Why Someone with ‘senile Dementia’ Was Designated a ‘lunatic’?
Lunatic is an informal term referring to a person who is considered mentally ill, foolish or unpredictable, conditions once attributed to lunacy. The term may be considered insulting in serious contexts in modern times, but is now more likely to be used in friendly jest. The word derives from lunaticus meaning “of the moon” or “moonstruck”. The term was once commonly used in law.
Many people are surprised to find that a person with a diagnosis of senile dementia was labeled a ‘lunatic’. But this was actually quite common. The word lunatic had a legal meaning. Anyone who was admitted to a lunatic asylum was, by definition, a lunatic. And lunatic asylums were often the only institutions which were prepared to accommodate older people with dementia.
The word lunatic conjures up a horrific stereotype of a raving mad person: a term which stigmatizes and dehumanizes the mentally ill. But like many such terms which now exist only as unacceptable insults, the word lunatic was widely used in the nineteenth century, as a general word for someone who was insane (another term which has disappeared from official language).
If a person was to be admitted to an asylum, they had to be legally certified as a ‘lunatic’. This certificate was filled in by a doctor, who had to record evidence that the person was really insane. He signed it, usually along with another doctor and a local magistrate. Without this certificate, properly completed, the patient could not be admitted to the asylum. This policy was strictly enforced. No one could be admitted to the asylum without being certified.
So, entering an asylum also involved being legally designated a ‘lunatic’. So people with senile dementia were considered to be lunatics, firstly, because their condition was explained using the same language and theories as other forms of insanity and secondly, because when they entered asylums because of their unmanageable behavior, they had to be legally certified as such.
At the same time, the status of senile dementia as a form of insanity was by no means assured. As the asylums filled up, asylum doctors became more determined to limit the definition of insanity, and thus to limit the number of people entering the asylum.
Older people suffering from dementia were particularly unappealing patients: they were seen as incurable, and were often suffering from physical ailments as well as mental ones.
Asylum doctors started to argue that ‘the senile’ should be excluded from the asylum because they were not truly insane, but suffering ‘simply from decay of nature‘(even the cause of patients disruptive behavior had never really been a factor in determining whether they were sent to the asylum).
In spite of these objections, there were no genuine attempts to provide more suitable alternative provision for older people with dementia. They continued to be sent to asylums, or remained warehoused on crumbling workhouse infirmary wards, until well into the twentieth century.