The self in Alzheimer's Disease: A Case Study with Implications for Life Quality

In neurodegenerative disorders such as dementia of the Alzheimer's type the person gradually loses skills and aspects of everyday living. Does that indicate that he/ she lose the self? In the past it was widely accepted that the self diminishes in dementia, until it is lost in the latest stage, yet in the recent years this premise has been challenged. Accepting that the self is 'lost' can be problematic theoretically in the approach of self-hood, and practically in the care of individuals. Currently a novel perspective is 'gaining ground' supporting the existence of the self in dementia, and the importance of enhancing the self-hood, in order to improve the life of the person. A case study is presented where the self emerged along with a need to target it in order to improve the life of the person. A man with Alzheimer's disease was expressing rapid cognitive decline, along with emotional agitation and behavioral disturbances, and began having sessions. An intervention was structured that used all art modalities as a stimulus, and focused on the existing skills, on the narrative of the person, and on self- qualities, in order to improve life quality. It was composed of activities, each of which had a cognitive, an emotional, a behavioral and a somatosensory aspect, all of which were linked to the self in the past, present and future. The intervention appeared to be efficient in delaying the progression of the disorder (as much as possible), in stabilizing the emotional state of the person and in harmonizing the behavior. All the above were made apparent through regular assessments with a Mini Mental State Examination (MMSE), a Geriatric Depression Scale (GDS), and through quantitative and qualitative measures regarding the self, and life quality. More research is required to be able to generalize the results, yet a focus on the self and all its aspects appears to be efficient in the psycho-social treatment of Alzheimer's, and manages to improve life quality.