Thursday, October 23, 2008

All anxieties tranquilised

The exit doors have been disguised so as not to be discerned by confused and enfeebled perceptions.

An ‘alternative pathway’ leads inmates through a corridor of rooms, which eventually and inevitably takes them back to the common room from which they’d hoped to escape.

This artifice has been contrived not only to constrain movement of the inmates, but also to reduce their awareness of constraint.

Lies are told to the inmates so as to avoid any responses which might cause them distress and thus upset the smooth running of the institution. Your mother may have died thirty years ago, but you will be told lies, to expect a visit from her, if it suits the powers-that-be.

No, this is not some sinister, nightmarish Cabinet of Doctor Caligari, but rather is presented as enlightened practice in the care of old people suffering progressive cognitive impairment, a.k.a. senile dementia.

The onset of dementia in advancing years is a problem which is growing with the increase in the aged population in many countries. It’s also a problem that many of us may have to personally face, whether it affects loved ones or (worst case scenario) our own selves.

To lose one’s marbles is indignity enough, but is it really necessary to be further insulted with lies and subterfuge?

Many experts increasingly would have it so, but there persists an opposing school of thought preferring an approach which favours ‘reality orientation’ — chiefly, so as to preserve the dignity of the sufferer.

Rubbish! say the cognitive engineers. The ‘reality orientation’ school are theorists, whereas we are realists. Better to be lied to — into believing, for instance, that your long-dead mother will soon come visit — in order to induce a pleasurable, rather than painful, reaction.

Better to induce reactions that are pleasurable than painful with which to colour their remaining twilight days.

Which would you choose to dispense?

Think on it carefully now, because when your time comes you’ll be unlikely to have any say in it.

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Anonymous Anonymous said...

«"Lies are told to the inmates so as to avoid any responses which might cause them distress and thus upset ...»

I heard something about this just the other day.

But backing up a bit, the Dr. said something like "If there is a positive it is this, the person doesn't - or hardly - realises that s/he's 'gone off.'"

Then, telling an affected person some *really bad news* (like the death of someone close) can cause an intense grief reaction. That cognitive capacity has been and continues to be lost, means that any 'bad news' is quickly forgotten - but a grief reaction, involving the emotions, can stay around. The person continues to experience the 'emotional hangover' - making them sad - without even knowing (having forgotten) why.

We take the attitude that whatever we say should be positive, to avoid any possible above-type scenario - and the person concerned need not be bothered with any negatives anyway. «Carpe diem!»

30/10/08 12:30 PM  
Anonymous Anonymous said...

Well, silly me. The 'something' I heard came from the link:

«And say we have an old lady aged 90, sitting in the living room there, and she says, 'When's mum coming?' If you go along the line of telling the truth and saying, 'Oh look, mum's been dead for 30 years now...' But the fact that mum's dead gives her a grief reaction. Now her memory may well be 15 seconds or 30 seconds, so she won't remember what's given her a grief reaction, but the emotional response goes on for hours. And so she'll say, 'I'd better talk to mum about this, when's mum coming?' every hour on the hour for the next 20 years, or 10 years. And you have her perpetually grieving.»

I'm a truth seeker, sometimes going as far as being brutally honest (or so some detractor(s) allege.) In this case, however, I prefer to err - on the 'Peace, brother!' side. Not 'Tell them no lies,' but 'Give them no grief!'

30/10/08 1:17 PM  

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