Skip to main content

Dementia

  • Chapter
  • First Online:
Book cover Person Centered Psychiatry

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Allen K. Communication and consultation; exploring ways for staff to involve people with dementia in developing services. Bristol: The Policy Press; 2001.

    Google Scholar 

  2. Alzheimer’s Research Trust. Dementia 2010: the economic burden of dementia and associated research funding in the United Kingdom. Health Economics Research Centre, University of Oxford for the Alzheimer’s Research Trust. 2010.

    Google Scholar 

  3. Alzheimer’s Society. Optimising treatment and care for people with behavioural and psychological symptoms of dementia. London: Alzheimer’s Society; 2011.

    Google Scholar 

  4. Baker C. Developing excellent care for people with dementia living in care homes. London: Jessica Kingsley; 2014.

    Google Scholar 

  5. Baldwin C, Capstick A. Tom Kitwood on dementia: a reader and critical commentary. Berkshire: Open University Press; 2007.

    Google Scholar 

  6. Ballard C, Brown R, Fossey J, Douglas S, Bradley P, Hancock J, James IA, Juszczak E, Bentham P, Burns A, Lindesay J, Jacoby R, O’Brien J, Bullock R, Johnson T, Holmes C, Howard R. Brief psychosocial therapy for the treatment of agitation in alzheimer disease (the CALM-AD trial). Am J Geriatr Psychiatry. 2009;17(9):726–33.

    Article  PubMed  Google Scholar 

  7. Banerjee S. The use of anti-psychotic medication for people with dementia: a time for action. London: Dept Health; 2009.

    Google Scholar 

  8. Bartlett R, O’Connor D. From personhood to citizenship: broadening the lens for dementia practice and research. J Aging Stud. 2007;21(2):107–18.

    Article  Google Scholar 

  9. British Standards Institute. PAS 800:2010 use of dementia care mapping for person-centred care in a care provider organization—guide. London: BSI; 2010.

    Google Scholar 

  10. Brodaty H, Green A, Koschera A. Meta-analysis of psychosocial interventions for caregivers of people with dementia. J Am Geriatr Soc. 2003;51(5):657–64.

    Article  PubMed  Google Scholar 

  11. Brooker D. What is person-centred care for people with dementia? Rev Clin Gerontol. 2004;13:212–22.

    Google Scholar 

  12. Brooker D. Person-centred dementia care: making services better. London: Jessica Kingsley; 2007.

    Google Scholar 

  13. Brooker D. Good practice inside. In: Dening T, Milne A, editors. Mental health and care homes. Oxford: Oxford University Press; 2011.

    Google Scholar 

  14. Brooker D, Argyle E, Clancy D, Scally A. Enriched opportunities programme: a cluster randomised controlled trial of a new approach to living with dementia and other mental health issues in extra care housing schemes and villages. Aging Men Health. 2011;15(8):1008–17.

    Article  Google Scholar 

  15. Brooker D, La Fontaine J, Evans S, Bray J, Saad K. Public health guidance to facilitate timely diagnosis of dementia: alzheimer’s cooperative valuation in Europe (ALCOVE) recommendations. Int J Geriatr Psychiatry. 2014;29:682–93.

    Article  PubMed  Google Scholar 

  16. Brooker DJ. Dementia care mapping. In: Abou-Saleh MM, Katona CLE, Kumar A, editors. Principles and practice of geriatric psychiatry. 3rd ed. Chichester: Wiley;ISBN; 9780470747230.

    Google Scholar 

  17. Bryden Christine. Dancing with dementia: my story of living positively with dementia. London: Jessica Kingsley; 2005.

    Google Scholar 

  18. Chenoweth L, King MT, Jeon Y-H, Brodaty H, Stein-Parbury J, Norman R, Haas M, Luscombe G. Caring for aged dementia care resident study (CADRES) of person-centred care, dementia-care mapping, and usual care in dementia: a cluster-randomised trial. Lancet/Neurol. 2009;8:317–25.

    Google Scholar 

  19. Choi NG, Ransom S, Wyllie R. Depression in older nursing home residents: the influence of nursing home environmental stressors, coping, and acceptance of group and individual therapy. Aging Ment Health. 2008;12(5):536–47.

    Article  PubMed  Google Scholar 

  20. Cohen-Mansfield J, Dakheel-Ali M, Marx MS. Engagement in persons with dementia: the concept and its measurement. Am J Geriatr Psychiatry. 2009;17(4):299–307.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Cohen-Mansfield J, Libin A, Marx MS. Nonpharmacological treatment of agitation: a controlled trial of systematic individualized intervention. J Gerontol Series A: Biol Sci Med Sci. 2007;62(8):908–16.

    Article  Google Scholar 

  22. Cole RP, Scott S, Skelton-Robinson M. The effect of challenging behaviour, and staff support, on the psychological wellbeing of staff working with older adults. Aging Ment Health. 2000;4(4):359–65.

    Article  Google Scholar 

  23. Commission for Social Care Inspection—CSCI. See me, not just the dementia: understanding peoples’ experiences of living in a care home. London: CSCI; 2008.

