ABSTRACT
A case presentation indicating the
importance of “happiness” in childhood causing memory block until the patent
presented with probable mixed vascular and neurodegenerative memory loss at 60
years of age is presented to highlight the role of emotional factors in causing
the disease. The question of whether Alzheimer’s disease is an adaptability
disorder is raised, given the patient blocked out her memory of her childhood
experience. The importance of “happiness” as a treatment goal raises issues of
advocacy and Guardianship as well as capacity, which is addressed by actual
case reference and court action in defence of the patient’s rights to have
their wishes respected and observed. Functional mental capacity assessment,
using the Functional Mental State Measure (FMSM) gives a greater indication of
neuronal reserve than standard cognitive testing, as it helps to unravel the
dilemma associated with pure cognitive assessment in Alzheimer’s Disease as
well as vascular dementia patients and patients who, despite retained and
intact functional capacity and ability to express their wishes, i.e. “best
interest”, are “wrongly” placed under Guardianship. Maladaptive responses, to control the change in
external environment that are sensed or perceived, and which lead to disorder
or to susceptibility to disease, exemplify a General Systems Theory approach,
in which appropriate and adequate responses to environmental change, in
behavioural terms, by a person, whether independently, or as the recipient or
giver, or both, leads to functional interaction and happiness.