Abstract
BackgroundThe ability to create and maintain an ongoing life narrative is a key characteristic of what makes us human; however, people with dementia lose this ability in the course of the disease. If the notion of having a self is intimately linked with being able to create and maintain a life narrative and if people with dementia tend to lose this ability, what kind of self do people with dementia still possess?Objective and methodsRecent theories developed in psychology and philosophy suggest that at least two notions of the self have to be distinguished: the experiencing self and the remembering self. This distinction is applied to people with dementia.ResultsWhile the remembering self is impaired in people with dementia, their experiencing self remains relatively intact. Critically, the experiencing self is a self with inner depth, mirroring the life history of the individual. Thus, the self of people with dementia is not unextended in time. Although people with dementia may have lost the ability to tell a story about their life, they are still able to express this story in their behavior.ConclusionUnderstanding the structure of the self of people with dementia can help guide interactions as well as the designing of appropriate interventions and environments. Moreover, realizing the inner depth of the self of people with dementia may help acknowledge their dignity and personhood.
Highlights
Despite the significant differences between the various forms of dementia, in all of them the deterioration of memory and language is a key characteristic
When someone asks you whether you liked the recording, you may no longer think about the wonderful piece of music that you were listening to but rather about the horrible sound that disturbed you near the end. It seems that the sound ruined the whole experience; according to Kahneman [16], who uses this example to distinguish between two kinds of selves, the experiencing self and the remembering self, the scratch does not ruin the whole experience. It ruins the memory of the experience, it ruins what the remembering self thinks about the experience when looking back on it, but not what the experiencing self perceived while listening to the music, i.e., while making the experience up until the shocking sound
Neither Kahneman nor the proponents of the distinction between a minimal and a narrative self explicitly refer to dementia in their writings, one could argue that dementia primarily affects the remembering self, i.e., the ability toputdifferentexperiences incontextand to perceive different events as belonging to the same story, while the experiencing
Summary
Despite the significant differences between the various forms of dementia, in all of them the deterioration of memory and language is a key characteristic. It ruins the memory of the experience, it ruins what the remembering self thinks about the experience when looking back on it, but not what the experiencing self perceived while listening to the music, i.e., while making the experience up until the shocking sound. Neither Kahneman nor the proponents of the distinction between a minimal and a narrative self explicitly refer to dementia in their writings, one could argue that dementia primarily affects the remembering self, i.e., the ability toputdifferentexperiences incontextand to perceive different events as belonging to the same story, while the experiencing
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