Dementia and Well-Being: Possibilities and Challenges

By Ailsa Cook | Go to book overview

CHAPTER 6
Conclusions and Recommendations

Over the past twenty years there has been a sea change within the field of dementia, so that people with dementia are no longer seen as ‘non persons’ incapable of well-being, but are recognised as having personhood and agency. Hand in hand with this sea change have come considerable developments in research and practice within the field, and the expertise now exists to ensure the well-being of people with dementia at home or in institutional care settings during every stage of the condition. The philosophy underpinning these developments is encapsulated within the model of person-centred care advocated most prominently by Tom Kitwood and described in Chapter 1. This approach to care highlights the importance of providing individually tailored care and support that sees the person in the context of their personal biography and social relationships and seeks to promote their positive self-identity. Knowing the person and building a good relationship over time is recognised as fundamental to providing person-centred care, as is a willingness to see the abilities and personhood of an individual in the face of sometimes severe impairment.

Despite the prominence of these ideas, it is clear from the evidence reviewed during the course of this book that this approach to supporting people with dementia is not being delivered consistently across the UK. Furthermore, it is clear that the well-being of people with dementia is being undermined by the quality of care provided to them at home, in institutional care settings and hospitals, and also through the widespread failure of the health and social care system to provide the specialist services and supports needed to enable the effective diagnosis, treatment and management of dementia. Thus, people with dementia are not being supported to realise four outcomes that are essential to well-being and that are prioritised by health and social care policy makers and people with dementia alike: health, independence, choice and control, and social inclusion.

In the preceding chapters, many specific challenges and opportunities in delivering on these outcomes have been reviewed, not least the development of new rafts of dementia-specific policy in both England and Scotland. It is, however, possible to discern some overarching themes running through these chapters and these are examined below.

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Dementia and Well-Being: Possibilities and Challenges
Table of contents

Table of contents

  • Policy and Practice in Health and Social Care iii
  • Title Page iv
  • Contents vi
  • Series Editors’ Introduction vii
  • Acknowledgements viii
  • Glossary of Abbreviations ix
  • Preface x
  • Chapter 1 - Definitions and Context 1
  • Chapter 2 - Promoting Health 18
  • Chapter 3 - Promoting Independence 35
  • Chapter 4 - Promoting Choice and Control 49
  • Chapter 5 - Social Inclusion 60
  • Chapter 6 - Conclusions and Recommendations 71
  • References 77
  • Index 86
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