Skip to main content
SpringerLink
Log in

Early Stage Dementia: Maximizing Self-Direction and Health

  • Chapter
Dementia Care

  • 2764 Accesses

Abstract

This chapter discusses early stage dementia including psychological response, individual needs, care partner roles, continuity of care and available resources. It highlights the importance of autonomy and empowering the individual with early stage dementia to be as independent as possible in areas of strength. This is demonstrated through the importance of early detection and diagnostic disclosure as well as having joint conversations about difficult topics with the individual in the early stages to further empower personal choice and voice. Overall, both the individual in the early stages and care partner(s) will go through a range of emotions that progress through stages of awareness, coping and self-evaluation. There are varying factors that can influence ones psychological responses pertaining to a diagnosis of dementia. Therefore, it is imperative that the individual in the early stages and care partner(s), with support from healthcare professionals, work together as a team thus enhancing a sense of control over this change of life situation through joint interventions and strategies.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Alzheimer’s Association. 2014 Alzheimer’s disease facts and figures. Alzheimers Dement. 2014;10(2):1–75.

    Article  Google Scholar 

  2. Alzheimer’s Association. Seven stages of Alzheimer’s 2014 [cited 2014 September 2]. Available from: http://www.alz.org/alzheimers_disease_stages_of_alzheimers.asp

  3. Alzheimer’s Association. Voices of Alzheimer’s disease: a summary report on the Nationwide Town Hall Meetings for people with early stage dementia; 2008.

    Google Scholar 

  4. Beard RL. In their voices: identity preservation and experiences of Alzheimer’s disease. J Aging Stud. 2004;18(4):415–28. PubMed PMID: WOS:000224598900004.

    Article  Google Scholar 

  5. Pratt RW, Wilkinson H. A psychosocial model of understanding the experience of receiving a diagnosis of dementia. Dementia. 2003;2(2):181–99.

    Article  Google Scholar 

  6. Robinson L, Clare L, Evans K. Making sense of dementia and adjusting to loss: psychological reactions to a diagnosis of dementia in couples. Aging Ment Health. 2005;9(4):337–47. PubMed PMID: 16019290.

    Article  CAS  PubMed  Google Scholar 

  7. Husband HJ. Diagnostic disclosure in dementia: an opportunity for intervention? Int J Geriatr Psychiatry. 2000;15(6):544–7. PubMed PMID: 10861922.

    Article  CAS  PubMed  Google Scholar 

  8. Clare L, Roth I, Pratt R. Perceptions of change over time in early-stage Alzheimer’s disease: implications for understanding awareness and coping style. Dementia. 2005;4(4):487–520.

    Article  Google Scholar 

  9. Clare L. We’ll fight it as long as we can: coping with the onset of Alzheimer’s disease. Aging Ment Health. 2002;6(2):139–48. PubMed PMID: 12028882.

    Article  CAS  PubMed  Google Scholar 

  10. Werezak L, Stewart N. Learning to live with early dementia. Can J Nurs Res. 2002;34(1):67–85. PubMed PMID: 12122774.

    PubMed  Google Scholar 

  11. Clare L, Nelis SM, Martyr A, Roberts J, Whitaker CJ, Markova IS, et al. The influence of psychological, social and contextual factors on the expression and measurement of awareness in early-stage dementia: testing a biopsychosocial model. Int J Geriatr Psychiatry. 2012;27(2):167–77. PubMed PMID: 21425345.

    Article  PubMed  Google Scholar 

  12. Harman G, Clare L. Illness representations and lived experience in early-stage dementia. Qual Health Res. 2006;16(4):484–502. PubMed PMID: 16513992.

    Article  PubMed  Google Scholar 

  13. Clare L, Whitaker CJ, Nelis SM, Martyr A, Markova IS, Roth I, et al. Self-concept in early stage dementia: profile, course, correlates, predictors and implications for quality of life. Int J Geriatr Psychiatry. 2013;28(5):494–503. PubMed PMID: 22767455.

    Article  PubMed  Google Scholar 

  14. Macrae H. Managing identity while living with Alzheimer’s disease. Qual Health Res. 2010;20(3):293–305. PubMed PMID: 19940091.

    Article  PubMed  Google Scholar 

  15. Morin A. Levels of consciousness and self-awareness: a comparison and integration of various neurocognitive views. Conscious Cogn. 2006;15(2):358–71. PubMed PMID: 16260154.

    Article  PubMed  Google Scholar 

  16. Hyden LC, Orulv L. Narrative and identity in Alzheimer’s disease: a case study. J Aging Stud. 2009;23(4):205–14. PubMed PMID: WOS:000271796300001.

