person centred care
Person-centred Dementia Care:
A Vision to be Refined
Healthcare professionals have increasingly been moving away from a task-oriented, professional-driven model of healthcare, towards a more holistic model of care which emphasizes patients’ perspectives and their subjectively defined experiences and needs. In the field of dementia care, this shift has been described most often as a move towards
“person-centred care.” Despite a wealth of literature describing the philosophy of personcentred care, we know very little about the current definition and implementation of this philosophy in dementia-care settings. This article will provide an overview of the literature to date. by Timothy D. Epp, PhD
T
Dr. Epp is an Assistant Professor of
Sociology at Redeemer University
College, and Adjunct Assistant
Professor at the Murray Alzheimer
Research and Education Program,
University of Waterloo,
Waterloo, Ontario.
he concept of the “person” is at the centre of current debates on the beginning and end of life,1 the assessment of competency,2,3 and human suffering.4 Promoted as a shift in the “culture” of care, holistic dementia care is referred to most often as “person-centred”
(although terms such as “individualized,” “resident-focused,” and
“patient-centred” also are utilized), and is based on various sources, including the social psychology of professor Tom Kitwood.5
Person-centred dementia care
(PCC) has emerged as a response to an old culture of care6,7 which:
1) reduced dementia to a strictly biomedical phenomenon;8 2) was task-driven; 3) relied on control techniques including chemical and physical restraints,9 warehousing and unnecessary medication; and
4) devalued the agency and individuality of persons with dementia. In contrast, PCC is valuedriven, focuses on independence, well-being and empowerment of individuals and families,10 and
14 • The Canadian Alzheimer Disease Review • April 2003
“enables the person to feel
A Vision to be Refined
Healthcare professionals have increasingly been moving away from a task-oriented, professional-driven model of healthcare, towards a more holistic model of care which emphasizes patients’ perspectives and their subjectively defined experiences and needs. In the field of dementia care, this shift has been described most often as a move towards
“person-centred care.” Despite a wealth of literature describing the philosophy of personcentred care, we know very little about the current definition and implementation of this philosophy in dementia-care settings. This article will provide an overview of the literature to date. by Timothy D. Epp, PhD
T
Dr. Epp is an Assistant Professor of
Sociology at Redeemer University
College, and Adjunct Assistant
Professor at the Murray Alzheimer
Research and Education Program,
University of Waterloo,
Waterloo, Ontario.
he concept of the “person” is at the centre of current debates on the beginning and end of life,1 the assessment of competency,2,3 and human suffering.4 Promoted as a shift in the “culture” of care, holistic dementia care is referred to most often as “person-centred”
(although terms such as “individualized,” “resident-focused,” and
“patient-centred” also are utilized), and is based on various sources, including the social psychology of professor Tom Kitwood.5
Person-centred dementia care
(PCC) has emerged as a response to an old culture of care6,7 which:
1) reduced dementia to a strictly biomedical phenomenon;8 2) was task-driven; 3) relied on control techniques including chemical and physical restraints,9 warehousing and unnecessary medication; and
4) devalued the agency and individuality of persons with dementia. In contrast, PCC is valuedriven, focuses on independence, well-being and empowerment of individuals and families,10 and
14 • The Canadian Alzheimer Disease Review • April 2003
“enables the person to feel
References: Haworth Press, Binghamton, New York, 1998, pp.129-42. Buckingham, 1997a, ps.20, 7-8, 91. Alzheimer’s. Elder, San Francisco, 1993. 17. Boden C. Who will I be when I die? HarperCollins, Sydney, 1997.