Do our definitions of death and dying include the loss of a person's defining characteristics? How are we to understand the fading away of dementia? When does that person die?
Dementia is when a person loses their short term memory. However, many dementia patients, such as my girlfriend's grandfather, have the ability to remember events from their childhood, or from defining moments in their life. This shows vitality. For example, Ashley's grandfather remembers specific events during WWII where he was a sniper for the US Army. Additionally, these dementia patients revert to an almost teenage state, or even younger. Their brain goes back and acts as the patient may have at a much younger age. This does not mean that this person is dead.
Although I agree with the higher brain definition of death, I do not believe Alzheimer's and dementia patients (in most cases) are "dead." They are still the same person, even though they cannot remember sometimes. I really like the example that Rob used about remembering specific events during WWII. There are so many different levels of dementia and Alzheimer's, and I believe even mild cognitive impairment calls under that category. People with MCI are forgetful and have trouble with problem-solving. However, they may not develop Alzheimer's and therefore they aren't necessarily going to "fade away." Dementia, also, is not always as severe and thus it would be unfair to define a dementia patient as dead. Alzheimer's, though, is where the lines get fuzzy. The early symptoms of Alzheimer's can include difficulty performing tasks that used to come easily to the patient, misplacing items, getting lost, etc. That patient is still the same person. They just are not as efficient as they used to be. As Alzheimer's becomes more severe, patients often cannot perform basic daily activities, such as eating and bathing. What makes an Alzheimer's patient dead, to me, is the complications of the disease. These can include malnutrition, dehydration, immobility, infection, loss of ability to interact, etc. These symptoms can clearly contribute to a biological death. So, in this case, I would have to go with the biological definition of death.
I would agree that the depth of Alzheimer's is the key. When a person no longer remembers to feed themselves or how to speak, that is dying from the disease. When the forgetting becomes for in depth that the person no longer has even basic functions that is the dying of the person.
I support the higher brain definition of death, however I do not consider patients with Alzheimer's or dementia to be considered "dead." For the higher brain definition, as well as some of my own thoughts, I consider an individual dead when they can no longer think, communicate, or perceive what is going on around them. Alzheimer's patients can still function, they just become less efficient at it as their ability to remember and process information deteriorates. However, if they still have the ability to perform daily tasks that are part of what make us human, than they are very much still alive in my opinion, the quality of life just may be a little more inconvenient.
I do not believe that Alzheimer's or Dementia patients are dead, even though I agree with the higher brain definition of death. People suffering from Alzheimer's or Dementia can still remember specific things, as Rob said in his example above. Just because they suffer from one of these doesn't mean that they are a different person or would do things differently on purpose. Dementia is a loss of brain function that occurs with certain diseases. Alzheimer's disease, however, is one form of dementia that will get worse over time. It usually affects memory, but it can affect a person's way of thinking and their behavior as well. Patients with Alzheimer's disease slowly begin to lose simple everyday activities. If they do not get this far as to lose simple everyday activities then I would consider them more alive than the ones that do. There is no cure for Alzheimer's disease, but they have specific things they aim to do. Managing symptoms and changing the home environment so the patient can perform daily activities are two big goals for people suffering with Alzheimer's disease. I would say patients in late stage Alzheimer's disease that are extremely confused and lack the ability to communicate and move around would be "dead" to me. When you are no longer able to survive on your own is when I would consider someone dead.
When someone is diagnosed with dementia and Alzheimer's they lose memory and with the loss of memory comes loss of functioning. We learned in gerontology that the patient loses their functioning in opposite orders in which they learned them. Meaning that they lose the most recent things first and things they learned earlier in life last. I still do not consider these people dead. When I had a patient in clinicals that had severe dementia, I still treated her as a normal patient, not as someone who has no meaning of life left.
We bring up Alzheimer's patients alot in class which hits home when I go to work. It always makes me look at my residents in a different light. I always wonder what it is exactally they are thinking. I wonder if they realize what is going on around them and inside them. With this thought in mind, I do not belive that Alzheimer's patients are considered dead. I believe they are just in a different state of life. While the disease is taking control of their brain, most of them still walk around, talk, eat, sleep...they have a different quality of life then they used to. I agree with Chelsea when she states that someone is dead when they cannot survive on their own. They may need help every now and then, like the patients in my assistant living facility, but they are still alive and doing natural things.
