Mr Vuillemin is 70 years old at the time of the interview. He lives at home with his wife, to whom he has been married for 45 years. He has two children. The family lives in French-speaking Switzerland. When Mr Vuillemin was in his mid-50s, he suffered an ischaemic stroke, which left him unable to work. Over time, he began to forget things. At 65, he was diagnosed with mixed Alzheimer's and vascular dementia. He does not need external care assistance at the moment, nor does he attend any day programs. His wife is there for him. To this day, he still walks a lot in the mountains. However, he had to give up his club activities. He is still independent but needs the daily help of his wife because of his memory lapses and orientation difficulties.
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Mr. Vuillemin has drawn up an advance directive on his own, without a doctor and without his wife. He does not want to talk about it with his wife and children until a later date. Mr. Vuillemin feels it is important to make decisions himself in advance to make the end of his life easier for his family.
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Herr Sonderegger
The questions in the advance directive are far too difficult and too detailed, says Mr. Sonderegger. He trusts in common sense.
The questions in the living will are far too difficult and too detailed, says Mr. Sonderegger. He trusts in common sense and in the fact that he can reasonably regulate a given situation with the health professionals.
Advance care planning
Frau Hofer
Mrs. Hofer created an advance directive together with her husband.
Mrs. Hofer created an advance directive together with her husband. At that time, he was still able to understand the contents as well as sign the document himself. When he could no longer write, she applied for guardianship with the municipality, which supported her.
Advance care planning
Mr Vuillemin is 70 years old at the time of the interview. He lives at home with his wife, to whom he has been married for 45 years. He has two children. The family lives in French-speaking Switzerland. When Mr Vuillemin was in his mid-50s, he suffered an ischaemic stroke, which left him unable to work. Over time, he began to forget things. At 65, he was diagnosed with mixed Alzheimer's and vascular dementia. He does not need external care assistance at the moment, nor does he attend any day programs. His wife is there for him. To this day, he still walks a lot in the mountains. However, he had to give up his club activities. He is still independent but needs the daily help of his wife because of his memory lapses and orientation difficulties.
Herr Vuillemin
Mr. Vuillemin thinks it is important for his wife do things without him to get breaks for herself.
Mr. Vuillemin thinks it is important that his wife do things without him to get breaks for herself.
Processes of adaptation
Dementia
Herr Vuillemin
Mr. Vuillemin's absent-mindedness causes him trouble.
Mr. Vuillemin's absentmindedness causes him trouble. He finds it difficult to constantly look for things or structure a day. He has to concentrate on simple things. Likewise, orientation difficulties occur.
Impairments, restrictions and impacts
Dementia
Herr Vuillemin
Mr. Vuillemin gives an example of his forgetfulness.
Mr. Vuillemin gives an example of his forgetfulness. He experiences it as humiliating that he cannot remember things.
Impairments, restrictions and impacts
Dementia
Herr Vuillemin
Mr. Vuillemin relates that when he can no longer assess a situation, he becomes unsettled.
Mr. Vuillemin uses an everyday example to describe how he becomes unsettled when he can no longer assess a situation. His wife then helps him to make decisions.
Impairments, restrictions and impacts
Dementia
Herr Vuillemin
Mr. Vuillemin's memory problems developed gradually.
Two years before the Alzheimer's diagnosis, Mr. Vuillemin suffered a stroke. The memory problems developed gradually after the stroke.
Diagnosis
Dementia
Herr Vuillemin
The positions in the marriage relationship have reversed, says Mr. Vuillemin.
The positions in the marriage relationship have reversed, says Mr. Vuillemin. The fact that he is no longer in the leading role, but is dependent because of his limited capacity to act, is difficult.
Processes of adaptation
Dementia
Herr Vuillemin
Mr. Vuillemin often feels certain of his convictions, even when those around him claim the opposite.
Not being able to remember something is unsettling and frightening. Mr. Vuillemin, though, describes often feeling sure of his convictions, even while those around him claim the opposite.
Impairments, restrictions and impacts
Dementia
Herr Vuillemin
Mr. Vuillemin puts himself in the position of his wife and concludes that she is just as affected by his dementia as he is.
Mr. Vuillemin puts himself in the position of his wife and concludes that she is just as affected by his dementia as he is. She helps him on a daily basis to cope with his memory failures and orientation difficulties, which trigger anxiety and aggression in him, which in turn is very stressful for her because she has to adjust to an aggressive partner. Both he and his wife changed.
Processes of adaptation
Dementia
Herr Vuillemin
Dementia is invisible, yet it causes suffering, says Mr. Vuillemin.
Dementia is invisible, yet it causes great suffering, says Mr. Vuillemin. Even though he is independent, that does not mean he suffers less from the disease.
