Mental Illness and Dementia in intimate late life relationships Gerontology 410 Jan/2008
Intimacy • Definition-close association and contact of a personal and private nature-marital, family, friends. • Five aspects-commitment, affective intimacy, cognitive intimacy, physical intimacy, and mutuality. • There are also elements of self-disclosure and communication • Mental illness or cognitive deterioration can destabilize this pattern. Death and catastrophic illness can have a similar effect.
Dementia • Incidence about 7% in seniors over sixty, increasing by each five year break, with 20-30% over the age of 80 demonstrating signs and symptoms. • Regardless of etiology, dementia is a chronic, progressive loss of function, affective memory, visual spatial abilities and language. • Many community dwelling elderly with dementia continue with intimate relations. However, losing the person as they were known changes the nature of the relationship and the concepts of intimacy
Intimacy and Dementia • Caregivers may grieve over the loss of cognition in their partners and once someone is severely impaired it may be argued they are incapable of intimacy or it may switch to affective and a variety of physical intimacies. • What is important is to understand how these couples formed their original kinds of intimacy and how this has been modified and adapted to deal with the changes they are experiencing.
Intimacy and Death • Loss and grief over the death of a partner, lover, or other intimate reveals how much cognitive effort is needed to make sense of this experience and to work through it to understand what the relationship meant to the person. See Kalish’s work on the stages of grief and the comparisons with Kubler-Ross and stages of dying. • The process of working through this and then moving on with life and with other intimate relationships may take a good deal of time and adjustment.
Summary • Dementia has been described a social death, and therefore the reactions to the disease by the partner may very much appear like the stages of grief over someone who has died. • Intimacy undergoes changes in both circumstances and manifests itself in quite different ways, perhaps in a more spiritual or affective way and less in demonstrations of physical and sexual intimacy. • It is here that we see how our brain is perhaps our major sex organ