Short term memory loss occurs when a patient is diagnosed with Alzheimer's disease. Our definitions of dying occur when someone takes their last breath. But Alzheimer's patients lose their ability to remember short term things. Like Rob said, they tend to remember more about their childhood. My grandpa went through this and it was very hard to see him lose his personality and his characteristics. We may see them as still living, but inside they just are not the same.
From a nursing point of view, death to me occurs when someone stops breathing. The person is still alive if they are in the end stages of Alzheimer's disease, it might not be an ideal state of life but they are still breathing and they have a heart beat. It is not right to say a person is dead because they cannot think for themselves anymore. There is so much new and advancing technology in the medical feild that a person be kept alive for much longer. But this brings the question of ethics and if it is right to keep them "alive", are they really living? In either case, the person is not themselves anymore but they are still alive.
I do not support the higher brain function definition of death because it is subjective, different people will consider different abilities as 'higher brain functions.' Therefore I consider people who suffer from Alzheimer's to be very much alive because Alzheimer's is nothing more than a disease that targets the brain rather than some other body organ.
I do support the higher brain function definition of death, but I find it disturbing that these patients with Alzheimer's could be declared dead according to this approach. Therefore, it is difficult to completely accept this definition as some serious moral questions are raised. Even though these patients no longer have those characteristics that we use to define ourselves as human beings it is still hard to think about a person with Alzheimer's being considered dead. What are those defining characteristics that without we would no longer be considered a person? When parts of the brain undergo irreversible damage, which parts definitely qualify as higher-brain? These are important questions in which the answers are most certainly not clear cut. This is exactly why it is so difficult to pinpoint when a person with dementia dies.
To me this seems to be a personal opinion. Everyone has there own ideas of when a person is truly lost. I believe once the person can no longer function from day to day and have no retention of past events or people. As harsh as it may sound the person is dead at that point to me because they will never again the the person I knew and loved.
I do not think that a person with memory or mental problems is dead. Their personality may be dead once they have no idea who they are, and cannot remember anything about themselves or any of their life. Their behavior will probably be different and they will be living with dependence on others, but not dead just because they can't remember anything.
Patients with Dementia or Alzheimer’s are certainly not dead. They live just as a normal person but have memory deficiencies. These people as Rob stated can remember the littlest details from years and years ago. My grandma is great example of this. She asks me all the time how Florida is because I went to school there two years ago, but she tells stories of my dad and his brothers from when they were little. The stories are from back in the 60’s and 70’s so we are talking 35+ years that she can remember. I did not agree with the brain definition of death and I certainly would stick by that when talking about people who have Dementia or Alzheimer’s. I saw a girl in a wheel chair the other day at a Thomas More at the volleyball game. You could see that she had brain deficiencies by the way she looked and moved. It was very evident by her actions that she was happy and certainly engaged in the game. At one point she was sitting on her moms lap and was cheering. When you see things like and really see how happy these people are, it’s hard to believe that there are those out there that define that as being “dead.”
“Listen With the Ears of Your Heart” by Dorothy Seman. The article is found in Nursing Homes Long Term Care Management, September, 2003, 52 (9): 34-40.
This is a great article about Alzheimer's and how they learn act and meeting the patients needs. One quote that stuck out was "I need a cane for my brain". By no means are this people "dead" it just takes more time and effort to recall daily activities
I support the higher brain definition of death when it coincides with traumas (like when a person is in an accident and is left in a vegetative coma with no chance of waking up). It is a sudden loss of function, lack of ability to take care of and provide for one's basic survival needs that constitutes 'dead' for me. Even if they are not biologically dead, they are definitely heading there unless some outside source intervenes. I don't think Alzheimer's or progressive dementia patients to be dead. They may eventually reach the stage where they are 'dead' to those around them, meaning that their personality, what made them who they were, has been lost to the disease. But as long as they can perform some skills (or at least make requests that those survival needs be met, by screaming or crying, etc.). Someone above mentioned that once a person loses those skills and must be fully supported by others, they are in the process of dying. I have to agree. But until biological death occurs, I say dementia patients are still alive.