    Google Scholar 

  24. Deudon A, Maubourguet N, Gervais X, Leone E, Brocker P, Carcaillon L, Riff S, Lavallart B, Robert PH. Non-pharmacological management of behavioural symptoms in nursing homes. Int J Geriatr Psychiatry. 2009;24(12):1386–95.

    Article  PubMed  Google Scholar 

  25. Edvardsson D, Sandman PO, Borell L. Implementing national guidelines for person-centered care of people with dementia in residential aged care: effects on perceived person-centeredness, staff strain and stress of conscience. Int Psychogeriatr. 2014;26(7):1171–79.

    Google Scholar 

  26. Fossey J, Ballard C, Juszczak E, James I, Alder N, Jacoby R, Howard R. Effect of enhanced psychosocial care on antipsychotic use in nursing home residents with severe dementia: cluster randomised trial. Br Med J. 2006;332:756–61.

    Article  Google Scholar 

  27. Fujii M, Ishizuka S, Azumi M, Sasaki H. Hypothesis of behavioral and psychological symptoms of dementia. Psychogeriatrics. 2010;10(3):113–6.

    Article  PubMed  Google Scholar 

  28. Hunter PV, Hadjistavropoulos T, Smythe WE, Malloy DC, Kaasalainen S, Williams J. The personhood in dementia questionnaire (PDQ): establishing an association between beliefs about personhood and health providers’ approaches to person-centred care. J Aging Stud. 2014;27(3):276–287.

    Google Scholar 

  29. James IA. Understanding behaviour in dementia that challenges; A Guide to Assessment and Treatment. London: Jessica Kingsley; 2011.

    Google Scholar 

  30. Jeon YH, et al. Staff outcomes from the caring for aged dementia care resident study (CADRES): a cluster randomised trial. Int J Nurs Stud. 2012;49:508–18.

    Article  PubMed  Google Scholar 

  31. Kaufmann EG, Engel SA. Dementia and well-being: a conceptual framework based on Tom Kitwood’s model of needs dementia. Published online 19 June 2014. doi:10.1177/1471301214539690.

    Google Scholar 

  32. Kelly F, Innes A. Human rights, citizenship and dementia care nursing. Int J Older People Nurs. 2013;8(1):61–70.

    Article  PubMed  Google Scholar 

  33. Killett A, Burns D, Kelly F, Brooker DJ, Bowes A, La Fontaine J, Latham I, Wilson M, O’Neill M. Digging deep: how organisational culture affects care home residents’ experiences. Ageing Soc. 2014;. doi:10.1017/S0144686X14001299.

    Google Scholar 

  34. Kirkley C, Bamford C, Poole M, Arksey H, Hughes J, Bond J. The impact of organisational culture on the delivery of person-centred care in services providing respite care and short breaks for people with dementia. Health Soc Care Commun. 2011;19(4):438–48.

    Article  Google Scholar 

  35. Kitwood T. Dementia and its pathology: in brain, mind or society? Free Assoc. 1987;8:81–93.

    Google Scholar 

  36. Kitwood T. Explaining senile dementia: the limits of neuropathological research. Free Assoc Press. 1987;10:117–38.

    Google Scholar 

  37. Kitwood T. The technical, the personal, and the framing of dementia. Soc Behav. 1988;3:161–79.

    Google Scholar 

  38. Kitwood T. Brain, mind and dementia: with particular reference to alzheimer’s disease. Ageing Soc. 1989;9(1):1–15.

    Article  Google Scholar 

  39. Kitwood T. The dialects of dementia: with particular reference to alzheimers’s disease. Ageing Soc. 1990;10(2):177–96.

    Article  Google Scholar 

  40. Kitwood T. Understanding senile dementia: a psychobiographical approach. Free Assoc. 1990;19:60–76.

    Google Scholar 

  41. Kitwood T. Quality assurance in dementia care. Geriatr Med. 1992;22:34–8.

    Google Scholar 

  42. Kitwood T. Person and process in dementia. Int J Geriatr Psychiatry. 1993;8:541–5.

    Article  Google Scholar 

  43. Kitwood T. Towards a theory of dementia care: the interpersonal process. Ageing Soc. 1993;13:51–67.

    Article  Google Scholar 

  44. Kitwood T. Dementia reconsidered: the person comes first. Buckingham: Open University Press; 1997.

    Google Scholar 

  45. Kitwood T, Bredin K. A new approach to the evaluation of dementia care. J Adv Health Nurs Care. 1992;1(5):41–60.

    Google Scholar 

  46. Kitwood T. A dialectical framework for dementia. In: Woods RT, et al editors. Handbook of clinical psychology of ageing, 1995. p. 267–82.

    Google Scholar 

  47. Kontos PC, Mitchell JG, Mistry B, Ballon B. Using drama to improve person-centred dementia care. Int J Older People Nurs. 2010;5(2):159–68.

