The Compounding Nature of Transitions in Dementia: Nursing Implications to Promote Dignity

Abstract

Transitions in older age can be fraught with challenges for older adults and their families. In particular, a diagnosis of dementia – as a transition in and of itself – can lead to multiple transitions. Within this paper, we present a case study of a couple in which the wife is diagnosed with dementia, and the resultant transitions which follow for the wife, husband, and adult daughter. The case study provides a background of the tremendous difficulties that arise with a diagnosis of dementia, becoming a caregiver, and the precariousness of the caregiver role when health changes occur, resulting in a transition to a care facility. Psychosocial and existential responses in relation to a diagnosis of dementia, becoming a caregiver, and transitioning to a facility are discussed. Challenges in navigating the healthcare system are addressed that may diminish a sense of personhood for those with dementia, as well as nursing implications are
presented. In particular, we discuss nursing implications of discourses in dementia care, as well as ethical issues of balancing the wishes of caregivers and individuals with dementia.