Abstract
Family caretakers of the elderly with dementia often claim that they “are the only people who know the real condition of these elderlies.” In this paper, I examine such remarks as the “claims of privileged knowledge” (Gubrium & Holstein 1990), which appear to conflict with recent medical theories about dementia. In recent years, Japanese medical practitioners have argued that dementia patients sustain their ability to interact, and they demand that such ability be respected. Family caretakers, on the other hand, seem to ignore the elderlies' abilities and impose upon them their “definition of reality” (Amada 2007). However, in this article, I emphasize that their claims are based on “dementia” as a medical concept and medical practitioners' discourses that stress the dementia patient's ability to interact. Many medical practitioners have pointed out that the environment and those concerned, such as doctors, social workers, and patients' relatives, often dramatically change the dementia patients' conditions because they sustain the patients' interaction abilities. For that feature of “dementia,” those concerned tend to make inconsistent judgments about the patients' conditions (e.g., “You said that he's getting worse and worse, but he is fine because he talked to us a lot about our old times.”). In such cases, family caretakers often insist on interpreting the patients' reactions (such as “talking about old times to relatives”) as symptoms of dementia and remain steadfast in their judgment. In brief, family caretakers make “claims of privileged knowledge” about how to apply the concept of “dementia” to the elderlies' daily lives and presume the elderlies' conditions. Such conflicts between the family caretakers and others reveal problems in the order of family care in “the new century of dementia care” (Iguchi 2007) in Japan.