    Google Scholar 

  48. Lawlor B. Managing behavioural and psychological symptoms in dementia. Br J Psychiatry. 2002;181:463–5.

    Article  PubMed  Google Scholar 

  49. Leng FY, Yeo D, George S, Barr C. Comparison of iPad applications with traditional activities using person-centred care approach: impact on well-being for persons with dementia. Dementia. 2014;13(2):1–9.

    Article  CAS  Google Scholar 

  50. Li J, Porock D. Resident outcomes of person-centered care in long-term care: a narrative review of interventional research. Int J Nurs Stud. Available online 18 Apr 2014. ISSN 0020-7489, http://dx.doi.org/10.1016/j.ijnurstu.2014.04.003.

  51. McKeown J, Clarke A, Ingleton C, Ryan T, Repper J. The use of life story work with people with dementia to enhance person-centred care. Int J Older People Nurs. 2010;5:148–58.

    Article  PubMed  Google Scholar 

  52. Mittleman M, Brodaty H, Wallen A, Burns A. A three-country randomized controlled trial of a psychosocial intervention for caregivers combined with pharmacological treatment for patients with Alzheimer disease: effects on caregiver depression. Am J Geriatr Psychiatry. 2008;16(11):893–904.

    Article  Google Scholar 

  53. Moniz-Cook ED, De Vugt M, Verhey F, James I. Functional analysis-based interventions for challenging behaviour in dementia. Cochrane Database of Systematic Reviews. 2008;1. Art. No. CD006929.

    Google Scholar 

  54. Mork Rokstad AM, Røsvik J, Kirkevold O, Selbaek G, Saltyte Benth J, Engedal K. The effect of person-centred dementia care to prevent agitation and other neuropsychiatric symptoms and enhance quality of life in nursing home patients: a 10-month randomized controlled trial. Dementia Geriatr Cogn Dis. 2013;36:340–53.

    Article  Google Scholar 

  55. NICE-SCIE (National Institute for Health and Clinical Excellence—Social Care Institute for Excellence). Dementia: A NICE-SCIE guideline on supporting people with dementia and their carers in health and social care. National clinical practice guideline number 42; 2007.

    Google Scholar 

  56. Nolan M, Ryan T, Enderby P, Reid D. Towards a more inclusive vision of dementia care practice and research. Dementia. 2002;1(2):193–211.

    Article  Google Scholar 

  57. O’Dwyer C. Official conceptualizations of person-centered care: which person counts? J Aging Stud. 2013;27(3):233–42.

    Article  PubMed  Google Scholar 

  58. Passalacqua SA, Harwood J. VIPS communication skills training for paraprofessional dementia caregivers: an intervention to increase person-centered dementia care. Clin Gerontol. 2012;35(5):425–45.

    Article  Google Scholar 

  59. Robert PH, Verhey FR, Byrne EJ, Hurt C, De Deyn PP, Nobili F, Riello R, Rodriguez G, Frisoni GB, Tsolaki M, Kyriazopoulou N, Bullock RA, Burns A, Vellas B. Grouping for behavioral and psychological symptoms in dementia: clinical and biological aspects consensus paper of the European alzheimer disease consortium. Eur Psychiatry. 2005;20(7):490–6.

    Article  PubMed  Google Scholar 

  60. Rosvik J, Brooker DJ, Mjorud M, Kirkevold O. What is person-centred care in dementia? Clinical review into practice: the development of the VIPS practice model. Rev Clin Gerontol. 2013;23:155–63.

    Google Scholar 

  61. Rosvik J, Kirkevold M, Engedal K, Brooker DJ, Kirkevold O. A model for using the VIPS framework for person-centred care for persons with dementia in nursing homes: a qualitative evaluative study. Int J Older Peoples Nurs. 2011;6:227–36.

    Google Scholar 

  62. The Swedish National Board of Health and Welfare. Nationella riktlinjer för vård och omsorg vid demenssjukdom 2010: stöd för styrning och ledning. Stockholm: Socialstyrelsen; 2010.

    Google Scholar 

  63. Todd SJ, Watts SC. Staff responses to challenging behaviour shown by people with dementia: an application of an attributional-emotional model of helping behaviour. Aging Ment Health. 2005;9(1):71–81.

    Article  CAS  PubMed  Google Scholar 

  64. Ulstein I, Sandvik L, Wyller T, Engedal K. A one-year randomized controlled psychosocial intervention study among family carers of dementia patients—effects on patients and carers. Dementia Geriatr Cogn Dis. 2007;24(6):469–75.

    Article  Google Scholar 

  65. Wimo A, Prince M. World alzheimer report 2010: the global economic impact of dementia, Alzheimer’s Disease International. 2010.

    Google Scholar 

Download references

Acknowledgements

Thanks to Heather Yemm at the Association for Dementia Studies for assistance in the preparation of this manuscript.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Dawn J. Brooker PhD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Brooker, D.J., Snaedal, J. (2016). Dementia. In: Mezzich, J., Botbol, M., Christodoulou, G., Cloninger, C., Salloum, I. (eds) Person Centered Psychiatry. Springer, Cham. https://doi.org/10.1007/978-3-319-39724-5_23

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-39724-5_23

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-39722-1

  • Online ISBN: 978-3-319-39724-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics