Person- and Relational-Centered Care Concepts
Provide Foundation for Our Work
We believe strongly in person- and relational-centered care. All of our services are designed to promote and facilitate this kind of care, and in so doing, improve the quality of life for those with Alzheimer's and dementias, and their families.
Person- and relational-centered care concepts originate as far back as 1949 in the foundational work of Carl Rogers and his approach to client-centered psychology. Then, in 1997, Tom Kitwood wrote a seminal book titled, Dementia Reconsidered: The Person Comes First. In it, he discussed how individuals living with dementia have an enduring sense of self, and maintain feelings, preferences and personality characteristics until the end of life. He said:
If personhood appears to have been undermined, is any of that a consequence of the ineptitude of others, who have all their cognitive powers intact? If uniqueness has faded into a grey oblivion, how far is it because those around have not developed the empathy that is necessary, or their ability to relate in a truly personal way?
If we follow the development of any person’s dementing condition closely, again and again we will come to see how social and interpersonal factors come into play, either adding to the difficulties directly arising from neurological impairment, or helping to lessen their effects…In very many cases, we find that the process of dementia is also the story of a tragic inadequacy of our culture…our medical system and our general way of life.
Today, variations on Kitwood’s person- and relational-centered care practices are accepted as the gold standard for healthcare by the World Health Organization and the Institute of Medicine. However, the general perception of dementia has traditionally and more commonly focused on cognitive losses and functional impairments rather than on proactive approaches for understanding individual symptoms and person-centered strategies for disease management.
In 2018, the Alzheimer's Association published their Dementia Care Practice Recommendations.
For each of the nine areas they highlight, specific care practice recommendations are provided. The Practice Recommendations for Person-Centered Care (Fazio, Pace, Flinner, & Kallmyer, 2018) are the foundation of the framework.
Know the person living with dementia
Recognize and accept the person’s reality
Identify and support ongoing opportunities for meaningful engagement
Build and nurture authentic, caring relationships
Create and maintain a supportive community for individuals, families, and staff
Evaluate care practices regularly and make appropriate changes