Lately, the importance of a new method for understanding elderly persons with dementia, referred to as "the relational model," as compared to dementia in "the disease model" has been emphasized. The model states that: (1) elderly persons with dementia have intention, will, and feeling and (2) that their problematic behavior, regarded as a symptom of disease, can be changed depending on their correspondence with others and with their environment.
This paper highlights the effect of emphasizing the importance of the "relational model" on communication between family caregivers and elderly persons with dementia.Therefore, this paper begins by making use of qualitative data to reconsidering the effect of "the disease model" on communication in family care settings.
"The disease model," which has dominated the understanding of dementia, regards most of the acts of elderly persons with dementia as symptoms of brain disease. On the other hand, "the relational model" criticizes "the disease model," suggesting that in the disease model, elderly persons with dementia are controlled and managed. However, is it proper to describe the two models simply as opposite approaches to family care? This paper examines "the disease model" based on two points: (1) the function of the disease model in exempting both parties from the responsibility for problematic behavior is clarified; and (2) difficulties that family caregivers have in continuing to make such an exemption due to their familiarity with a former image of an elderly person with dementia is shown.
The following issues are raised: (1) how can elderly persons with dementia be accorded dignity? It is important to consider that the relational model is not opposed to the disease model, and to remember that the accomplishments of the latter are tied to the practices of the former. (2) We should also consider the problem that care responsibility, generated by a change of an assumption about the cause of "problematic behavior," concentrates on the caregiver.
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