I’m still the same person: The impact of early-stage dementia on identity

Research suggests that the onset and progression of dementia may pose a threat to a person’s sense of identity. This qualitative study used Interpretative Phenomenological Analysis to explore participants’ perceptions of the impact of dementia on their identity. Participants were ten people with dementia. The four themes emerging from the data represented participants’ views on aspects of their current identities, whether they believed that dementia would alter their identities in the future, perceptions of how dementia had affected their lifestyle, and relationships with friends and family. The analysis suggested that for the most part, participants felt that little had changed with respect to their identities as a whole, but most identified features of themselves that were different than they had been prior to the onset of dementia. Thus it appeared that participants were in a state of flux, experiencing both continuity and change in their sense of identity simultaneously.

Interventions supporting self and identity in people with dementia: A systematic review

OBJECTIVES

Recently, researchers have started to focus on ways to support self and identity in people with dementia. The purpose of this review is to discuss the main features of existing interventions aiming to support self and identity in people with dementia, to draw conclusions regarding the effectiveness of these interventions and to highlight the implications for future research.

METHOD

Systematic review of intervention studies aiming to support self and identity in people with dementia.

RESULTS

Ten studies met the inclusion criteria. All reported some benefits to participants. There were significant methodological limitations and study quality was generally low. The interventions varied in terms of participant characteristics, content and outcome measures, making it difficult to draw overall conclusions about effectiveness.

CONCLUSIONS

Interventions aiming to support self and identity in people with dementia are currently in the early stages of development. Firm recommendations cannot be made at this time. Further well-designed studies are required to provide more robust evidence.

Identity, mood, and quality of life in people with early-stage dementia

BACKGROUND

There is little empirical research regarding the relationships between identity and well-being in people with dementia. The aim of the study was to explore the relationship of identity with mood and quality of life (QoL) in the people in the early stages of dementia.

METHOD

This was a cross-sectional questionnaire-based study. Fifty people in the early stages of dementia completed measures pertaining to different aspects of identity, mood, and QoL. Multiple regression analyses were carried out to determine whether it was possible to predict any of the variance in mood and QoL from aspects of identity.

RESULTS

It was possible to predict 12.8% of the variance in anxiety, 23.4% of the variance in depression, and 25.1% of the variance in QoL from different aspects of identity. Predictors varied for each dependent variable.

CONCLUSIONS

Aspects of identity predict a modest proportion of the variance in anxiety, depression, and QoL. This suggests that supporting identity in people with dementia who are experiencing difficulties in this regard might have a positive impact on mood and QoL. However, the majority of the variance in mood and QoL must be accounted for by other variables.

A profile of identity in early-stage dementia and a comparison with healthy older people

The aim of the study was to determine whether people in the early stages of dementia experience their sense of identity differently to healthy older people and to examine whether different aspects of identity are related to each other in each group. This was a cross-sectional questionnaire-based study; 50 people with early-stage dementia and 50 age-matched people without dementia completed measures pertaining to different aspects of identity. Measures of mood and self-esteem were also included so that any differences could be taken into account in the analysis. There were very few differences in identity between the groups. After differences in levels of anxiety were accounted for, there were no differences in scores on most measures of identity. However, people in the early stages of dementia scored significantly lower on one subtotal for one measure of identity, whereas healthy older adults reported significantly more identity-related distress than people in the early stages of dementia. For both groups, there were no associations between different aspects of identity. People in the early stages of dementia do not differ much from healthy older adults in terms of their identity. Since healthy older people experience more distress relating to identity, they may be more likely to benefit from some sort of intervention than people in the early stages of dementia. It might be useful to consider identity as consisting of multiple components in future studies, rather than assuming that one aspect of identity represents the overall experience of identity.

Studying the self in people with dementia: How might we proceed?

The impact of dementia on the self has become the subject of much research over the last few years, mainly due to the implications for support and care for people with dementia. However, there are a number of limitations of this research that make it difficult to integrate the existing evidence and to draw any firm conclusions regarding the persistence of self. This highlights the need for a different approach to studying the self in people with dementia in order to obtain more robust evidence from future studies. This paper attempts to integrate current research using an existing systematic and comprehensive framework of the self, and outlines the advantages and limitations of using such a framework as the basis for future studies.