By Catherine Van Son

The number of people living with dementia is growing exponentially. The effects of this neurocognitive disorder (the majority are the Alzheimer's type) are non confined to the numbers affected past the status. The affect of dementia on the lives of persons living with dementia (PLWD), their caregivers and intendance professionals must be explored. It is important to reflect on the relationship between order and dementia equally it has an overwhelming consequence on the individual and those around them. From the moment a person is suspected to exist suffering from dementia, their social interactions with others progressively changes.

The occurrence of dementia as a news item has led to a growing influence on the social depictions of erstwhile age as the general population learns more about its touch on one'south life. The various contexts of dementia are redefining what aging and old historic period mean in society with life expectancy increases and health improvements at later ages shifting our understanding of normal aging. Unfortunately, mass media creates fearfulness related to the loss of cognitive and physical ability over time and focuses on any and all measures to keep aging at bay. Social gerontology has been discussing and debating changes in crumbling however, these issues have not been addressed sufficiently inside other disciplines such every bit medical sociology.

Forgetting Items: The Social Experience of Alzheimer's Disease (Indiana University Press, 2019) written by Baptiste Brossard considers the social aspect of dementia by because how symptoms are expressed past the individual and understood/interpreted by those close to them. The author'southward goal is to assistance us understand mutual experiences associated with dementia and ways to interpret those experiences through the lens of sociology.

I make this point as I am a nurse gerontologist and exercise not take a sociology background. However, although nursing is rooted in the biomedical perspective, our work incorporates health related topics of the entire person, their family unit and club. Nursing is the protection, promotion, and optimization of wellness and abilities, prevention of disease and injury, the diagnosis and treatment of homo response to illness and treatments, and advocacy in the care of individuals, families, communities, and populations in all settings. To attain this we need to know: does the person nosotros are working with have access and transportation to a drug shop to obtain their  medications? What is a community'south behavior near the cause of dementia?, what social supports be for the family unit caregiver? And, is it ethical to tell a PLWD that their hubby (deceased for many years) volition be abode for dinner presently, rather than reminding her he is dead and she relives those emotions once once again? Each of these questions require an integrated approach in the nursing profession.

In Forgetting Items, Brossard writes nearly the social interactions between the PLWD and others as it changes over time due to the progression of the affliction. The chapters focus on four interactional processes he states shapes the experience of dementia. The first affiliate addresses the observation that dementia threatens daily activities (i.e., medication direction, turning off the stove), and leads to the establishment of a support network to clinch the individual'due south safety. It is the recurring missteps in daily behavior that oft lead (the individual or their meaning other) to seek medical attention. Dr. Brossard describes this procedure as a "reorganization of activities". In the start, the reorganization of activities focuses on safe issues and efforts made by the individual to salvage face within their social groups. These progressive changes in reorganizing activities occurs while the diagnosis of Alzheimer'southward has not however been accepted.

The second chapter focuses on the caregiver and the professional'south interpretation of individual with dementia behaviors and language equally the illness erodes one'southward 'credibility'. Over time the PLWD's recollection and description of events are interpreted as flawed. While this process tin accept years, inaccuracies lead to the loss of credibility in the eyes of those around them. Brossard explains that the rate of the PLWD being discredited is often proportional to their cultural/social and gender capital. He describes examples of patients who have high levels of education, social continuing or being male person announced to keep their capital longer and maintain their credibility longer. However, all PLWD still have agency and the understanding of their actions is our responsibility. Their agency is often driven past basic and/or unmet human needs. For instance, when they continuously repeat, "I want to go habitation", they are not seeking the firm they lived in, but the emotional connections attributed to home; the familiar, being cared for and feeling safe. What they desire is a warm and quiet environment, caring eye contact, and comforting voice communication and impact. Existence a human existence should exist capital letter plenty for them to maintain brownie in their environment.

The third chapter describes the development of deference every bit a mechanism of preserving the PLWD's dignity, through social engagement. Deference is the effort to deinstitutionalize nursing homes and create home like more than humane environments though the provision of person-centered intendance. However, the writer describes how the institutionalization of those with dementia and the routinizing deference tends to remove the ability of caregivers to interact with their residents/patients with genuine humanity. He describes how this organizational deference has created a form of individuals (PLWD) by standardizing "treating them with nobility and respect", which ignores their private agency.

The terminal chapter illustrates the efforts made by those around PLWD to interpret what the person'south communication might mean if the private did non accept cognitive deficits. The author labels the reconstruction of a memory to interact positively with PLWD every bit 'reconstituting'. It is the endeavor made past caregivers and institutions to back up the memories that are part of the person's lived experience. Some examples of this include giving a woman a babe doll to care for, believing this will comfort a woman who had several children. Or, this might mean decorating facility interiors to support an environment from earlier decades in their life. In nursing, this is referred to as 'agenda behavior' and the efforts used for caregivers to step into the PLWD life every bit they see it.

Equally a nurse I found it interesting to look at Alzheimer's using a sociological lens. The areas discussed and labeled by the author were familiar to me, just interpreted differently. Many nuances of dementia are a direct effect of its wearisome progression and long duration. Thus, the touch on of this disease requires thoughtful reflection on the experience of the private with the disease and those around them.

More than than half of all residents in long-term care have dementia; and is one of the nigh feared attribute of aging. While medicine still searches for a cure, the pharmaceutical industry continues to develop and market various 'anti-dementia' drugs that continue to accept a high failure charge per unit. Currently efforts have focused more on pre-clinical risk assessments and methods aimed at slowing the progression of dementia. Thus, other areas of scholarship are needed to contribute to our understanding of the social and cultural aspects of dementia. Graduate students and academics interested in the sociological perspective of dementia will discover this book an interesting read. Other disciplines would also detect that this book is a thoughtful addition to their agreement of dementia.

Dr. Baptiste Brossard received his Ph.D. in folklore and is a French sociologist and Lecturer in the College of Arts and Social Sciences at Australian National University.

Virtually the Author
A black and white photograph of Catherine Van Son, who has short hair and is wearing glasses

Catherine Van Son, PhD, RN, ANEF, FGSA is an Associate Professor/ Nurse Gerontologist at Washington State University Higher of Nursing.  Her research focuses in part on the office of civilisation in understanding and managing health behaviors in different populations. She consults on qualitative methodologies and issues related to older adults. She has good as a nurse for more 30 years with the goal of improving health outcomes for all older adults. Her collaborations span local, national, and international arenas. Her professional twitter account is  https://twitter.com/geronurse_notes