Tuesday, December 29, 2015

What is a good visual exercise to demonstrate the fright, fight or flight response in dementia?

The fight or flight response refers to the biological process related to the autonomic nervous system. Specifically, the body’s sympathetic system is activated in the face of a threat. This system mobilizes the body for action: either standing one’s ground and fighting, or fleeing from the threat, hence the phrase fight or flight. When the threat has passed, the parasympathetic system kicks in and begins to return the body to normal.


Dementia can be caused...

The fight or flight response refers to the biological process related to the autonomic nervous system. Specifically, the body’s sympathetic system is activated in the face of a threat. This system mobilizes the body for action: either standing one’s ground and fighting, or fleeing from the threat, hence the phrase fight or flight. When the threat has passed, the parasympathetic system kicks in and begins to return the body to normal.


Dementia can be caused by many diseases. Its most common form is Alzheimer’s disease. Symptoms and progression of dementia depend on the specific cause of the dementia. Very general symptoms might include forgetfulness especially with short term memory (e.g., forgetting where you put your car keys or forgetting someone’s name you know well). In Alzheimer’s disease people generally progress through stages beginning with mild symptoms and impairment, progressing to moderate, then severe. In severe stages of the disease the person has often wasted significantly and may even be in a non-communicative vegetative state. A great website to learn more about Alzheimer’s disease http://www.alz.org/ and dementia.


A visual exercise for autonomic arousal (i.e., fight or flight response) in the average person would be to present the person with some sort of threat. Think about childhood games where you yelled out “boo!” to scare your friend, which then resulted in your friend being scared (autonomic arousal). It is not really possible to provide an example specific to someone with dementia without knowing how far along in the disease process they are, but the same general concept can be applied. To induce this response one would present a threat or something frightening and they may respond in the same manner a well person would (i.e., startled, fearful, screaming). Ethically, I would advise against intentionally exposing someone to this situation. If you are looking for fight or flight responses that already exist in the demented person, you might consider the following situation. Imagine you have dementia and have been removed from your home for nursing home care. You no longer have familiar surroundings and might easily become lost or confused in your new environment full of people you do not know well. You might observe in this individual many behaviors and signs of autonomic arousal (fight or flight) ranging from looking fearful or crying to elevated blood pressure. 

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