Medicalization of Insight and Caregivers’ Responses to Risk in Dementia

Abstract

Lack of insight or impaired awareness of deficits in people with Alzheimer’s disease or other dementias (AD) is a relatively neglected area of study. The terms are widely used in professional and everyday life without a shared understanding of what lack of insight means to health professionals, informal caregivers or people with dementia. Content analysis of 49 psychiatry or psychology texts, in which insight or a synonym is mentioned, found lack of clarity in definitions and their operationalization. In general, insight is defined as the ability to understand one’s own problems. Lack of insight therefore is a professional judgement grounded in the medicalization of dementia. People labelled as lacking insight of their dementia will consequently experience more acutely depersonalization, loss of independence, loss of social and political rights and they will have their behaviour individualized. Caregivers’ understanding of the loss of insight may influence the way they deal with risk during caregiving.