Caregiver Accounts of Lucid Episodes in Persons with Advanced Dementia

© The Author(s) 2023. Published by Oxford University Press on behalf of The Gerontological Society of America..

BACKGROUND AND OBJECTIVES: Paradoxical lucidity is defined as an instance of unexpected lucid behavior in a person who is assumed to be noncommunicative due to a progressive and pathophysiologic dementing process. To inform studies of the prevalence, characteristics, and impact of these behaviors, this interview study examined caregivers' experiences of witnessing paradoxical lucidity.

RESEARCH DESIGN AND METHODS: Participants were family caregivers of persons living with advanced dementia caused by a neurodegenerative disease producing significant impairments in communication. Semi-structured interviews elicited the caregivers' experiences of plausible lucid episodes. Data analysis used a thematic analysis approach.

RESULTS: Most caregivers reported at least one episode of lucidity. Episodes were typically brief. Most involved utterances, but nonverbal behaviors were also common. The mental capacities associated with these behaviors included recognition, awareness of surroundings, recognizing others' emotions, and goal-directed behavior. Most caregivers' reactions were positive. Episodes did not lead to changes in major medical decisions but instead to efforts to either modify or reinforce daily caregiving efforts.

DISCUSSION AND IMPLICATIONS: Episodes of lucidity were common, a finding seen in other studies. If prevalence studies confirm this, the qualifier "paradoxical" should be eliminated. The caregivers' familiarity with the person living with dementia allowed them to attribute meaning to subtle behaviors that might not otherwise be detected or considered lucid. Clinicians who care for persons with advanced stage dementia should routinely ask caregivers about episodes of lucid communication and their emotional reactions.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - year:2023

Enthalten in:

The Gerontologist - (2023) vom: 22. Dez.

Sprache:

Englisch

Beteiligte Personen:

Karlawish, Jason [VerfasserIn]
Peterson, Andrew [VerfasserIn]
Kleid, Melanie [VerfasserIn]
Harkins, Kristin [VerfasserIn]
Largent, Emily A [VerfasserIn]
Stites, Shana D [VerfasserIn]
Coykendall, Cameron [VerfasserIn]
Clapp, Justin T [VerfasserIn]

Links:

Volltext

Themen:

Alzheimer’s disease caregiving
Journal Article
Mental capacity
Mind perception
Paradoxical lucidity

Anmerkungen:

Date Revised 29.03.2024

published: Print-Electronic

Citation Status Publisher

doi:

10.1093/geront/gnad170

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM366250922