Glossary of Terms Related to Dementia and Alzheimer’s Disease
Alzheimer’s is one of the diseases that cause dementia. It results primarily in problems with memory and, like all forms of dementia, in problems with thinking and behavior. Symptoms usually develop slowly and get worse over time, becoming severe enough to interfere with daily tasks. Alzheimer’s disease is the most common cause of dementia in the United States.
Dementia is a condition, not a disease. It is a descriptive term for a collection of symptoms that can be caused by a number of disorders that affect the brain. People with dementia have significantly impaired intellectual functioning (loss of rational thought) that interferes with normal activities and relationships. They lose their ability to solve problems and maintain emotional control, and they may experience personality changes and behavioral problems. Memory loss by itself does not mean that a person has dementia. Doctors diagnose dementia only if two or more brain functions, such as memory and language skills, are significantly impaired.
The condition of being unable to perceive or be aware of one’s physical or neurological deficits. In dementia, people are often aware that they have memory problems but are unable to comprehend that they have problems with using judgment or rational thought. (See a more in depth anosognosia definition in the DAWN Method blog.)
A term used in the United States to identify health care in which the expected clinical benefits outweigh the expected negative effects, justifying the treatment. This has been the default approach in dementia care and senior care facilities. The hallmark of the appropriate-care approach is reality orientation, which asks people with dementia to accept our common reality although they do not have the necessary cognitive skills (memory and rational thought) to perceive it.
The opposite of the appropriate-care approach. We are using habilitative care when we accept people’s abilities and disabilities and change the environment to make it safer and more comfortable for them. Caregivers who are habilitative in their approach focus on their charges’ individual interpretations of reality rather than requiring acceptance of our common reality. They focus on meeting their charges’ emotional needs and preserving dignity and autonomy.
Dementia care that is based on a person’s specific and changing personal needs rather than dictated by schedules, protocols, or norms. The person-centered caregiver supports the care receiver’s abilities and provides targeted assistance in the areas where help is needed. This not only meets the person’s needs but also supports his or her interests.
Strength-based dementia care identifies the skills people keep and continue to use when experiencing dementia, rather than only those lost, which enables their companions to understand how they can purposefully rather than inadvertently shape and determine the person’s experience. Strength-based care enables companionship and wellbeing through recognizing human behaviors as expressions of unmet emotional needs rather than symptoms of disease, and results in empowerment and dignity for those of us who experience dementia.
The part of us that enjoys looking back and recalling earlier times. It is nostalgic and provides us with the sense of familiarity in our surroundings. Our remembering selves shape our view of the present by providing verification and explanations drawn from our past experiences.
The part of us that is in the present, experiencing what is occurring to us and around us. The experiential self is absorbing information from the five physical senses even if we are not able to make sense of the stimuli we are receiving, describe what we are experiencing, or express what we are feeling.
Rational thought processes:
Our System 2 thought processes, sometimes referred to as our left brain. Rational thought is our conscious, reasoning self. With it we can analyze data, be methodical, make choices, see cause and effect, prioritize information and actions, and follow a process or series of steps. Rational thought is not instantaneous; it takes effort. Rational thought will also tell us whether our behavior is appropriate for the circumstance and includes our ability to learn by rote.
Intuitive thought processes:
Intuitive thought processes are our System 1 thought processes, sometimes referred to as our right brain. Intuitive thought operates automatically, instantaneously, and without effort. It is the source of our feelings, impressions, and gut reactions. We are using our intuitive thought skills when we read intonation, facial expressions, and body language. Intuitive thought is our means of enjoying music and beauty. It includes our ability to learn by experience.
The fight-or-flight response, also known as the acute stress response, is a physiological reaction that occurs in the presence of something that is terrifying, either mentally or physically. The response is triggered by the release of hormones that prepare your body to either stay and deal with a threat or run away to safety. It’s part of our intuitive thought processes.
According to Ellen Langer, “Mindfulness is a flexible state of mind in which we are actively engaged in the present, noticing new things.” It comes from being able to use rational thought to focus or pay attention.
When we are not actively engaged in what we are doing, we are acting unconsciously and following a series of steps or behaving without conscious decision.
Automatic thinking scripts:
The first tool of mindlessness. The ability to mindlessly complete a routine task without thinking about the individual steps. Automatic thinking scripts are created by repetition. People experiencing dementia continue to be able to perform routine tasks using automatic thinking scripts, as long as there is no interruption or change to the setting.
The second tool of mindlessness. The ability to mindlessly follow a route or the steps in a task that we have performed many times before. Our muscles are following the pattern without conscious direction. When we ask someone to pay attention, muscle memory is interrupted and lost.