Intelligent Optimist

People, not Patients

"I know this has been hard on you." It had been two years since Butch had said anything, which only made these words, among the last he uttered to his wife and daughter before he died, all the more poignant. Over the years, they had always thought they saw recognition in his eyes, had always believed he knew who they were and who he was. But that one sentence confirmed it. This man, a late-stage dementia sufferer in his 80s who took part in a family support program at Duke University Medical Center, was aware of what was happening to him.

An increasing body of evidence supports the notion that people with dementia are aware, to varying degrees, of their condition. These new insights are a departure from the traditional view of dementia as an all-consuming state that erodes our knowledge of self and others, and they have radical implications for the care of people with all forms of dementia. The shift is leading to a reduction in the use of prescription medications, improved intepretation of behavior and a range of pioneering activities in the nursing home environment.