Unit 1, Block 1.

Phyllis Harris, Friendship
1. In order to maintain the friendship both must ...
  1. People first, dementia second
  2. Willingness to disclose diagnosis
  3. Trust
  4. Friendship still rewarding
  5. Recognise strengths, while acknowledging limitations
  6. Recognise the core values of the person with dementia are still the same
2. Friendships for someone with early-stage dementia can provide ...
  1. Comfort
  2. Support
  3. Meaning
  4. Although difficult to maintain friendship
Sense of self
1. Goffman
  1. Public self - displayed to others Private self - director of performance
  2. People perform roles, interactions with others enables us to construct a 'sense of self'
  3. Social order depends of people's competency to play their roles. The slow loss of ability to retain identity, has heavy impact on family life / roles.
  4. Stigma - people with 'undesirable charactistics' are often stigmatised
2. Memory important to regain 'sense of self'
  1. Loss of memory, has profound impact of ones identity
  2. Unable to perform roles, can leave you marginalised by social networks, resulting in social exclusion
3. Charmaz
  1. Sense of self comes from social interactions.
  2. Chronic illness can mean the loss of positive self image, replaced by one less valued (by individual and others)
4. Sabat and Harre
  1. Sense of self created through language
  2. Self 1 - person identity, persists throughout dementia progression
  3. Selves 2 - roles a person plays, is lost with dementia, due to the way person is treated by others
Person-centred care
1. Kitwood
  1. Came up with person centred care, arguing being totally dependant, depersonalised people, leaving then disempowered and disabled.
  2. Says people with dementia need, comfort, attachment, inclusion, occupation and identity
2. Considers needs of the whole person - psychological, spirtual, physical, and social needs
3. Makes person a 'partner' in their own care
Stigma
1. Links and phelan, five components of stigma
  1. Identification and labelling of differences
  2. Stereotyping
  3. Separation of stigmatised from non stigmatised
  4. Experiences of discrimination
  5. Exercise of power - charities campaign
Relationships
1. Family members may struggle to maintain personhood, as they try to cope with changes in loved on
2. People caring need to know - personal history, social world, and build picture of person to understand care needs
3. Nolan et al. Suggest quality of care is determined by the quality of the relationship
4. In early diagnosis, other people's attitudes often disable person, before dementia does. Being treated as a person is a fundamental human right!

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Unit 1, Block 1.

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