Individualized Activities Based on Role Identities for People with Dementia

Abstract

While a full exploration of the identity of persons with dementia is an ongoing and difficult pursuit, the examination of role-identity has been accelerated by the development and utilization of the Self-identity In Dementia (SID) questionnaire. This assessment explores past and present role identities in 4 domains: family and friends; work; hobbies and leisure activities; and personal attributes. The SID has been administered to persons with dementia, to their family members, and to formal caregivers in nursing homes and adult daycare centers. Several studies have clarified trends in the role identities of persons with dementia and examined utilization of the information obtained from the SID to design individualized activities for enhancing the sense of identity of persons with dementia. Findings have demonstrated that the importance of role identities decreases over time and with the progression of dementia. The family role has been found to be the most important and salient role identity for all informant groups. The professional role was the one that showed the steepest decline in importance from past to present. Family members reported a greater decline in the importance of role identities from the past to the present than did the older persons themselves. In a study in which the experimental (treatment) group participants were presented with activities designed to correspond to each participant's most salient self-identity, the treatment group showed a significant increase in interest, pleasure, and involvement in activities, fewer agitated behaviors during treatment, and increased orientation during the treatment period. No changes were seen in the control group. Other studies have demonstrated that activities based on role identity enhance engagement and well-being and decrease agitated behaviors in persons with dementia. The results of these studies highlight the powerful roles played by perception of self and by fulfillment of self-identity in overall well-being in this population.