The value of knowledge and persons living with dementia: a healthcare professional’s reflection

Background: I am a social worker with experience in working with persons with dementia in long-term care. This is a critical reflection of my practical experience of my assumptions regarding the knowledge held by persons with dementia in long-term care. I will suggest my initial assumptions were influenced by positivist epistemology and outline how they change when I changed to a constructivist epistemological stance. Aim: The aim of this article is to break down assumptions arising from a positivist epistemological stance so that I, and other healthcare professionals who might share similar assumptions, will better value the knowledge of persons with dementia and incorporate it into their care and our overall practice. Findings: I identified my two inadvertent assumptions. First, I assumed cognition was the only way of knowing. However, persons with severe dementia can still know their needs and wants from their bodies (embodied knowledge). Second, I assumed that knowledge only had value if it was real to me, yet there could be multiple subjective realities. Conclusion: A change from a positivist to constructivist epistemological stance can lead to a better appreciation of the knowledge held by persons living with dementia, and thereby allow them to have input into their own care. Implications for practice: Professionals could better value the knowledge held by persons with dementia by: Practising reflexivity Acknowledging the views of persons with dementia Thinking about the interrelation among various areas of care