Desafios e possibilidades da clínica com demência: escutando o sujeito silenciado

Abstract

This work originated from the experience in the Multidisciplinary Residence in Elderly Health at the Elderly Care Center, Geriatrics service at the Pedro Ernesto University Hospital. Due to the reorganization of the service because of the pandemic, I was responsible for monitoring, remotely, some patients from the dementia outpatient clinic and then, I became interested in clinically listening to people with dementia and memory complaints. The category of dementia encompasses a series of neurodegenerative diseases of unknown etiology but with multiple causal aspects. Therapies focus on biological and neurological aspects for purely cognitive treatment based on drug interventions and/or cognitive stimulation for rehabilitation. In this sense, a question arises regarding the subject of dementia, which presents forgetfulness and repetition as the main issues. This work proposed to insert the subjective dimension into these phenomena, as well as draw attention to the proportion and complexity of the issue, which also encompasses social, historical, and cultural aspects. Starting from the study of old age and the place of old people in today’s society, we sought to present how this condition has a psychic impact on people who are experiencing old age. In people diagnosed with dementia, there is a narcissistic disruption, and they meet something psychically unbearable. We consider the complexity of the issue, a more accurate clinical investigation, a greater delicacy in transmitting the diagnosis and, mainly, a different way of treating the patient by including the subject.