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Preserving a sense of Self

Memory loss and other losses associated with neurocognitive impairment (dementia) do not necessarily lead to a loss of “self”. Within the biomedical model, it is often noticed that personhood and a sense of Self are not considered. The person living with dementia is seen as vacuous, as not being a person any longer, not having any agency or autonomy. We now know that this is not true, that in spite of the decline in cognitive abilities, the person living with dementia will maintain a strong sense of Self, of knowing and consciousness. The purported sense of loss is not attributed to the disease, but to the way that people are treated, especially in institutional settings. If a person is not validated for who they are and only observed through the medical gaze, they will withdraw more and more, disengage and disconnect. The sense of Self is multi-facetted, complex, multi-layered and situated within the context of Being-in-the-world. While people might battle with doing and with sentence construction, it does not imply that there is no knowledge or awareness of their Being. The sense of self identity stays intact if people living with dementia are treated in ways that honour them for who they are, and not for what they have lost. Awareness does not need to be articulated in cohesive sentences, it can be seen in the eyes of a person who can no longer verbally communicate. It is always there.
Dr. Rayne Stroebel PhD (Dementia Studies, University of Stirling, Scotland, 2022)
Mobile number: +27 82 455 5300

1 thought on “Preserving a sense of Self”

  1. Very true. I have a cousin with dementia, 66yrs old, diagnosed 4 years ago. Those closest to her are all employed in the conventional medical field. To me it feels as if her diagnosis has come to define the person.

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