One of the most notorious disorders that many people who are aging face is the onset of dementia, which can lead to memory loss and is often associated with Alzheimer’s disease. Ray (2016), states that things are looking up for those who have dementia, but that it was not always such a positive outlook. Before this outlook it was thought that a diagnosis of dementia meant that the individual was more or less done for and had no hopes of ever living life without bowing to the diagnosis and letting it take over completely and totally losing the person who once inhabited the body. Kitwood (1997), refers to the change in the dementia outlook as a “reappraisal” meaning that the diagnosis is viewed in a different light now than several years ago (p. 13). Both Kitwood (1997) and Ray (2016) emphasize the use of Person-Centered care for dementia patients as opposed to a generalized care method. This means that the care that is provided will be based on the person as an individual not as just a dementia patient because all people are different and care should be adjusted to the individual not the population. Person-Centered care should be the only way that those who have dementia should be cared for.
Kitwood (1997) discusses what it is like for someone to experience dementia. Some of the discussion is from excerpts of those who have dementia and how they have experienced it. A few times the words fog or mist are used in those descriptions to describe a certain fuzziness that surrounds those who suffer from dementia. One of the main points that Kitwood (1997) that is reinforced by Ray (2016), is that the diagnosis of dementia does not have to lead to a sense of sadness, but that there can still be positivity in the lives of those who do have dementia and they aren’t necessarily lost to the diagnosis. One of the descriptions in the Kitwood (1997) article by a woman who had rather serious dementia starts off rather pleasantly using terms such as warm and feeling at home, but then followed up with words such as chill and sinking feeling. This shows that the dementia experience can be both pleasant and not so pleasant in a very short period of time and that there is no set state for someone who has these experiences.
Kitwood (1997), states that there are six methods, according to him, that can be used to understand the dementia experience. He relates the methods to that of a collage where each method alone only forms part of the whole experience that is dementia, but with them all together the picture becomes much more clear and whole. Kitwood refers to these as “Access Routes” (p.15) and gives a description of each.
The first of these access routes, described by Kitwood (1997), to get a better idea of the dementia experience is to read what those who have dementia have written about the experience itself. Listening to a dementia patient speak is the second route described in the Kitwood article (1997). The dementia patients tend to use their words to explain how the dementia is making them feel even if they are not explicitly saying it. Kitwood explains that they often use metaphors to describe the dementia experience. This ties into Kitwood’s (1997) third route to get a better idea of the dementia experience, which is that much of what a dementia patient says is not entirely literal and because of that it may be up to the listener to find the deeper meaning in the patients words. This method is followed up by talking to people who have been through something similar to dementia and are also able to give feedback on what it was like to go through that. Kitwood (1997), goes on to explain that his fifth method is that many times the regular way of talking is not quite abstract enough to get a really good idea of the dementia experience, but that something like poetry can display it better because it is less literal. Lastly, the sixth access route described by Kitwood involves actual simulation of what it is like to be someone who has dementia, but only under proper conditions and that the subject being observed is wholeheartedly involved. With these six methods Kitwood (1997) believes that the dementia experience can be much more clear for someone who does not have it.
Both Kitwood (1997) and Ray (2016) discuss the aspect of person-centered care for dementia patients and how it should focus on the individual rather than the diagnosis as a way of dealing with the patient. Kitwood (1997) states that there are five things that a person with dementia needs that are necessary to help establish person-centered care. These five needs all culminate to form love, which people with dementia crave possibly more so than someone who does not have dementia.
The first of Kitwood’s (1997), five needs that form love is comfort. Comfort gives person who might feel like they are losing part of themselves the ability to relieve some of their ailments while helping to relax and feel warmth from others. Providing comfort is crucial to Kitwood’s version of person-centered care. The second need that Kitwood (1997), believes should be fulfilled is attachment. Kitwood relates those who suffer from dementia to children in a way where an attachment, such as a mother, is crucial and he believes that people may revert to needing this type of attachment whilst going through dementia. Kitwood’s third need for dementia patients involves their social lives, which he refers to as inclusion. Kitwood (1997), goes on to state that when someone has dementia their need to socialize may increase, but often times will decrease and if they are not able to be social then they could end up in what Kitwood refers to as a “vegetative state” (p. 20). Kitwood goes on to explain that people who have dementia also need to feel occupied; of course this does not mean having a job, but feeling as though they have something to fulfill them selves and if they do not feel occupied with their life they can end up being bored, but as long as the individual themselves has been taken into account it can be much easier to fulfill their need of occupation. Finally the last of Kitwood’s (1997), five needs to feel loved for dementia patients is a sense of identity. Kitwood goes on to explain that naturally with the memory loss involved in the dementia process parts of a persons identity can also be lost, but if there is someone there to fill in the blanks of identity this can help to maintain their sense of it. If all of these needs are fulfilled Kitwood (1997), believes that the patient will feel loved, but this can only be done with person-centered care because each need will need to be attended to differently for each patient instead of an overarching way to handle each need.
The study completed by Hunter, Hadjistavropoulos, & Kaasalainen (2016) examined person-centered care for people with dementia that is handled by nursing assistants (NA’s) in Canada. This study was mainly in forms of interviews with the NA’s who were asked what they thought went into very good care for dementia patients. The goal of these interviews was to see how the nursing assistants idea of good care lined up with that of the person-centered approach to caring for someone with dementia.
Once all the interviews in the study by Hunter, Hadjistavropoulos, & Kaasalainen (2016) were completed the answers were complied to give overarching themes of what all the nursing assistants believed constituted quality care for dementia patients. There were five overall things that the NA’s focused on when caring for dementia patients.
The first of the five ways to care for a dementia patient as given by NA’s in Hunter, Hadjistavropoulos, & Kaasalainen (2016) was to build a relationship with their patient. This entails actually caring about the patients themselves and showing them that there is someone who wants to listen to them and taking the time to do so. Hunter, Hadjistavropoulos, & Kaasalainen (2016) state that the NA’s said that as a general rule these patients want to feel love and this goes back to Kitwood (1997) who stated that in order to give good person-centered care for dementia patients they need to feel love. The NA’s also mentioned that it is important to “go the extra mile” (p. 1219) to show the patient that they care and this all in turn will help to build a sold foundation for a goo relationship.
The second concept in the study by Hunter, Hadjistavropoulos, & Kaasalainen (2016) that NA’s felt was necessary to give good care to their dementia patients was to be accommodating to the individualistic preferences of the patient. This included being respectful of the choices that the patient chooses. This also is tied to person-centered care in the way that they treat the person with dementia as the individual that they are.
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