I feel like the answer to this question is more universal than we let on to be. Everyone that I know, who is affected by family members with Alzheimer's (myself including), feel like the Alzheimer's patient is "slipping away" or "not themselves anymore". Even if we don't conscious give it the term "dying", I believe that we acknowledge it subconsciously which is why it is so hard to witness a loved one with Alzheimer's. Let's apply this to a less terminal case. Say your at your high school reunion and for the first time in years you get to see all your old friends. Then out of the blue your crazy party pal Kati shows up. Kati was always the wild, outgoing life of the party and you have many fond memories of her. But after talking to her you realized she settled down and raised a family of four. She now works car insurance and prefers the name Katherine. Her tone of voice is more calming and her conversation topics are more reserved. This is not the same Kati you crashed Steve's prom party with. That Kati is gone and instead this Kathrine has taken her place. This change is initially thought as a lost. Her higher brain personality seems like something she replaced rather than morphed into. My point is that changes in personality in general are more treated as a loss of the old person than a change. Our conscious brain may eventually work around it, but our gut reaction treats it like Kati died. When an angry dad hears of their son doing something awful so cognitively dissonant, so against every value he taught his son, he might scream without thinking "YOUR DEAD TO ME!" this could be evidence on how we subconsciously feel about death.
I believe that a person dies when they no longer have their individual identity. While this is up to interpretation I think that there is a general truth to it all. An individual with severe Alzheimer's (to keep with the trend above) who no longer has a sense of who they are and who those people are that were close to them. I'm not trying to say by any means that assisted suicide or euthanasia should be an option here but With our more advances in medical technology our definition of death should also be different (as long as the memory and individual's integrity is spared).
Alzheimers and Dementia both run in my family and both of my grandfathers have suffered from them along with our family. One of them the dementia hit the hardest they thought that someone was after them and that they had shot and killed someone in Arizona. He had become pretty violent and then eventually the Alzheimer's surpressed that behavior thank God. He is still alive and lives in Hospice but recognizes no one and doesn't even speak. Hasn't spoken in twelve years and two years ago my other grandfather was diagnosed with Alzheimer's and the medicine he has been taking has slowed the process a lot. He can remember things from ten years ago but nothing from ten minutes ago.
Dementia is when a person loses their short term memory. However, many dementia patients, such as my girlfriend's grandfather, have the ability to remember events from their childhood, or from defining moments in their life. This shows vitality. For example, Ashley's grandfather remembers specific events during WWII where he was a sniper for the US Army.
ReplyDeleteAdditionally, these dementia patients revert to an almost teenage state, or even younger. Their brain goes back and acts as the patient may have at a much younger age. This does not mean that this person is dead.
Although I agree with the higher brain definition of death, I do not believe Alzheimer's and dementia patients (in most cases) are "dead." They are still the same person, even though they cannot remember sometimes. I really like the example that Rob used about remembering specific events during WWII. There are so many different levels of dementia and Alzheimer's, and I believe even mild cognitive impairment calls under that category. People with MCI are forgetful and have trouble with problem-solving. However, they may not develop Alzheimer's and therefore they aren't necessarily going to "fade away." Dementia, also, is not always as severe and thus it would be unfair to define a dementia patient as dead. Alzheimer's, though, is where the lines get fuzzy. The early symptoms of Alzheimer's can include difficulty performing tasks that used to come easily to the patient, misplacing items, getting lost, etc. That patient is still the same person. They just are not as efficient as they used to be. As Alzheimer's becomes more severe, patients often cannot perform basic daily activities, such as eating and bathing. What makes an Alzheimer's patient dead, to me, is the complications of the disease. These can include malnutrition, dehydration, immobility, infection, loss of ability to interact, etc. These symptoms can clearly contribute to a biological death. So, in this case, I would have to go with the biological definition of death.
ReplyDeleteI would agree that the depth of Alzheimer's is the key. When a person no longer remembers to feed themselves or how to speak, that is dying from the disease. When the forgetting becomes for in depth that the person no longer has even basic functions that is the dying of the person.
DeleteI support the higher brain definition of death, however I do not consider patients with Alzheimer's or dementia to be considered "dead." For the higher brain definition, as well as some of my own thoughts, I consider an individual dead when they can no longer think, communicate, or perceive what is going on around them. Alzheimer's patients can still function, they just become less efficient at it as their ability to remember and process information deteriorates. However, if they still have the ability to perform daily tasks that are part of what make us human, than they are very much still alive in my opinion, the quality of life just may be a little more inconvenient.
