Half 1,000,000 Canadians reside with dementia and one in 5 Canadians has cared for somebody with dementia. Dementia is an umbrella time period for a lot of circumstances inflicting “lack of reminiscence, language, problem-solving and different considering talents which can be extreme sufficient to intrude with each day life.”
As PhD college students and health-care suppliers, in addition to members of the family of individuals with dementia, we’re vital of stereotypes and customary misconceptions. These usually emerge within the metaphors used to elucidate and perceive dementia. Whereas some metaphors could also be useful, they can be dangerous.
Frequent dementia metaphors
Some metaphors of dementia embrace comparisons to zombies or kids. We see this when somebody refers back to the expertise of dementia as “regressing to childhood” or as being “the strolling useless.”
These metaphors can compound beliefs that folks with dementia are incompetent, unable to consent and don’t must be consulted about their care. This will happen whatever the sort or severity of dementia they’re experiencing.
It might additionally lead these with dementia to really feel they aren’t credible reporters of their very own expertise. They might subsequently be hesitant to contribute essential details about their expertise, or not be granted the autonomy they’re able to.
The widespread framing of dementia socially and within the media may trigger hurt. This typical narrative usually frames all types of dementia as Alzheimer’s illness.
A standard and cardinal early symptom of Alzheimer’s is progressive reminiscence impairment described as anterograde long-term episodic amnesia. This entails issue creating new recollections and remembering earlier occasions. Some metaphors used to uphold this narrative are that dementia is an invader that “assaults and destroys” the mind and recollections, or is a predator that “sneakily robs an individual of their sense of self.”
Nevertheless, that metaphor just isn’t enough for different sorts of dementia. For instance, vascular dementia is any dementia because of cerebrovascular illness (comparable to stroke), impairing blood circulation to elements of the mind.
Not like Alzheimer’s, vascular dementia could spare episodic reminiscence and considerably impair government perform as an alternative, comparable to the flexibility to summary, plan, manage and adapt. Nevertheless, the signs rely upon which space of the mind is affected.
One option to perceive vascular dementia is to make use of a balloon analogy. Think about you’re holding a bundle of balloons. Think about the balloons are recollections and information, and their strings the pathways to forming and retrieving them.
In one of these dementia, you should still have balloons, however their strings have been lower — for instance, you’ll have shaped language however are unable to retrieve it to talk. Or sure balloons could have popped leaving some gaps, whereas others stay the identical. For instance language could stay intact, however planning and sustained consideration could also be tough.
Execs and cons of dementia metaphors
We do want metaphors in drugs. Metaphors could be integral instruments for info sharing between sufferers and health-care suppliers.
Well being-care suppliers could use metaphors to assist facilitate communication with sufferers. Sufferers additionally usually categorical their signs and experiences metaphorically to create a shared understanding with health-care suppliers. Metaphors can assist sufferers and health-care suppliers work along with a standard understanding of the objective for care.
Whereas metaphors could also be wonderful instruments for this, all instruments have their limitations. Metaphors could not do every thing you need them to, and will omit essential elements of the story.
What makes metaphors dangerous is that they could work to homogenize the expertise of dementia whereas additionally discrediting and invalidating essential elements of its expertise. Metaphors can not at all times seize combined dementias or extreme dementia — when individuals have signs from a number of sorts.
Metaphors could be limiting
Whereas metaphors above could spotlight a few of the biomedical components of dementia, these similar metaphors could not seize relationships between individuals, what they worth, the issues they do of their day and the areas they navigate.
Of their comparability of two issues, metaphors spotlight what’s widespread between them. These could then direct our response to dementia in restricted methods. Individuals are extra more likely to reply with an answer framed the identical metaphorical method as the issue. For instance, understanding dementia as a predator or invader doubtless directs a response that entails attacking it with instruments comparable to treatment.
Then again, limiting the response to solely this may occasionally neglect to think about essential environmental modifications and caregiver relationships that may additionally assist enhance high quality of life. If our considering turns into confined to a specific metaphor, these essential items could also be left unacknowledged in scientific communication.
Working collectively, health-care suppliers and sufferers must be vital of dementia metaphors. As a result of they assist to create a shared understanding, metaphors can play a vital position in navigating the hole between the information sufferers and health-care suppliers convey.
Nevertheless, asking “What may this metaphor have ignored?” and “How is that this metaphor useful for complete care?” could also be equally essential facilitators of scientific communication.
Jasmine Mah is an Inner Drugs resident with Nova Scotia Well being and receives scholarships supporting her PhD analysis from the Division of Drugs at Dalhousie College, Dalhousie Medical Analysis Basis, Dr. Patrick Madore Basis, Alzheimer Society of Nova Scotia and the Pierre Elliott Trudeau Basis. She is a part of the Canadian Consortium on Neurodegeneration in Getting old (CCNA) Group 14, which investigates how multi-morbidity, frailty and social context modify threat of dementia and patterns of illness expression. The CCNA receives funding from the Canadian Institutes of Well being Analysis (CNA-137794) and associate organizations (www.ccna-ccnv.ca). The affiliations/funders had no enter into any side of this topic or article.
Kaitlin Sibbald receives funding from the Social Sciences and Humanities Analysis Council. She is affiliated with the Canadian Affiliation of Occupational Therapists.