Interrogating Person-centred Dementia Care in Social Work and Social Care Practice

Abstract

• Summary: Traditional approaches to the understanding and organization of dementia care, often drawn from medical perspectives, are examined. Alternative understandings based around the conception of ‘personhood’ are critically considered. Some of the philosophical challenges and practical difficulties raised by this debate are explored in the context of care management in the UK. • Findings: The concept of personhood presents a challenge to traditional thought and has been influential in promoting the ‘new culture’ of dementia care within health and social service settings. It is crucial in contemporary social and health care to retain a clear sense of the person with whom we are working at any point in time. Medical, sociological and psychological approaches to dementia should not be seen as mutually exclusive. • Applications: A shift in culture and thinking does not deny the importance of medical advance but adds a holistic and human element that brings back the person with dementia to centre stage. While the diseases underlying the personal and mental deterioration are important, it is equally important to consider how the disease and its characteristics are interpreted by the person with dementia, their carers, professionals and wider society.

The Development and Pilot Testing of an Instrument to Measure Nurses’ Working Environment: The Nursing Context Index

“…This lack of quantitative evidence to support the benefits of adopting a person‐centered nursing approach has led to criticism and questioning of its value. Parker (2001), for example, questioned whether person‐centered nursing actually exists, whether it is achievable, or whether it is simply an evangelical ideal. Ford and McCormack (2000) argued that the benefits of person‐centered nursing in terms of nurse and patient outcomes are hard to identify, articulate, and quantify due to the complexity and interplay of factors that comprise person‐centered nursing.…”

The content of available practice literature in dementia and intellectual disability

“…In European-heritage countries, dementia is often considered a disease that is studied and care managed through a biomedical lens (Parker, 2001). Alternatively, dementia is a part of some people's unique life story as it unfolds over time.…”

“…Person-centered planning and environmental factors that mitigate dementia are areas of increasing interest for providers of dementia care services. It is, however, within day-to-day practice that concepts and ideas are enacted and have either a positive or negative effect on the individual (Parker, 2001;Saperstein, Calkins, Haitsma, & Curyto, 2004).…”

Facing dementia as a we: Investigating couples’ challenges and communicative strategies for managing dementia

“…Viewing dementia from this perspective, challenges are mainly related to the deterioration of brain functions and the decline of the person's previous abilities, which in turn are considered to lead to a loss of self (Parker, 2001;McGovern, 2011). Within this perspective, challenges have mainly been understood in terms of dementia symptoms and the care burden for the relatives.…”

“…Within this perspective, challenges have mainly been understood in terms of dementia symptoms and the care burden for the relatives. However, there has been a shift towards a model which emphasises psychosocial aspects of dementia (Hydén & Antelius, 2017), Tom Kitwood being one of the most important researchers to influence this change (Marshall & Tibbs, 2006;Parker, 2001). Kitwood and his colleagues place the person at the forefront, alongside relational and interactional aspects, and dementia and decline remain in the background.…”