ReplyDeleteI do not believe that Alzheimer's or Dementia patients are dead, even though I agree with the higher brain definition of death. People suffering from Alzheimer's or Dementia can still remember specific things, as Rob said in his example above. Just because they suffer from one of these doesn't mean that they are a different person or would do things differently on purpose. Dementia is a loss of brain function that occurs with certain diseases. Alzheimer's disease, however, is one form of dementia that will get worse over time. It usually affects memory, but it can affect a person's way of thinking and their behavior as well. Patients with Alzheimer's disease slowly begin to lose simple everyday activities. If they do not get this far as to lose simple everyday activities then I would consider them more alive than the ones that do. There is no cure for Alzheimer's disease, but they have specific things they aim to do. Managing symptoms and changing the home environment so the patient can perform daily activities are two big goals for people suffering with Alzheimer's disease.
ReplyDeleteI would say patients in late stage Alzheimer's disease that are extremely confused and lack the ability to communicate and move around would be "dead" to me. When you are no longer able to survive on your own is when I would consider someone dead.
When someone is diagnosed with dementia and Alzheimer's they lose memory and with the loss of memory comes loss of functioning. We learned in gerontology that the patient loses their functioning in opposite orders in which they learned them. Meaning that they lose the most recent things first and things they learned earlier in life last. I still do not consider these people dead. When I had a patient in clinicals that had severe dementia, I still treated her as a normal patient, not as someone who has no meaning of life left.
ReplyDeleteWe bring up Alzheimer's patients alot in class which hits home when I go to work. It always makes me look at my residents in a different light. I always wonder what it is exactally they are thinking. I wonder if they realize what is going on around them and inside them. With this thought in mind, I do not belive that Alzheimer's patients are considered dead. I believe they are just in a different state of life. While the disease is taking control of their brain, most of them still walk around, talk, eat, sleep...they have a different quality of life then they used to. I agree with Chelsea when she states that someone is dead when they cannot survive on their own. They may need help every now and then, like the patients in my assistant living facility, but they are still alive and doing natural things.
ReplyDeleteShort term memory loss occurs when a patient is diagnosed with Alzheimer's disease. Our definitions of dying occur when someone takes their last breath. But Alzheimer's patients lose their ability to remember short term things. Like Rob said, they tend to remember more about their childhood. My grandpa went through this and it was very hard to see him lose his personality and his characteristics. We may see them as still living, but inside they just are not the same.
ReplyDeleteFrom a nursing point of view, death to me occurs when someone stops breathing. The person is still alive if they are in the end stages of Alzheimer's disease, it might not be an ideal state of life but they are still breathing and they have a heart beat. It is not right to say a person is dead because they cannot think for themselves anymore. There is so much new and advancing technology in the medical feild that a person be kept alive for much longer. But this brings the question of ethics and if it is right to keep them "alive", are they really living? In either case, the person is not themselves anymore but they are still alive.
ReplyDeleteI do not support the higher brain function definition of death because it is subjective, different people will consider different abilities as 'higher brain functions.' Therefore I consider people who suffer from Alzheimer's to be very much alive because Alzheimer's is nothing more than a disease that targets the brain rather than some other body organ.
ReplyDeleteI do support the higher brain function definition of death, but I find it disturbing that these patients with Alzheimer's could be declared dead according to this approach. Therefore, it is difficult to completely accept this definition as some serious moral questions are raised.
ReplyDeleteEven though these patients no longer have those characteristics that we use to define ourselves as human beings it is still hard to think about a person with Alzheimer's being considered dead.
What are those defining characteristics that without we would no longer be considered a person?
When parts of the brain undergo irreversible damage, which parts definitely qualify as higher-brain? These are important questions in which the answers are most certainly not clear cut. This is exactly why it is so difficult to pinpoint when a person with dementia dies.
To me this seems to be a personal opinion. Everyone has there own ideas of when a person is truly lost. I believe once the person can no longer function from day to day and have no retention of past events or people. As harsh as it may sound the person is dead at that point to me because they will never again the the person I knew and loved.
ReplyDeleteI do not think that a person with memory or mental problems is dead. Their personality may be dead once they have no idea who they are, and cannot remember anything about themselves or any of their life. Their behavior will probably be different and they will be living with dependence on others, but not dead just because they can't remember anything.
