
D. W. O'Connor
Affiliation:
Hughes Hall, Cambridge CB1 2EW, England.
I. Anderson
Affiliation:
Hughes Hall, Cambridge CB1 2EW, England.
Get access Rights & Permissions [Opens in a new window]

Abstract

The focus of this paper is on the beginnings of dementia – on the grey area where normal and abnormal ageing seem to overlap, but where a diagnosis can be established. We look at a group of elderly people diagnosed as suffering from mild dementia and at the relatives most closely involved with them and whom we had assumed to be their carers. Our principal interest is in the relatives' perception of the deterioration in intellectual function, and in their awareness of and response to problems associated with it. Contrary to expectation, these relatives did not see themselves as carers, or the elderly person as demented. Spouses often saw their partner as no more disabled than themselves; and, more generally, the relationship between them often showed a high degree of reciprocity. Sons and daughters were usually aware of changes in their parents' behaviour but tended to explain them in terms of normal ageing. Improvement in the process of early identification and the creation of more appropriate services are generally seen as desirable. Questions are raised about the usefulness and justification for intervention in a situation which is not yet recognised by those involved as requiring it.

Type
Research Article
Information
Ageing & Society , Volume 9 , Issue 3 , September 1989 , pp. 261 - 275
Copyright
Copyright © Cambridge University Press 1989

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

NOTES

1 Mace, N. L. and Rabins, P. V., The 36-Hour Day (Baltimore, Johns Hopkins University Press, 1981)Google Scholar; Morris, R. G., Morris, L. W. and Britton, P. G., Factors affecting the emotional wellbeing of the caregivers of dementia sufferers, British Journal of Psychiatry, 153 (1988), 147–156CrossRefGoogle ScholarPubMed; Rabins, P. V., Mace, N. L. and Lucas, M. J., The impact of dementia on the family, Journal of the American Medical Association, 248 (1982), 333–335.CrossRefGoogle Scholar

2 Bergmann, K., Foster, E. M., Justice, A. W. and Matthews, V., Management of the demented elderly patient in the community, British Journal of Psychiatry, 132 (1978), 441–449CrossRefGoogle Scholar; Isaacs, B., Geriatric patients: do their families care?, British Medical Journal, 4 (1971), 282–286CrossRefGoogle ScholarPubMed; Argyle, N., Jestice, S. and Brook, C. P. B., Psychogeriatric patients: their supporters' problems, Age and Ageing, 14 (1985), 355–360.CrossRefGoogle ScholarPubMed

3 Wright, F., Left to Care Alone (Gower Publishing Co. Ltd, Hampshire, England, 1986)Google Scholar; Fadden, G., Bebbington, P. and Kuipers, L., The burden of care: the impact of functional psychiatric illness on the patient's family, British Journal of Psychiatry, 150 (1987), 285–292CrossRefGoogle ScholarPubMed; Levin, E., Sinclair, I. and Gorbach, P., The Supporters of the Confused Elderly at Home (Family Studies Policy Centre, 1984)Google Scholar; Jones, D. A. and Vetter, N. J., Formal and informal support received by carers of elderly dependants, British Medical Journal, 291 (1985), 643–645.CrossRefGoogle Scholar

4 See Challis, D. and Davies, B., Case Management in Community Care: An Evaluated Experiment in the Home Care of the Elderly (Gower Publishing Co. Ltd, Hampshire, England, 1986)Google Scholar; Askham, J., Lindesay, J., Murphy, D. et al. , Enhanced home support for dementia sufferers, Age Concern Research Report, 1987 (Age Concern Institute of Gerontology, University of London, England)Google Scholar. There are several schemes in operation throughout the country. Sheffield Family and Community Services Department have set up Elderly Persons' Support Units. One of these is described in Bond, M. E. and Ferrari, P., Ecclesfield Support Unit 1984–1987: A Report (Sheffield Family and Community Services Department, 1987).Google Scholar

5 Folstein, M. F., Folstein, S. E. and McHugh, P. R., ‘Mini-mental state’: a practical method for grading the cognitive state of patients for the clinician, Journal of Psychiatric Research, 12 (1975) 189–98.CrossRefGoogle Scholar

6 Roth, M., Tym, E., Mountjoy, C. Q. et al. , CAMDEX: a standardised instrument for the diagnosis of mental disorder in the elderly with special reference to the early detection of dementia, British Journal of Psychiatry, 149 (1986), 698–709.CrossRefGoogle Scholar

7 For a more detailed description of the diagnostic criteria see O'Connor, D. W., Pollitt, P. A., Hyde, J. B. et al. , The prevalence of dementia as measured by the Cambridge Mental Disorders of the Elderly Examination, Acta Psychialrica Scandinavica (in the press).Google Scholar

8 O'Connor, D. W., Pollitt, P. A., Roth, M., Brook, C. P. B. and Reiss, B. B., The validity of informant histories in a community study of dementia, International Journal of Geriatric Psychiatry (in the press).Google Scholar

9 Teusink and Mahler liken this to the mourning process described by E. Kubler Ross: Teusink, J. P. and Mahler, S., Helping families cope with Alzheimer's disease, Hospital and Community Psychiatry, 35 (1984), 152–156.Google ScholarPubMed

10 Kreisman, D. E. and Joy, V. D., Family response to the mental illness of a relative: a review of the literature, Schizophrenia Bulletin 9 (1974), 34–57.CrossRefGoogle Scholar

11 Lederer, H., How the sick view their world, Journal of Social issues, 8 (1952), 4–15.CrossRefGoogle Scholar

12 This has also been documented by Teusink and Mahler: ‘At times families even fail to recognise grossly disturbed behaviour and marked deterioration in memory and cognitive functioning.’ Teusink, J. P. and Mahler, S., Helping families cope with Alzheimer's disease, Hospital and Community Psychiatry, 35 (1984), 153.Google ScholarPubMed