What is dementia?
Dementia
Herr Vuillemin
Mr. Vuillemin wants to know more about what is happening in his head. He finds information about the disease important not only for himself but also for his family.
Mr. Vuillemin wants to know more about what is happening in his head. He finds information about the disease important not only for himself, but also for his family, who must find a way to deal with him and the changes in his identity. He shares his knowledge and experience with others at information events.
Diagnosis
Dementia
Herr Vuillemin
Having a notebook and an agenda help him to organize himself in everyday life, Mr. Vuillemin says.
So that he does not get disoriented and can instead keep himself organized, Mr. Vuillemin always carries his notebook and agenda with him.
Learning to live with dementia
Dementia
Herr Vuillemin
Although he didn't want to, Mr. Vuillemin carries a smartphone so his wife won't worry about him.
Mr. Vuillemin now carries a smartphone with him, even though he didn't want to, so that his wife won't worry about him when he's alone in the mountains.
Processes of adaptation
Dementia
Herr Vuillemin
Due to dementia, Mr. Vuillemin has changed his diet.
Because of dementia, Mr. Vuillemin has changed his eating habits. Eating healthy helps him keep the dementia at bay, he says.
Therapeutic approaches
Dementia
Herr Vuillemin
Mr. Vuillemin's fear of what the diagnosis would entail only came afterwards.
Mr. Vuillemin had witnessed his mother's Alzheimer's disease, so he kept the diagnosis away from himself. He hoped his memory lapses were not due to dementia and would get better. The fear of what the diagnosis would bring came only afterwards.
Diagnosis
Dementia
Herr Vuillemin
Mr. Vuillemin describes the psychological tests as very destabilising.
His wife also noticed his memory lapses, as Mr. Vuillemin recounts. He then contacted the doctor. Mr. Vuillemin found the subsequent psychological tests very destabilizing.
Diagnosis
Dementia
Herr Vuillemin
Mr. Vuillemin no longer sees himself as the capable, active person who made something of his life.
Mr. Vuillemin experiences a break in his life, in his self-perception. He no longer sees himself as the capable, active person who made something of his life.
Impairments, restrictions and impacts
Dementia
Herr Vuillemin
Mr. Vuillemin describes experiencing, on the one hand, a loss of self-identity, but, on the other hand, access to a deeper layer of his personality.
Mr. Vuillemin describes experiencing, on the one hand, a loss of self-identity, but, on the other hand, access to a deeper layer of his personality, which interests him more today than in the past. He writes for himself or reads books that he read a long time ago, which he feels does him good.
Impairments, restrictions and impacts
Dementia
Herr Vuillemin
Although dementia fundamentally changes one's attitude toward life, how one holds it is crucial, says Mr. Vuillemin.
Mr. Vuillemin feels at the mercy of the disease. It has fundamentally changed his attitude toward life. Nevertheless, he believes that how one holds the situation is crucial.
Learning to live with dementia
Dementia
Herr Vuillemin
Mr. Vuillemin has made an advance directive on his own.
Mr. Vuillemin has drawn up an advance directive on his own, without a doctor and without his wife. He does not want to talk about it with his wife and children until a later date. Mr. Vuillemin feels it is important to make decisions himself in advance to make the end of his life easier for his family.
Advance care planning
Dementia
Herr Vuillemin
Mr. Vuillemin leaves open the question of how he will be cared for in the future if his wife can no longer provide care.
Mr. Vuillemin believes that he and his wife will have to face some difficult years. He leaves open, though, how he will be cared for in the future if his wife can no longer manage the care.
At home or in a nursing home?
Dementia
Herr Vuillemin
Mr. Vuillemin walks a lot and practices muscle relaxation every day.
Mr. Vuillemin hikes a lot in the mountains. Besides that, he practices muscle relaxation exercises every day.
What helps? - Patients' perspective
Dementia
Herr Vuillemin
Mr. Vuillemin observes himself.
Mr. Vuillemin has learned to counteract his distraction. He does this by noting down many things and observing himself.
Learning to live with dementia
Dementia
Herr Vuillemin
Mr. Vuillemin says that he must concentrate intently in order to put one action after another.
Mr. Vuillemin says that he must concentrate intently so as not to lose things or get confused on how to follow one action with the next. If he doesn’t focus closely, he is distracted and scattered.
Learning to live with dementia
Dementia
Herr Vuillemin
His wife helps him deal with memory lapses on a daily basis, Mr. Vuillemin says.
Mr. Vuillemin is largely independent. He does not need assistance with toileting or most other daily tasks. However, his wife helps him regularly to manage lapses in memory.
What helps? - Patients' perspective
Dementia
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