DEM301: Understand the Process and Experience of Dementia

Handout 4: Different reactions to diagnosis

Learning outcome 2, 3 Assessment criteria 2.1, 2.4, 3.4

When an individual is diagnosed with dementia, everyone involved may have different reactions. Some of these may be positive, and others are negative. Jim described it as ‘a living bereavement’. What do you think he meant by this?

Becoming ill, losing independence or accessing a care service can be a frightening experience for many people. There are many associated fears that may or may not seem rational. The experience of loss, for example moving away from their home or family, and fear of illness, disability and its effects, may contribute to their distress in a similar way to bereavement.

Dr. Kubler-Ross identified the following stages of grief or loss that can be attributed to traumatic change such as bereavement, facing death or life-limiting illness, or any significant loss

Stages of grief/loss as identified by Elizabeth Kubler-Ross Stage Coping strategies 1. Denial, Accept denial, but be realistic. shock Don’t break down the individual’s defences. Be aware that denial often breaks down in the early hours when they feel alone.

2. Anger, rage, Accept anger – allow expression through positive means if hostility possible. Anger may be directed towards family members, care workers or others involved. Help individuals and their supporters to recognise that it is usual to experience anger at what they are losing.

3. Bargaining A period for those involved to regain strength. (from ‘No, not Time to complete unfinished business. me’ to ‘Yes me, but…’

4. Depression Recognise as a normal reaction and expression of strength. Experience of Accept as a usual pattern of behaviour that the individual doesn’t silent grief, want to talk and excludes help. mourning past Reassure them that you understand and respect their feelings. and future losses.

5. Acceptance Help family and others to provide continuing, loving human contact.