Old vs. New View of Dementia Care
 

Old View of Dementia Care	New View of Dementia Care
Dementia is an inevitable part of aging which has no treatment and results in loss of all memory and personal identity.	Dementia is caused by brain disease that can be prevented and treated.  How a person is affected also depends crucially on the quality of care.
Medications are aimed at alleviating behavioral symptoms and improving memory.	We are looking for means to prevent, delay or slow decline through medical and psychosocial interventions.
Those with dementia are significantly different than the rest of us because of their “organic mental disorder”.	Those who have dementia are equal members of the human race with the rest of us.  All persons are damaged in some way.  This should be reflected in our practice.
Doctors possess the most reliable and relevant knowledge.	Skilled and insightful practitioners possess the most reliable and relevant knowledge.
It is important to have a clear and accurate understanding of a person’s impairment in order to chart decline over time.	It is important to have a clear and accurate understanding of a person’s background, abilities, tastes, interests, values and spirituality.
Care is concerned with providing a safe environment, meeting basic needs and giving physical care in a competent way.	Care is primarily concerned with the maintenance and enhancement of personhood.
“Problem behaviors” are triggered by brain pathology and need to be managed quickly and efficiently, probably with medications.	Behaviors should be viewed, primarily as attempts at communication, related to unmet needs.  The caregiver needs to seek the meaning of the communication and to address the need.
Those with dementia require medical attention in psychiatric units or nursing homes patterned after hospitals.	Those with dementia require home-like settings which emphasize a social model of care involving a variety of individual and group activities.
Staff are “servants of the organization” and it is not necessary to take their needs seriously.	Personhood of staff must be respected if they are to respect the personhood of those in their care.  Well-being is a result of the relationship between the caregiver and the person with dementia.
There is not much we can do positively for a person with dementia until we have medical breakthroughs.  Science will provide definitive answers.	There is a great deal we can do through human insight and skill.

 

Revised from the presentation:  “Changing the Culture of Dementia Care:  Making Person-Centered Care Happen”, presented at the Indiana Alzheimer’s Education Conference, October 2001, by Anna Ortigara, RN, MS, VP of Program Development, Life Services Network,