Episodes of lucidity in people with severe dementia as narrated by formal carers

Abstract

Twenty formal carers employed in three nursing homes narrated 92 episodes of lucidity (ELs) in people with severe dementia. Sixty-two episodes concerned speech, nine concerned actions and 21 episodes concerned both speech and actions. Most ELs were said to occur spontaneously when the patients were acting closely together with a carer who did not make demands on them and regarded them as valuable human beings whose behaviour was a meaningful expression of their experiences. The narrations showed characteristics that indicated trustworthiness and the episodes described in three separate nursing homes were very similar and resembled descriptions given in previous research reports as well as in relatives' reports. Further research seems necessary and the assumption that severe dementia implies the destruction of the self or personhood must be questioned.

Dignity-preserving dementia care

“…55 However, even persons suffering from severe dementia may exhibit episodes of lucidity, especially when professional caregivers emphasize person-centeredness in caring, affirming the resident/patient as an individual with personal value and encouraging meaningful expressions of experience. 56 This first-level synthesis suggests how caregivers perceived dignity in their residents/patients as a phenomenon involving two central perspectives: an inherent self-respect with feelings of worthiness and being respectfully recognized through the confirmation of others. Caregivers underlined the importance of discovering the personality of each person, an essential insight when aiming to confirm and preserve each resident's sense of self and feeling of value.…”

Evaluation of communication behavior in persons with dementia during caregivers’ singing

“…46,47 In this study, caregivers decreased their instructions and instead continuously sang when providing morning care during MTC sessions; and consequently, the PWDs significantly increased their ability to use relevant communication and ask relevant questions. Based on these findings and other MTC study results, [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30]48,49 we suggest that during MTC sessions, verbal communication and instructions that are normally referred to through speech can be excluded and instead use MTC in order to enhance communication in the encounters between the PWDs and their caregivers.…”

Stepping out of the shadows of Alzheimer’s disease: a phenomenological hermeneutic study of older people with Alzheimer’s disease caring for a therapy dog

“…Episodes of lucidity are moments of temporary presence of mind in people with AD and other dementias (Normann et al, 1998). These moments often occur when the person is cared for in a person-centred way (Edvardsson et al, 2014, 2008; McCormack & McCane, 2010).…”

“…A few examples are caregivers singing (Hammar, Emami, Götell, & Engström, 2011), validation therapy (Söderlund, Norberg, & Hansebo, 2012), and person-centred conversations (Hedman, Hansebo, Ternestedt, Hellström, & Norberg, 2012). These methods are often used as memory triggers, so-called reminiscence (Woods, Spector, Jones, Orrell, & Davies, 2005), and temporary presence of mind in the moment (Normann, Asplund, & Norberg, 1998). …”