理解痴呆症:老年人对痴呆症和阿尔茨海默病的主观表述

Jaroslava Hasmanová Marhánková, Michaela Honelová
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摘要

研究目的 本研究探讨了老年人如何构建痴呆症患者生活的表征和意义。方法 对居住在捷克共和国的 65 岁以上老年人进行了焦点小组(19 人)和深入访谈(29 人),这些老年人代表了个人对痴呆症患者护理的不同熟悉程度。结果 我们发现了两种不同的话语:1) "痴呆症是人格的窃贼 "和 "痴呆症是人性的窃贼 "这两种截然不同的悲剧话语。在这些话语中,痴呆症超越了单纯的医学术语,象征性地表达了与衰老和失去控制有关的生存焦虑。2) "痴呆症是人们对待世界的一种特殊方式 "这一论述主要由照护者表述,为他们提供了一种应对机制和重建痴呆症患者代理权的手段。在老年人的表述中,家庭成员之间的痛苦成为与痴呆症的主要关联。痴呆症对家庭成员的影响被描述为 "传染性",而家庭成员在某种意义上被描述为痴呆症的主要患者。讨论 痴呆症往往是老年人表达对晚年担忧的象征性工具,它超越了临床定义,传达了与衰老相关的根深蒂固的恐惧。被诊断为痴呆症患者的周围人的经历以及这种疾病的影响在身体之间的渗透性,是在老年人的叙述中将痴呆症概念化的重要框架。
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Making sense of dementia: Older adults’ subjective representations of dementia and Alzheimer’s disease
Objectives This research explores how the representations and meanings of living with dementia are constructed by older adults. Methods Focus groups (N = 19) and in-depth interviews (N = 29) were conducted with older adults aged 65+ living in the Czech Republic, representing different levels of personal familiarity with care for an individual experiencing dementia. Results We identified two different discourses: 1) Tragedy discourse with two distinctive repertoires “dementia as a thief of personality” and “dementia as a thief of humanity”. Within such discourse, dementia transcends mere medical terminology, serving as a symbolic representation of existential anxieties linked to aging and the perceived loss of control. 2) The discourse of Dementia as a specific way in which people approach the world was articulated mainly by caregivers, providing them with a coping mechanism and a means to reconstruct the agency of the person experiencing dementia. In older adults’ representations, references to suffering among family members emerged as a primary association with dementia. Dementia was portrayed as “contagious” in its effect on the family members who were, in a sense, depicted as the primary sufferers of the disease. Discussion Dementia often serves as a symbolic tool for older adults to articulate concerns about advanced old age, extending beyond its clinical definition to convey deep-seated fears associated with aging. The experience of people surrounding those diagnosed with dementia and the permeability of the impacts of this disease between bodies represented crucial frameworks for conceptualizing dementia in the narratives of older adults.
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