Journal du vieillissement et de la psychiatrie gériatrique

Abstrait

Life Quality and the Self: A Person-Centered Case Study of Alzheimers Disease

Sylva Sarafidou

Alzheimer’s is a neurodegenerative disorder that manifests itself physically, cognitively, emotionally, behaviourally. Despite that AD influences all aspects of life of the sufferer, treatment focuses on the biological and cognitive aspects, fact which is problematic, both theoretically (as cognitive abilities decline, it is thought that the self is gradually lost) and practically (aspects that should be targeted are neglected). The result is that AD is approached differently from other neuropsychiatric disorders and there is no focus on the individual’s actual well- being. A Person- Centered Approach recognizes and targets all aspects of the person. The model approaches the core of the self and its goal is to promote the holistic well- being of the person, leading to a life with quality despite the disorder. The importance of the PCA is made apparent through a case study of an 84- year old man with AD. The interaction with the man began with sessions of cognitive reinforcement only, as requested by the caregivers, yet the spherical needs of the person and his low life quality lead to the PCA being applied. The treatment plan became more personalized (atuned to the preferences and mood of the man), more engaging (allowing a sense of agency, including the person in the process and the goal) and elements that allowed the expression of the self (roles, character) were added. After some time, a therapeutic alliance was developed and the man became more stable emotionally and cognitively, learned to manage life with his existing skills, and his subjective well- being increased, as reported by the caregivers, the man himself, and as revealed through questionnaires. A PCA in AD allows the person to maintain a sense of self, and a quality of everyday life, because it approaches individuals as persons and not as manifestations of disorders.

Keywords: Alzheimer’s dementia, Self, Selfhood, Personhood, Person-centered approach, Intervention, Psychotherapy, Therapy, Treatment, Art, Art modalities, Case study, Greece.

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