Moving towards a special kind of care for people with dementia living in care homes

This paper considers the position of people with dementia in care homes, and the different understandings of their predicament. There are conflicting pressures on care homes. On the one hand there are reasons to ignore dementia, but on the other there are new expectations that a reasonable quality of life is both possible and desirable for people with dementia. These expectations are informed by a view of dementia which challenges narrow medical understandings and implies a kind of care that is based on sensitive interpretations of individuals, and is able to meet a broad range of needs. Drawing upon findings from a study of wellbeing among people with dementia in long-term care, the paper suggests that applying new understandings to care practice is a slow but worthwhile process. In a favourable care environment, people with dementia can maintain wellbeing, although staff need continuing encouragement and support, especially when residents' needs are complex. In their own way, people with dementia make efforts to hold on to the essential underpinnings of wellbeing, and these efforts need to be recognised and supported. Staff who develop a special understanding of the lived experience of dementia, together with skills to support broader needs, can make a significant difference to residents' lives. The challenge for care homes is to find ways of enabling staff to work in this way.