It is absolutely critical that the person living with dementia is given person-centred care.
"There is a Zulu saying that is very true: ‘A person is a person through others’. Give us reassurance, hugs support, a meaning of life. Value us for what we can still do and be, and be sure we retain social networks” - Christine Bryden (person living with dementia)
‘Personhood’ is a status that is bestowed on one human being by others, in the context of relationship and social being. It implies recognition, respect and trust. Person-Centred Care is the process by which we maintain the Personhood of those who have dementia [i]
Person-Centred Care: the VIPS Framework [ii]
Person-centred care supports a person living with dementia to maintain their Voice, Choice and Control [iii] as it means that the person’s carers listen to what that person wants and needs, and builds a care plan and routine around this. This care plan must be continually updated as – like with any one of us – their wants and needs may change over time.
Sometimes, understanding a person's wants and needs can be very difficult if the individual is no-longer able to verbally articulate them, perhaps due to dementia. In these cases, providing basic validation and reassurance, and building upon a person's past preferences for how they spent their time, is a good starting point. For example, when we first met one of our new Clients, George, he was unable to give any indication as to what his wants and needs were as he barely spoke and was extremely hard of hearing, along with living with dementia. We started with a few pieces of information from his wife; his love of dogs, music and nature. Initial sessions included stroking his hand and giving him a dog teddy to cuddle, and using a new hearing device to help him listen to some of his favourite pieces of music. We also placed a bird feeder outside the window he sat in front.
Slowly but surely over the months, George has engaged more and more in a few activities, and with it his cognition and verbal communication skills have hugely improved. Now he plays a portable keyboard a little on his lap, he comments on the birds at the window and the children playing in the park, and looks at the local newspaper with his Creative Companion. This has also meant that he is now able to articulate much more clearly for himself when he is in pain, thirsty, or wanting to go to the toilet.
As a carer, check your approach towards the person you are caring for against the VIPS framework guiding principles. If in doubt, read the Individual's body language, looking for signs of comfort and relaxation.
[i] Dementia Reconsidered, Tom Kitwood, 1997
[ii] Person Centred Dementia Care, Dawn Brooker, 2006