This qualitative study explored family and caregiver perspectives on the expression of emotion by individuals in the middle and late stages of Alzheimer's disease (AD). Indepth interviews were conducted with family members and facility staff Respondents readily ascribed expression of a wide range of emotions to individuals in the advanced stages of AD. More negative than positive emotions were identified. Caregivers attributed much of the negative emotion to individual response to the difficulties imposed by the disease. Differences by stage of the disease and sudden shifts in mood were also described, including a difficult period coinciding with recognition of increasing deficits and their consequences in the middle stages.
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References
1.
1. Lawton MP, VanHaitsma K, Klapper J: Affect in nursing home residents with Alzheimer's disease. Journal of Gerontology: Sociology Sciences. 1996; 51B(1): 3-14.
2.
2. Cotrell V, Schultz R: The perspective of the patient with Alzheimer's disease: A neglected dimension of dementia research. The Gerontologist. 1993; 33(2): 205-211.
3.
3. Hughes D: Alzheimer's Disease and psychiatric nursing: Treating the depression. Perspectives in Psychiatric Care. 1987; 10(11): 5-8.
4.
4. Scott JP, DeGhett VJ: Development of affect in dogs and rodents, In Communication and Affect: A comparative Approach, Alloway T, Kramer L & Pliner P. (eds). New York: Academic Press, 1972: 129-150.
5.
5. Bayles KA, Kaszniak AW: Communication and cognition in normal aging and dementia. Boston: Little, Brown & Co., 1987.
6.
6. Joseph R: Neuropsychology, neuropsychiatry and behavioral neurology. New York: Plenum Press, 1990.
7.
7. Cohen D: The subjective experience of Alzheimer's Disease: The anatomy of an illness as perceived by patients and families. American Journal of Alzheimer's Care and Related Disorders and Research. 1991; 6(3): 6-11.
8.
8. Brosgole L, Kurucz J, Plahovinsak TJ, et al: On the mechanism underlying facial affective agnosia in sexnile demented patients. International Journal ofNeuroscience. 1981; 15: 207-215.
9.
9. Bungener C, Jouvent R, Derouesne C: Affective disturbances in Alzheimer's Disease. Journal of the American Geriatrics Society. 1996; 44: 1066-1071.
10.
10. Bartol MA: Nonverbal communication in patients with Alzheimer's Disease. Journal of Gerontological Nursing. 1979; 5: 21-31.
11.
11. Zandi T, Cooper M, Garrison L: Facial recognition: A cognitive study of elderly dementia patients and normal older Adults. International Psychogeriatrics. 1992; 4: 215-221.
12.
12. Albert MS, Cohen C, Koff E: Perception of affect in patients with dementia of the Alzheimer's type. Archives of Neurology. 1991; 48: 791-795.
13.
13. Allender J, Kaszniak AW: Processing of emotional cues in patients with dementia of the Alzheimer's type. International Journal ofNeuroscience. 1989; 40: 147-155.
14.
14. Kurucz J, Feldman G: Prosopo affective agnosia as a symptom of Cerebral Organic Disease. Journal of the American Geriatrics Society. 1979; 27: 225-229.
15.
15. Wands K, Merskey H, Hachinski V, et al: A questionnaire investigation of anxiety and depression in early dementia. Journal of The American Geriatrics Society. 1990; 38: 535-538.
16.
16. Burke WJ, Rubin EH, Morris JC, et al: Symptoms of “Depression” in dementia of the Alzheimer type. Alzheimer Disease and Associated Disorders. 1988; 2: 356-362.
17.
17. Pearson JL, Teri L, Reifler BV, et al: Functional status and cognitive impairment in Alzheimer's patients with and without depression. Journal of the American Geriatrics Society. 1989; 37: 1117-1121.
18.
18. Cooper JK, Mungas D, Weiler PG: Relation of cognitive status and abnormal behaviors in Alzheimer's Disease. Journal of the American Geriatrics Society. 1990; 38: 867-870.
19.
19. Thompson LW, Wagner B, Zeiss A, et al: Cognitive/behavioral therapy with early stage Alzheimer's patients: An exploratory view of the utility of this approach, In Alzheimer's Disease Treatment and Family Stress: Directions for Research, Light E &. Lebowitz BD, (eds). Washington DC: US Government Printing Office, (DHHS Pub No ADM 89-1569), 1989.
20.
20. Miles MB, Huberman AM: Qualitative data analysis: A sourcebook of new methods (2nd ed). Newbury Park, California: Sage, 1994.
21.
21. McKhann G, Drachman D, Folstein M, et al: Clinical diagnosis of Alzheimer's Disease: Report of the NINCDS-ADRDA work group under the auspices of the Department of Health and Human Services Task Force in Alzheimer's Disease. Neurology. 1984; 34: 939-944.
22.
22. Kolb B, Wishaw IQ: Fundamentals of human neuropsychology. New York: W.H. Freeman, 1990.
23.
23. Reisberg BC: Alzheimer's Disease. New York: Free Press, 1983.