    Article  Google Scholar 

  17. Caddell LS, Clare L. A profile of identity in early-stage dementia and a comparison with healthy older people. Aging Ment Health. 2013;17(3):319–27. PubMed PMID: 23171274.

    Article  PubMed  Google Scholar 

  18. Clare L. Managing threats to self: awareness in early stage Alzheimer’s disease. Soc Sci Med. 2003;57(6):1017–29. PubMed PMID: 12878102.

    Article  PubMed  Google Scholar 

  19. Cotter VT. Hope in early-stage dementia: a concept analysis. Holist Nurs Pract. 2009;23(5):297–301. PubMed PMID: 19713788.

    Article  PubMed  Google Scholar 

  20. Snyder L. Satisfactions and challenges in spiritual faith and practice for persons with dementia. Dementia. 2003;2(3):299–313.

    Article  Google Scholar 

  21. Carpenter BD, Xiong C, Porensky EK, Lee MM, Brown PJ, Coats M, et al. Reaction to a dementia diagnosis in individuals with Alzheimer’s disease and mild cognitive impairment. J Am Geriatr Soc. 2008;56(3):405–12. PubMed PMID: 18194228.

    Article  PubMed  Google Scholar 

  22. Vernooij-Dassen M, Derksen E, Scheltens P, Moniz-Cook E. Receiving a diagnosis of dementia: the experience over time. Dementia. 2006;5(3):397–410.

    Article  Google Scholar 

  23. Lecouturier J, Bamford C, Hughes JC, Francis JJ, Foy R, Johnston M, et al. Appropriate disclosure of a diagnosis of dementia: identifying the key behaviours of ‘best practice’. BMC Health Serv Res. 2008;8:95. PubMed PMID: 18452594. Pubmed Central PMCID: 2408568.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Zaleta AK, Carpenter BD, Porensky EK, Xiong C, Morris JC. Agreement on diagnosis among patients, companions, and professionals after a dementia evaluation. Alzheimer Dis Assoc Disord. 2012;26(3):232–7. PubMed PMID: 22037598. Pubmed Central PMCID: 3277665.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Alzheimer’s Association. Dementia & Driving Resource Center 2014 [cited 2014 September 19]. Available from: http://www.alz.org/care/alzheimers-dementia-and-driving.asp

  26. Alzheimer’s Association. Plan for Your Future, Make Your Wishes Known 2014 [cited 2014 September 19]. Available from: http://www.alz.org/i-have-alz/plan-for-your-future.asp

  27. Irving K, Lakeman R. Reconciling mental health recovery with screening and early intervention in dementia care. Int J Ment Health Nurs. 2010;19(6):402–8. PubMed PMID: 21054726.

    Article  PubMed  Google Scholar 

  28. Shepherd G, Boardman, J., & Slade, M. Making Recovery a Reality London: Sainsbury Centre for Mental Health; 2008 [cited 2014 September 19]. 2008 [Available from: http://www.centreformentalhealth.org.uk/pdfs/Making_recovery_a_reality_policy_paper.pdf.

  29. Alzheimer’s Association. Building a Care Team 2014 [cited 2014 September 19]. Available from: http://www.alz.org/i-have-alz/building-a-care-team.as

  30. Alzheimer’s Association. Early Stage 2014 [cited 2014 September 8]. Available from: http://www.alz.org/delval/in_my_Community_15417.asp

  31. Logsdon RG, Pike KC, McCurry SM, Hunter P, Maher J, Snyder L, et al. Early-stage memory loss support groups: outcomes from a randomized controlled clinical trial. J Gerontol B Psychol Sci Soc Sci. 2010;65(6):691–7. PubMed PMID: 20693265. Pubmed Central PMCID: 2954328.

    Article  PubMed  Google Scholar 

  32. Morhardt D. Educating medical students on Alzheimer’s disease and related disorders: an overview of the Northwestern University Bubby Program. Dementia. 2006;5:448–56.

    Article  Google Scholar 

  33. Morhardt DJ. The effects of an experiential learning and mentorship program pairing medical students and persons with cognitive impairment: A qualitative content analysis. Dissertations Paper 727; 2013.

    Google Scholar 

  34. Jefferson AL, Cantwell NG, Byerly LK, Morhardt D. Medical student education program in Alzheimer’s disease: the PAIRS Program. BMC Med Educ. 2012;12:80. PMID: 22906234. Pubmed Central PMCID: 3500260.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Dunn JC, Clare L. Learning face-name associations in early-stage dementia: comparing the effects of errorless learning and effortful processing. Neuropsychol Rehabil. 2007;17(6):735–54.

