A person-centred problem

It has become commonly expected that the "personhood" of people with dementia should be recognised, understood in the relational sense that is now widely adopted in healthcare practices. Despite its broad acceptance, however, the concept of personhood remains problematic in dementia care, as a result both of the theoretical challenges it poses and the practices that arise from it. This work employs the technique of ethnographic observation of residents, family members, and care staff of an aged care facility to explore the ways in which various modalities of the "self" are displayed in persons with dementia. The results provide insights into the moral and ontological impact of personhood on the systems that structure and influence interactions involving people with dementia. We conclude that privileging a preserved identity in dementia, and delivering care that conforms to contemporary "person-centred" expectations may limit recognition of the fluid, ongoing selfhood of people with dementia and that a reconsideration of this focus may enable us to expand our understanding of, and our responses to, their changing experiences.

Michael Chapman, Jennifer Philip, Paul Komesaroff