Case study 36.1

Possible answer to: What factors might influence Michael and Joan’s reaction to Michael’s diagnosis?

Michael retains awareness into his condition (some might say he has insight), but his level of understanding of his diagnosis of Alzheimer’s disease may be partial and he may not understand the more complex implications of having dementia. Also, he may, at the point of diagnosis, be experiencing a degree of ‘denial’, which is not a bad or abnormal thing but which may be helping him at that moment come to terms with the news. Although Joan was anticipating Michael’s diagnosis, just as with a diagnosis of terminal cancer, the news will have come as a shock. Joan and Michael have not been together for long and this is not what Joan anticipated when embarking on their relationship. As well as the eventual loss of her partner (and the period of cognitive decline that will precede Michael’s death), Joan will be concerned about the implications of becoming his carer and whether she will have any support in taking on that role.