We so underestimate people living with dementia.
I have heard us say things like, “You can’t connect with a person with dementia, because of the dementia. The person is gone. They are no longer there.”
I am grateful to Dr. Steve Sabat, who reintroduced me to something I had buried deep in my brain from my former psychology studies – the idea of “fundamental attribution error”.
Fundamental attribution error is a social psychological phenomenon in which, when we are interacting with a person, we attribute that person’s actions more to his or her internal factors rather than external factors. Internal factors could be personality, disposition, motivation, etc. External factors could be the situation, or how we are acting towards the person. It is not that the internal factors of a person are NOT a factor. It is just that we overemphasize the influence of these internal factors on their behaviors, and under-emphasize, or even ignore, the influence of external factors on their behaviors.
An example of fundamental attribution error would be:
I go to a networking work event, and I am talking to an entrepreneur, who during our conversation, continually looks around the room and seems less interested in our conversation. My interpretation of his behavior is that he is an essentially rude person (internal factors). I underestimate the impact of the situation – that he is at a network event in which there are several investors, and that he has accurately surmised from our conversation that I have no money to give him (external factors). I might even have the same behavior as him, later that evening, in which I rather abruptly end a conversation and wave at another person on the other side of the room. Yet, when I act that way, I attribute my actions to being social, not to being rude.
In human nature, we tend to do this in a lot of social situations. And it seems to be especially true in our interactions with people living with dementia.
In many cases, the way a person with dementia is acting is attributed more to the person with dementia, and their internal factors, i.e their dementia, than to external factors – the situation that person is being put in, how s/he is being treated by others, etc.
If a person with dementia is upset, we attribute it to the dementia. Less to the situation in which we are asking someone to do something she does not want to do. If a person with dementia is frustrated, we attribute it to the dementia. Less to the situation in which a person with dementia is being talked over, or not given a chance to communicate his/her thoughts.
Maybe it is us.
Maybe we need to find ways to attribute the actions, or lack of actions, of a person with dementia to ourselves, and to other external factors, that limit a person with dementia from being more than their dementia (which they are).
Maybe we need to take responsibility, that even though we are caring, loving, well-intentioned people, we might enable (or even create) the situations in which people with dementia are “no longer there”.
I have “done” fundamental attribution error. And pure grace has led me to people living with dementia and experiences that have created awareness of this so that I could do better. They have helped me SEE people as more than their dementia.
This is a story I recorded a year or two ago for In The Moment, an organization which “provides education, support, and inspiration to thrive in dementia and in life.”
It is a story of fundamental attribution error, and how we will see what we expect to see in people living with dementia.
In other words one should check tbeir biases when dealing with others no matter their circumstances or state of mind.
Failing to check one’s biases is the number one reason therapists and psychologists fail to actually help their patients.
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Loved hearing about Nellie. So glad you took the time to “stumble upon” something that opened her up and didn’t give up on her. Such a good lesson for all of us.
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Thanks, Laura!
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Thank you, Sonya! I so look forward to your posts and I appreciated your video on fundamental attribution error It can be so easy to walk on by someone with dementia as they sit “passively” in their wheelchair. In my work as a volunteer ombudsman, too often I see staff on their way from one place to another, too busy to see the person right in front of them. The person is quiet, not making a fuss, so no need to interact with them…
It’s easy to gravitate towards people who are smiling and verbal, happily engaging with anyone who walks by. It seems that it takes more effort and patience to sit in silence with someone, hold their hand and simply be with them.
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