Dementia

The growing number of people living with dementia presents a worldwide challenge. The progressive cognitive impairments that are the hallmark of dementia can make it appear that the person is disappearing as the disease progresses. Since the seminal theoretical work of Kitwood in the 1990s, a person-centred model for understanding the experience of dementia and the way in which treatment is delivered has developed. This challenges the assumption that dementia is the death that leaves “the body behind”. Indeed, Kitwood asserted that the maintenance of personhood was the key outcome for long-term care and support services. Kitwood’s theories have been developed into a practical framework for person-centred care delivery—the VIPS framework. VIPS asserts the value of all human life regardless of cognitive ability or age; recognises people living with dementia as unique individuals; uses the perspective of the person with dementia as the starting point for therapeutic care, and provides a supportive psychosocial milieu to enable people with dementia to feel socially confident and that they are not alone. Whilst there have been many developments within person-centred care practice, research evidence is only just beginning to emerge. How these ideas and practices become part of regular care remains a challenge.