Therapeutic Implications Of Integrating Validation Therapy For The Management Of Capgras Syndrome In Patients With Vascular Dementia | 105592
Journal of Alzheimers Disease & Parkinsonism
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Patients in each domain of dementia may experience hallucinations, delusions or misidentification syndromes. One form of
misidentification syndrome, called Capgras syndrome, also known as Imposter syndrome, occurs when a patient believes that
their primary caretaker is duplicated and searches for the “real” person (Sinkman, 2008). This phenomenon occurs when the pathway
between the occipital face area of the brain and the amygdala is obstructed. Typically seen in patients with schizophrenia or bipolar
disorder, Capgras syndrome is also significantly prevalent in patients with dementia (Cummings, Miller, Hill, & Neshkes, 1987).
The patient recognizes the significant person, but the emotional connection from the amygdala does not receive the signal that the
recognized face is the actual significant individual; therefore, continues to search for the person who meets the “significant” criteria.
The delusion is frightening to the patient and upsetting to the caretaker, who is usually the spouse or close relative. In patients
with vascular dementia (VaD), somatic impairments in vision and/or ambulation can exacerbate fear during Capgras episodes. The
importance of caretakers to undertake a subjective and supportive perspective within the patient’s experience during a Capgras
episode cannot be overstated. Validation therapy, which contradicts the natural inclination to reason the objective reality, must be
exercised to restore a sense of safety to the patient’s reality. Compassionate and creative measures, such as voice, tactile, and natural
supports, are what comprise the most effective techniques in validation interventions for VaD patients with Capgras syndrome.
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