Care & Identity
Michelle is an 82-year- old extrovert with an impish smile and expressive hands. A life-long animal lover, Michelle never married or had children, but she established a local animal shelter and cared for several of her own pets.
Michelle is living with Alzheimer’s disease, and resides in an assisted living community where staff members know her well. Her room is full of photos of animals, and staff made a small album of her pets that Michelle can show other residents. When therapy dogs visit the residence, staff seek
out Michelle because she loves to walk with them through the halls. Despite significant lapses in her memory, Michelle’s identity remains, and staff reinforce it through the way they interact with her and the things around her.
“We find that people with Alzheimer’s and other dementias don’t actually lose their sense of self, instead, they lose the ability to communicate aspects of themselves. If they can’t tell you who they are or who they’ve been, it’s up to us— caregivers, family, and friends—to reach out and find ways to connect based on what we know about them,” says Sam Fazio, Ph.D., director of Constituent Services at the Alzheimer’s Association. Studies of people with Alzheimer’s disease show that despite cognitive impairment they can still recognize themselves in mirrors and photographs, use pronouns like “I” and “me,” and describe what they felt and believed during significant life events, such as going to war or celebrating their wedding day.
“Identity is more than memory,” Fazio explains. “It’s important to find out who a person with dementia has been their whole life and to weave that into your interactions with them. For example, if you know that the person with Alzheimer’s used to be a dancer, you can ask them about their performances while helping them with a bath.”
Fazio is describing “person- centered care,” an approach that views the person living with Alzheimer’s as an individual, not just as a patient with symptoms to manage.
The following principles are the basis behind person-centered care:
• Value the person with dementia and the people who care for them.
• Treat people as individuals.
• Look at the world through the person’s eyes.
• Provide a positive social environment that supports the person’s well-being1.