Providing person centered care to individuals that have dementia is essential to their quality of life. A critical challenge in achieving this is understanding the perspective of the person with cognitive impairment. With a proper appreciation of that perspective, one can communicate better to achieve more precise assessments, better care and evaluation. It is also critical to follow the evolution of the disease and support the family and caregiver during the journey. It helps achieve empathy by putting your own feelings aside and taking on the emotions of the other person, which is always better than sympathy.

To see from their eyes and evaluate the residents’ needs correctly to better serve them, the caregivers need to take into account all the factors that may shape the perception, reaction and behavior modification that come with dementia. As highlighted by different studies, people do not undergo the disease passively and use both emotion-oriented and problem-oriented coping strategies to deal with its challenges. The experiences of living through dementia appear to yield a more subtle picture than the usual assumptions. To grasp a good picture, one needs to be aware of the changes brought on by the disease. Here is a list of the physical/sensory and social/psychological changes and their impact:

1. Physical/sensory:

• Short-term memory as part of the disease or just normal aging
• Senses such as eyesight, hearing and touch start to fail
• Lack of sensory stimulation; as one is more isolated, stimulation tends to decrease
• Illnesses increase as part of normal aging
• Cells regenerate much slower
• Muscles lose elasticity
• Ability to walk is often reduced

2. Social/psychological:

• Friends and loved ones die (increasing isolation)
• Social roles, job or feeling of purpose decreases
• Often mobility is more limited (increasing isolation)
• Lack of status respect: losing the right to drive for example
• Increasing desire to review one’s life and find peace
• Drugs and treatment can modify mood and behavior
• Depression often accompanies losses and accentuates the decline in quality of life

A great book that explains and captures in remarkable detail what it’s like to go through dementia such as Alzheimer’s is Still Alice from Lisa Genova