Dementia. A personal legacy beyond words

Abstract

This is the revised text of a lecture presented at the Joint Meeting of the Faculty of Old Age Psychiatry and the Special Interest Group in Spirituality and Psychiatry on 14 December 2005. The paper explores the interface of clinical, ethical, and spiritual dimensions in the promotion of communication in dementia. Themes are derived from personal anecdotal experience, principles of logotherapy, and ethical frameworks. It is argued that individuals with dementia remain at the centre of meaningful interaction through the period of illness and that it is incumbent upon formal carers to be aware of the lasting needs of the whole individual, and not to dismiss a spiritual approach. Finally, the paper introduces suggestions for the development of an integrated framework. Strategies and tools are being developed jointly by clinicians and spiritual advisors, and are aimed at preserving the dignity of the person with dementia, their right to be accepted at different stages of decline, in recognition of a meaning to their life and experience even beyond the point where normal language skills are irreparably lost. In view of the possibility of finding meaning in suffering, life's meaning is an unconditional one, at least potentially. That unconditional meaning, however, is paralleled by the unconditional value of each and every person. It is that which warrants the indelible quality of the dignity of man. (Frankl, 2004 Frankl, V. 2004. Man's search for meaning, 5th, London: Random House. [Google Scholar], p. 151, first published as Ein Psycholog erlebt das Konzentrationslager in 1946)

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