430 - The Puzzled and Puzzling Self: Self-Perception of People With Dementia in the Residential Care Homes of Hong Kong

Abstract

In Hong Kong, people aged 65 years or more was approximately 17.7% of the total population which is identified as “super-aged” city. The prevalence of dementia in Hong Kong aged 70 years or older had risen from 6.1% to 9.3% between 1998 and 2008. However, only 11% of people with dementia are diagnosed and receive medical follow-up. Although people live longer than they once did, their increased longevity can be a mixed blessing, both for themselves and for their societies. How people perceive dementia and interpret people with dementia will be one of the key elements to develop the 21^st century’s dementia care culture in the Chinese society.

A qualitative research in understanding how people with dementia perceive themselves always requires interpreting how others in their daily lives perceive them was conducted. Twenty in-depth interviews and two focus groups between people with dementia and the care staff in the residential care homes in Hong Kong were done. Indeed, if someone in your daily life perceives you differently from how you perceive yourself, then how do you make sense of the discrepancy? People with dementia tend to struggle with understanding not only situations occurring around them but also who they are, especially when others’ reactions to them are unexpected.

Interpretivism and thematic analysis was applied whereas the difference between real and perceived selves was found. The findings included (1) Doubt About One’s Trustworthiness; (2) Doubt About One’s Value; (3) Doubt About One’s Capability. From their perspective, residents with dementia were trustworthy, but the care staff ignored their requests and prerogatives nonetheless. They also interpreted that they were valuable, but the staff overlooked their needs and did not show them any respect, either. Beyond that, they thought that they were capable, but the staff did not recognise their abilities and disregarded their input in decision-making. Puzzled about whether they should accept or reject the staff’s responses in interpreting who they were, the residents with dementia experienced heightened confusion about their circumstances. This research become one of the directions to explore the implementation of person-centred care in the Hong Kong’s residential care homes.