Changing our understanding of dementia 'behaviour'
Posted 02-02-2016 at 02:10 PM by DavidRaonic
Consider this: A man with Alzheimer's living in a long-term care home hits his table mates at meal times. Is this a symptom of dementia requiring restraint? Pia Kontos, a health services researcher at the Toronto Rehabilitation Institute-University Health Network, urges a closer look.
Kontos observed the man remove his hat before entering the dining room, then hit only those wearing hats. “This is a meaningful expression of his respect for table etiquette, a custom he values,” says Kontos. She suggests that reassigning the seating rather than restraining him would be more humane.
"We assume that with Alzheimer's there's a loss of self, but this is not so. People living with dementia can engage in meaningful ways through verbal and non-verbal expressions.”
Kontos has spent much of her career showing that we don't lose our self with a diagnosis of dementia. She coined the term "embodied selfhood" to stress the importance of movements and gestures of the body for self-expression and relationships.
Her research shows that even after losing the ability to speak coherently, people with dementia can continue to have conversations that follow recognizable rhythms of speech, question-answer formats, taking turns, sometimes even teasing by mimicking each others' sounds.
The arts like music, dance and painting also offer creative ways for people with dementia to enjoy, experience and express themselves, enhance relationships and enrich their lives.
"We rely a great deal on our bodies, even when our cognitive abilities are intact, to communicate," says Kontos. "Embodied selfhood takes on even greater significance with cognitive impairment since it becomes the primary source of relating to the world.”
“There is life with dementia. We must nurture and support opportunities for participation in life to the fullest extent possible."
Life doesn't end when Alzheimer's begins.
Kontos observed the man remove his hat before entering the dining room, then hit only those wearing hats. “This is a meaningful expression of his respect for table etiquette, a custom he values,” says Kontos. She suggests that reassigning the seating rather than restraining him would be more humane.
"We assume that with Alzheimer's there's a loss of self, but this is not so. People living with dementia can engage in meaningful ways through verbal and non-verbal expressions.”
Kontos has spent much of her career showing that we don't lose our self with a diagnosis of dementia. She coined the term "embodied selfhood" to stress the importance of movements and gestures of the body for self-expression and relationships.
Her research shows that even after losing the ability to speak coherently, people with dementia can continue to have conversations that follow recognizable rhythms of speech, question-answer formats, taking turns, sometimes even teasing by mimicking each others' sounds.
The arts like music, dance and painting also offer creative ways for people with dementia to enjoy, experience and express themselves, enhance relationships and enrich their lives.
"We rely a great deal on our bodies, even when our cognitive abilities are intact, to communicate," says Kontos. "Embodied selfhood takes on even greater significance with cognitive impairment since it becomes the primary source of relating to the world.”
“There is life with dementia. We must nurture and support opportunities for participation in life to the fullest extent possible."
Life doesn't end when Alzheimer's begins.
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