To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
For most of the past century, people with dementia were viewed through a biomedical lens and treated accordingly. This was logical to a degree because dementia is a syndrome produced by many different diseases that damage the brain and it is true that dementia is defined by dysfunctions in particular aspects of explicit memory, language, visual perception, and the organization of movement as demonstrated on standard neuropsychological tests. The use of a biomedical lens alone, however, is inappropriate if one seeks to understand the subjective experience and remaining abilities of people living with dementia.
In the past thirty years, through the increased use of a biopsychosocial lens, we have learned that the actions of people living with dementia are not due solely to brain damage, but also involve (1) their psychological reactions to the effects of brain damage, (2) how they are treated in social situations, and (3) their reactions to said treatment. We have learned also that people with dementia are semiotic subjects: they can act intentionally and appropriately in response to the meaning of social situations. As well, they are able to evaluate those situations in terms of the values and meanings they have held dear for the balance of their adult lives. For example, they can respond appropriately to the emotional needs of others, seek to avoid potentially embarrassing and humiliating situations, feel and demonstrate self-respect and proper pride, feel and demonstrate loneliness as well as being loved and respected, miss their loved ones, express themselves creatively, appreciate and display humour, along with a host of other healthy socio-cognitive abilities. People living with dementia share much social and emotional common ground with people who are deemed healthy. This has become increasingly apparent as their voices have been heard and respected as meaningful rather than being summarily dismissed as reflections of pathology and as they have been engaged in places other than hospital and memory clinics. Indeed, although a person with dementia may have difficulty finding and pronouncing words and organizing them syntactically, if we assume that the person is trying to tell us something meaningful, it is possible to facilitate the person's expression of his or her thoughts and open lines of communication.
Over the past 15 years, a growing body of research has shown that people with Alzheimer's disease (AD) are affected not only by brain neuropathology but also by their reactions to its effects, by the environments in which they live, and by how they are treated by others. Nevertheless, three relatively neglected social influences on people with AD remain to be examined: negative stereotyping, negative self-stereotyping and stereotype threat. Numerous studies reviewed in this paper indicate that: (1) negative self-stereotypes at conscious and unconscious levels can have adverse effects on the performance of healthy elderly people on tasks demanding explicit memory (recall in particular), and (2) the mere threat of being stereotyped negatively can have adverse effects on the performance of healthy elderly people on tasks including those involving memory. In this paper, we discuss the relevance of these phenomena for our understanding and treatment of people with AD who are exposed to negative stereotypes about old age and about AD before and after they are diagnosed. There is evidence to suggest that these influences may have significant effects on people with AD. The paper concludes with recommendations for best practice in the treatment of people with AD in the light of the most apparent effects of negative self-stereotyping and stereotype threat. These include advocacy for an approach that involves aspects of counselling.