ReplyDeletePatients with Dementia or Alzheimer’s are certainly not dead. They live just as a normal person but have memory deficiencies. These people as Rob stated can remember the littlest details from years and years ago. My grandma is great example of this. She asks me all the time how Florida is because I went to school there two years ago, but she tells stories of my dad and his brothers from when they were little. The stories are from back in the 60’s and 70’s so we are talking 35+ years that she can remember. I did not agree with the brain definition of death and I certainly would stick by that when talking about people who have Dementia or Alzheimer’s.
ReplyDeleteI saw a girl in a wheel chair the other day at a Thomas More at the volleyball game. You could see that she had brain deficiencies by the way she looked and moved. It was very evident by her actions that she was happy and certainly engaged in the game. At one point she was sitting on her moms lap and was cheering. When you see things like and really see how happy these people are, it’s hard to believe that there are those out there that define that as being “dead.”
“Listen With the Ears of Your Heart” by Dorothy Seman. The article is found in Nursing Homes Long Term Care Management, September, 2003, 52 (9): 34-40.
ReplyDeleteThis is a great article about Alzheimer's and how they learn act and meeting the patients needs. One quote that stuck out was "I need a cane for my brain". By no means are this people "dead" it just takes more time and effort to recall daily activities
I support the higher brain definition of death when it coincides with traumas (like when a person is in an accident and is left in a vegetative coma with no chance of waking up). It is a sudden loss of function, lack of ability to take care of and provide for one's basic survival needs that constitutes 'dead' for me. Even if they are not biologically dead, they are definitely heading there unless some outside source intervenes. I don't think Alzheimer's or progressive dementia patients to be dead. They may eventually reach the stage where they are 'dead' to those around them, meaning that their personality, what made them who they were, has been lost to the disease. But as long as they can perform some skills (or at least make requests that those survival needs be met, by screaming or crying, etc.). Someone above mentioned that once a person loses those skills and must be fully supported by others, they are in the process of dying. I have to agree. But until biological death occurs, I say dementia patients are still alive.
ReplyDeleteI feel like the answer to this question is more universal than we let on to be. Everyone that I know, who is affected by family members with Alzheimer's (myself including), feel like the Alzheimer's patient is "slipping away" or "not themselves anymore". Even if we don't conscious give it the term "dying", I believe that we acknowledge it subconsciously which is why it is so hard to witness a loved one with Alzheimer's. Let's apply this to a less terminal case.
ReplyDeleteSay your at your high school reunion and for the first time in years you get to see all your old friends. Then out of the blue your crazy party pal Kati shows up. Kati was always the wild, outgoing life of the party and you have many fond memories of her. But after talking to her you realized she settled down and raised a family of four. She now works car insurance and prefers the name Katherine. Her tone of voice is more calming and her conversation topics are more reserved. This is not the same Kati you crashed Steve's prom party with. That Kati is gone and instead this Kathrine has taken her place. This change is initially thought as a lost. Her higher brain personality seems like something she replaced rather than morphed into.
My point is that changes in personality in general are more treated as a loss of the old person than a change. Our conscious brain may eventually work around it, but our gut reaction treats it like Kati died. When an angry dad hears of their son doing something awful so cognitively dissonant, so against every value he taught his son, he might scream without thinking "YOUR DEAD TO ME!" this could be evidence on how we subconsciously feel about death.
I believe that a person dies when they no longer have their individual identity. While this is up to interpretation I think that there is a general truth to it all. An individual with severe Alzheimer's (to keep with the trend above) who no longer has a sense of who they are and who those people are that were close to them. I'm not trying to say by any means that assisted suicide or euthanasia should be an option here but With our more advances in medical technology our definition of death should also be different (as long as the memory and individual's integrity is spared).
ReplyDeleteAlzheimers and Dementia both run in my family and both of my grandfathers have suffered from them along with our family. One of them the dementia hit the hardest they thought that someone was after them and that they had shot and killed someone in Arizona. He had become pretty violent and then eventually the Alzheimer's surpressed that behavior thank God. He is still alive and lives in Hospice but recognizes no one and doesn't even speak. Hasn't spoken in twelve years and two years ago my other grandfather was diagnosed with Alzheimer's and the medicine he has been taking has slowed the process a lot. He can remember things from ten years ago but nothing from ten minutes ago.
ReplyDelete