Relatedness among people diagnosed with dementia: Social cognition and the possibility of friendship

In this study, we examined the social relatedness of people in the moderate stage of dementia as defined by their performance on standard tests and clinical examination. The individuals herein were observed in the natural social environment of an adult day center that they attended on weekdays. A number of important aspects of mutually desired, independently initiated, supportive social relationships were observed to exist, through which the principals revealed semiotic, or meaning-driven, behavior that would not be predicted by their meeting the criteria that contributed to their diagnosis. Losses in social functioning described in the DSM and associated with the clinical diagnosis of dementia appear to be caused more by social dynamics involving healthy others than by brain injury alone. Implications for the non-pharmacological treatment of people with dementia are explored and discussed within the context of Kitwood's idea of positive person work.