Can I Hold That Thought for You? Dementia and Shared Relational Agency

Author:

Klein Eran,Goering Sara

Abstract

AbstractAgency is talked about by many as something that people living with dementia lose, once they've lost much else—autonomy, identity, and privacy, among other things. While the language of loss may capture some of what transpires in dementia, it can obscure how people living with dementia and their loved ones share agency through sharing capacities for memory, language, and decision‐making. We suggest that one consequence of adopting a framework of loss is that it makes the default response to changes in agency the substitution of a family member's agency for the purported lost agency of someone living with dementia. We argue for an alternative framework in which sharing agency is recognized as a central feature of living with dementia. Building on the work of relational theorists, we argue for the value of thinking about agency in dementia as fundamentally shared, and explore potential implications for treatment, caregiver support, and building dementia‐friendly environments.

Funder

National Institute of Mental Health

Publisher

Wiley

Subject

Health Policy,Philosophy,Issues, ethics and legal aspects,Health (social science),Industrial and Manufacturing Engineering,Environmental Engineering

Reference65 articles.

1. ‘We do things together’

2. Staying in the Loop: Relational Agency and Identity in Next-Generation DBS for Psychiatry

3. Of course even within a framework of loss the rate and order of loss for example of agentic or autonomous capacities can vary by individual and across time. For instance someone with dementia could be said to have a substantive loss of identity but still retain forms of agency (for example hugging a stranger) or could be said to retain features of identity in the face of lost agency (for example wanting to comfort a nearby loved one but being unable to find the words due to anomia).

4. World Health Organization “Dementia ” in “International Statistical Classification of Diseases and Related Health Problems 11th Revision” (“ICD-11”) January 2023 https://icd.who.int/browse11/l-m/en#/http%3A%2F%2Fid.who.int%2Ficd%2Fentity%2F546689346.

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