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this post was submitted on 04 Mar 2024
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Yeah but still... a diagnosis is usually made after an interview and tests where appropriate.
That's why they're using a phrase like "is consistent with dementia" rather than "is dementia"
Yeah, that little bit of phrasing is doing a lot of work.
That said, as a layman, at what point is the vast corpus of data that is his assorted interviews, statements, appearances, etc on TV enough to call it? I'm curious how much more a one-on-one with a therapist could reveal. Obviously, there's a persona that is prominent any time a camera is on, but if the camera is on all the time, when is it just his base personality?
I don't think really any amount of this particular form of data is enough to be confident in an opinion.
As an analogy, I might be obese and have chest pain, but without scans and tests no doctor is going to say I have ischaemic cardiovascular disease.
Does a 77yo who mixes up names have dementia? Is it just diminished cognitive abilities due to age, combined with stress? Does it really matter?
IMO, any self-respecting psychologist would avoid paying an opinion without having a chance to interview a co-operative patient.
That makes sense, and I feel like that's a good rule for 99.99% of people. Trump introduces one unusual facet and one that I don't know enough about:
He's on camera all the time. His media presence is more than that of most of humanity, including those that do it professionally. Both being filmed and participating. Sure, a doctor needs scans to do things, but what is the test for this kind of thing and can the answers be derived from his very prominent existence?
How does a therapist handle a non-cooperative patient? Let's say the court order's therapy. What does the poor bastard who works with him have to do to accomplish their task?
In practice, there's not a huge emphasis on diagnosis.
As in, if grandma is buying a 12 pack of toilet paper every week when she does her shopping, it doesn't really matter whether you classify it as dementia or forgetfulness, you just need to figure out the best way to minimise the harm and give her the best quality of life moving forward.
Most mental health diagnoses are the same. Even if you get a clinical diagnosis of "bi-polar" the treatment options are similar to most other mental health problems and you just work through them until you find a good one.
Similarly courts don't care about diagnosis. They might get a psychiatrist to assess whether someone is fit to stand trial, but that's a measurement of cognitive function rather than diagnosing the reason for cognitive impairment.