Alzheimer's disease (AD) is a condition marked by progressive intellectual decline and memory loss, which typically affects individuals over the age of 60. Its origins are unknown but genetic factors are suspected in some cases. There is limited information about the subjective experience of AD although it is often described as a calamity that inevitably destroys the self irrespective of its victims' social circumstances. This dissertation offers an alternative to this nihilistic portrayal that draws on a critical phenomenological framework. It explores the loss of self as an intersubjective phenomenon that is mediated by three contexts: (1) Western representations of the self as autonomous and individualistic; (2) the public description of AD; and (3) the biomedical practices that construct AD as a diagnostic object. / The dissertation examines the experiences of 16 patients and 37 family members who participated in a multi-disciplinary assessment at a dementia clinic. The participants also include 14 clinicians and staff members from the clinic. The findings are derived from a prospective study that includes in-depth, at-home interviews and observations of clinical assessment activities and research-based genetic counseling. The dissertation examines how memory trouble interferes with the intersubjective fabric of everyday life in families as affected participants lose the ability to meaningfully reciprocate on the basis of their individualistic identities. The analysis emphasizes the role of the clinical assessment, diagnosis, and public description in restoring intersubjective order. A salient aspect of this process is the way in which medicalized interpretations of memory trouble facilitate reinterpretation of the eroding self as being animated by pathology. The self is thus rendered meaningful again as it is being indexed to lay descriptions of what people do and say in AD. The analysis also considers how this process extends to participants who came to perceive themselves as victims of AD although they were assessed as not having a dementia disorder. The dissertation finally considers the impact of acquiring genetic knowledge about AD on interpretations of the self. Overall, the research underscores the loss of self in AD as a phenomenological process that is mediated by familial and institutional contexts.
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.36792 |
| Date | January 2000 |
| Creators | Smith, André P. |
| Contributors | Rains, Prudence (advisor) |
| Publisher | McGill University |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Format | application/pdf |
| Coverage | Doctor of Philosophy (Department of Sociology.) |
| Rights | All items in eScholarship@McGill are protected by copyright with all rights reserved unless otherwise indicated. |
| Relation | alephsysno: 001777960, proquestno: NQ69933, Theses scanned by UMI/ProQuest. |
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