DR M.E MAJEKODUNMI
Consultant Psychiatrist UCH IBADAN
Destigmatising dementia
Dr. M.E. Majekodunmi
Dementia is a group of symptoms that can be caused by some progressive illnesses that affect memory, thinking, behaviour and the ability to perform everyday activities(Instrumental and Basic Activities of Daily Living). Dementia is recognized by the World Health Organization as a mental health disorder. The symptoms of dementia includes depression, hallucination, delusion, agitation and aggression which can be found in mental health conditions even in younger adults. anyone suffering from dementia can find themselves lost in familiar environment, lose all executive functions such as; drive cars, handle finances, unable to use phones.
The good news is that mental Health Symptoms( also known as Behavioral and Psychological Symptoms of Dementia) which promotes labelling as witches are treatable.
STIGMA
Stigma results from a process whereby certain individuals and groups are unjustifyably rendered shameful, excluded and discriminated against.(WPA WHO). This is a mark of disgrace, shame, or discredit which leads to silence, secrecy and shame. About 90% of persons living with dementia will have at least one behavioral and psychological symptoms of dementia. The stigma, delays presentation to health facilities.
Stigma associated with mental health disorders are due to misconception. Behavioural and psychological symptoms of dementia contributes to stigma because of similarity with other mental health condition like schizophrenia and depression. However, the symptoms are not as debilitating as in young adults
WHY STIGMA
Stigma is the use of negative labels to identify a person with disability or illness (DEMENTIA), stigma around Dementia exists due to lack of public awareness and understanding of the disease. Living with dementia can be isolating for the patients, families and caregiver. As social interactions get awkward, people begin to withdraw. Not only do their memories fail, but people themselves begin to fade from view. In the developing world, people with early stage dementia want to change that orientation, they don’t want people to forget the individuals they are or people to stigmatise them hence, instead of hiding their disease, they are celebrating life with it.
TYPES OF STIGMA
Self stigma: refers to internalization of ideas and reactions of those personally targeted by stigma.
Public stigma : refers to reactions of lay people towards a stigmatised individual or group.
Stigma by association: includes the emotion and beliefs of those surrounding the stigmatised person, including family members and professionals.
These types of stigma interact with one another.
NEGATIVE ASSOCIATIONS WITH DEMENTIA
Lack of understanding
Discounted/Disregarded
Avoidance
Crazy
Fear
REASONS FOR STIGMATIZATION
People believe that they are a misfit to life and country.
Diagnosis transforms them as labelled people.
The people cannot see that their brain is diseased .
They have impairment in activities of daily living.
Stigma of receiving and giving dementia diagnosis
CONSEQUENCES OF STIGMA
This stigma prevents people from getting the diagnosis or the opportunity for early intervention that could improve their quality of life. We need to reduce stigma to encourage persons with mild or even no symptoms of dementia to enrol in treatment.
WHAT WE MUST DO
Educate the public
Outreach programs
Reduce isolation of people with dementia
Give people with dementia a voice
Recognise the rights of people with dementia and their carers
Involve people with dementia in their local communities
Support and educate informal and paid carers
Improve the quality of care at home and in care homes
Government to create National Dementia plan
Improve training and research to address stigma
Early diagnosis
PREVENTING STIGMATIZATION
Preventing stigma has to involve government and society, through psycho-education and advocacy.
Financial support from government to family members of people living with dementia should be considered, because most carers stop working or reduce work to care for their loved ones.
This is the practice in most advanced countries and there is nothing wrong starting such here. This will make life better for both carer and care recipient.
GAINS OF DESTIGMATIZATION
If there were no stigma, we might recognise people with dementia as being different but still make effort to include them as members of the society.
- The government and health care providers would set up appropriate treatments and include them in care programmes..
- This will save cost as less people will spend their time in the hospital and more time in the community for everyone’s benefit.
