'I do not enjoy too much being with people, it takes me a long time to interact': a qualitative analysis of awareness of relationships in people with dementia.

OBJECTIVES: To investigate the presence of awareness of changes in relationships domain, and additional subdomains (cognitive, emotional and functional status) in a group of participants with dementia. METHOD: Using a qualitative design, 9 participants with mild and moderate dementia attended in a day care center were interviewed. Analyses were implemented throughout the modified version of the Grounded Theory Method. RESULTS: Some participants well-recognized changes in their relationships, albeit a tendency to immediately deny those changes was observed among them. The participants' reports showed that the kind of familiar or social relationship might facilitate the expression of awareness. Less discomfort in social interactions with familiars and friends compared to embarrassment with unfamiliar relationships were described. All participants could partially recognize their cognitive deficits, although attempts to normalize their condition and minimize difficulties were identified. Only two participants partially recognized changes in all investigated domains. The other participants partially described changes in two domains beyond the cognitive domain, such as relationships and emotional status or emotional and functional status. However, answers concerning emotional status reflected that some coping styles were not related to a general condition. CONCLUSION: The relationship domain may provide a valuable perspective of awareness of disease. People with dementia may feel less embarrassed to recognize deficits in the presence of familiars and friends.

Awareness of Functional Status: People with Alzheimer's Disease Abilities to Self-Report Impairment in Activities of Daily Living.

BACKGROUND: Awareness of functional status may underlie specific profiles and differences related to stage severity in individuals with Alzheimer's disease (AD). OBJECTIVE: This study aimed to assess self-reported experiences of awareness of functional activity in people with mild and moderate AD. METHODS: This is a mixed methods approach. The qualitative part was conducted through semi-structured interviews concerning the experiences and awareness of deficits in 38 older adults with mild or moderate AD. The quantitative approach included a comparison between groups with regard to concerns of awareness and clinic and demographic data. RESULTS: Impairment on awareness of disease and awareness of functional deficits was observed even in the mild stages of AD. There was also a noticeable progression of impairments of both kinds of awareness from mild to moderate stage of disease. The majority of participants with mild and moderate AD were partially aware of their functional deficits. Both groups of participants reported some negative impact; however, they were not able to entirely describe their functional status. Also, deficits to recognize the need for help with hygiene and general tasks were observed. Significant differences were found in awareness of need for help with general tasks and awareness of need for help with hygiene tasks. CONCLUSION: People with mild and moderate AD may describe their aware of the disease better than specific functional deficits, and most of them can provide some reports concerning to the impact of the disease.