    Article  PubMed  Google Scholar 

  36. Kanaan SF, McDowd JM, Colgrove Y, Burns JM, Gajewski B, Pohl PS. Feasibility and efficacy of intensive cognitive training in early-stage Alzheimer’s disease. Am J Alzheimers Dis Other Demen. 2014;29(2):150–8. PubMed PMID: 24667905.

    Article  PubMed  Google Scholar 

  37. Clare L, Wilson BA, Carter G, Roth I, Hodges JR. Relearning face-name associations in early Alzheimer’s disease. Neuropsychology. 2002;16(4):538–47. PubMed PMID: 12382992.

    Article  PubMed  Google Scholar 

  38. Clare L, Woods RT, Moniz Cook ED, Orrell M, Spector A. Cognitive rehabilitation and cognitive training for early-stage Alzheimer’s disease and vascular dementia. Cochrane Database Syst Rev. 2003;(4):CD003260. PubMed PMID: 14583963.

    Google Scholar 

  39. Clare L. Does awareness of cognitive difficulties influence the outcome of cognitive rehabilitation for people with early-stage Alzheimer disease? Neurobiol Aging. 2004;25:S72-S. PubMed PMID: WOS:000223058700243.

    Google Scholar 

  40. Reifler BV, Larson E. Alzheimer’s disease treatment and family stress: excess disability in dementia of the Alzheimer’s type. New York: Hemisphere; 1990.

    Google Scholar 

  41. Mottram P. Art therapy with clients who have dementia. Dementia. 2003;2:272–7.

    Article  Google Scholar 

  42. Harlan JE. The therapeutic value of art for persons with Alzheimer’s disease and related disorders. Loss Grief Care. 1993;6(4):99–106.

    Article  Google Scholar 

  43. Hannemann BT. Creativity with dementia patients. Can creativity and art stimulate dementia patients positively? Gerontology. 2006;52(1):59–65. PubMed PMID: 16439826.

    Article  PubMed  Google Scholar 

  44. Stewart EG. Art therapy and neuroscience blend: working with patients who have dementia. Art Ther J Am Art Ther Assoc. 2004;21(3):148–55.

    Article  Google Scholar 

  45. Alzheimer’s Association. Memories in the Making 2014 [cited 2014 September 8]. Available from: http://www.alz.org/delval/in_my_Community_63511.asp

  46. Rentz CA. Memories in the making: outcome-based evaluation of an art program for individuals with dementing illnesses. Am J Alzheimers Dis Other Demen. 2002;17(3):175–81. PubMed PMID: 12083348.

    Article  PubMed  Google Scholar 

  47. Caldwell RL. At the confluence of memory and meaning- Life review with older adults and families: using narrative therapy and the expressive arts to re-member and re-author stories of resilience. Fam J. 2005;13(2):172–5.

    Article  Google Scholar 

  48. Arkin SM. Student-led exercise sessions yield significant fitness gains for Alzheimer’s patients. Am J Alzheimers Dis Other Demen. 2003;18(3):159–70.

    Article  PubMed  Google Scholar 

  49. McCurry SM, Pike KC, Logsdon RG, Vitiello MV, Larson EB, Teri L. Predictors of short- and long-term adherence to a daily walking program in persons with Alzheimer’s disease. Am J Alzheimers Dis Other Demen. 2010;25(6):505–12. PubMed PMID: 20660515. Pubmed Central PMCID: 2935497.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University of Pennsylvania School of Nursing, Claire Fagin Hall, Office 350, 418 Curie Blvd., Philadelphia, PA, 19104, USA

    Valerie T. Cotter DrNP, AGPCNP-BC, FAANP

  2. Alzheimer’s Association Delaware Valley Chapter, 399 Market Street, Suite 102, Philadelphia, PA, 19106, USA

    Julie Teixeira BFA, MA

Authors
  1. Valerie T. Cotter DrNP, AGPCNP-BC, FAANP
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Julie Teixeira BFA, MA
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Valerie T. Cotter DrNP, AGPCNP-BC, FAANP .

Editor information

Editors and Affiliations

  1. William F. Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts, USA

    Marie Boltz

  2. Charles E. Schmidt College of Medicine, Florida Atlantic University, NEW YORK, Florida, USA

    James E. Galvin

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Cotter, V.T., Teixeira, J. (2016). Early Stage Dementia: Maximizing Self-Direction and Health. In: Boltz, M., Galvin, J. (eds) Dementia Care. Springer, Cham. https://doi.org/10.1007/978-3-319-18377-0_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-18377-0_5

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-18376-3

  • Online ISBN: 978-3-319-18377-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation