Dementia and the phenomenon of social death.

Many cultures have distinguished between biological and social death, the latter usually occurring some time after the former. More recently social death has been noted to occur before biological death in terminally ill comatose patients. This paper presents the results of an exploratory study which examined the extent to which social death may occur before biological death among elderly people with dementia. One hundred semistructured interviews were conducted with the caregiving relatives of dementia sufferers. Ratings were made of the degree to which carers appeared to believe their dementing dependent was socially (or 'as good as') dead, as well as note taken of behaviour suggesting that they had discounted the sufferer in social terms. In over one third of caregiving relatives there was evidence of both beliefs and behaviours suggesting that a degree of social death had occurred before the sufferer's biological death. Almost all those categorised as behaving towards a sufferer as if they were socially dead expressed beliefs indicating that this was how the sufferer was perceived. However, perceiving a sufferer in ways which could be characterised as socially dead was not necessarily combined with behaving as though they were. Examples of degrees of social death are presented and discussed against the background of increasing numbers of dementia sufferers in modem Western societies. [ABSTRACT FROM AUTHOR]