Here is another excerpt from my upcoming book,
Dementia Beyond Drugs: Changing the Culture of Care (Feb. 2010, Health Professions Press). Chapter 5 (“Other Eyes”) introduces a new “experiential” model for viewing dementia. This excerpt is taken from a section that contrasts the new model with the traditional biomedical view:
Each model also holds important implications for how we view and respond to behavioral expressions in people with dementia. The biomedical view sees such expressions as confused, purposeless, and/or neurochemically mediated. They are viewed as a “problem” that rests with the individual with the “disease”, and that must be “managed”. The primary goal is to return people to a “normal” state, often using psychotropic medication.
Kitwood (1997) remarked that “It has become far too easy to ignore the suffering of a fellow human being, and see instead a merely biological problem, to be solved by some kind of technical intervention.”
As a person who has lived with Alzheimer’s disease, Taylor (2007) takes the challenge even farther:
The professionals become cheerleaders for caregivers, and sympathetic observers of me. The professionals are well-intentioned, but it is quicker and easier to “fix” caregivers then it is to listen to, understand, or even attempt to “fix” me. Caregivers’ needs are clearer, more consistent and easier to address than mine! . . .
Why not see us as a source of answers to our problems, rather than as a source of problems to which our caregivers need answers. (p. 67)
Thus, the biomedical model centers on the perceptions and the needs of the families and care staff, while discounting the unique perspective of the person who actually experiences the illness. This attitude leads one to position the opinions of the person with dementia as less valid, and to resort to medication to “fix” the problem from the caregivers’ perspective.
But if unmet needs are present, as studies show they usually are, then we must agree with Cohen-Mansfield’s contention (2005, May) that “even if there was a ‘magic pill’ that stopped the agitated behavior occurring immediately and had no side effects, we shouldn’t give it or start there”. Why? Because doing so would still ignore those unmet needs, and continue to rob the person of well-being.
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