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Towards a Theory of Dementia Care: Personhood and Well-being

  • Tom Kitwood and Kathleen Bredin


Some foundations are laid for a social-psychological theory of dementia care. Central to this is a conceptualisation of personhood, in which both subjectivity and intersubjectivity are fully recognised. Evidence is brought forward concerning relative well-being even in those who are, from a cognitive standpoint, severely demented. In the light of this it is argued that the key psychological task in dementia care is that of keeping the sufferer's personhood in being. This requires us to see personhood in social rather than individual terms.



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1 Kitwood, T., The technical, the personal and the framing of dementia. Social Behaviour, 3 (1988), 161180.

2 See, for example, Shotter, J., Images of Man in Psychological Research. Methuen, London, 1975.

3 Menzies, Lyth I., Containing Anxiety in Organizations. Free Associations Books, London, 1989.

4 Freire, P., Cultural Action for Freedom. Penguin, Harmondsworth, 1972.

5 Kitwood, T., The dialetics of dementia: with particular reference to Alzheimer's disease. Ageing and Society, 10 (1990), 177196.

6 Bredin, K., A Review of Psycholosocial Interventions in Dementia. University of Bradford, 1991. Copies available on request.

7 See, for example, Mair, M., Between Psychology and Psychotherapy: Towards a Poetics of Experience. Routledge, London, 1989.

8 This term, or rather ‘the pathology of normalcy’ was coined by Erich Fromm. See Fromm, E., The Sane Society. Routledge, London, 1956.

9 See, for example, Gubrium, J.Old-timers and Alzheimer's: the Descriptive Organization of Senility. JAI Press, London, 1986.

10 Gilleard, C. Losing One's Mind and Losing One's Place. Address to the British Society of Gerontology, 1989.

11 Kitwood, T.Concern for Others. Routledge, London, 1990.

12 Malerstein, A.J. and Ahern, M., A Piagetian Model of Character Structure. Human Sciences Press, New York, 1982.

13 Smail, D.Illusion and Reality. Dent, London, 1984.

14 Bell, J. and McGregor, I., Living for the moment. Nursing Times, 87 (1991), 18, 4547.

15 Rovner, B., Lucas-Blanstein, J., Folstein, M. F. and Smith, S. W., Stability over one year in patients admitted to a nursing home dementia unit. International Journal of Geriatric Psychiatry, 5 (1990), 7782.

16 Diamond, M., The potential of the ageing brain for structural regeneration. In Arie, T. (ed.), Recent Advances In Psychogeriatrics, 1. Churchill, London, 1985.

17 Karlsson, I., Brane, G., Melin, E., Nyth, A-L. and Ryko, E. Effects of environmental stimulation on biochemical and psychological variables in dementia. Acta Psychiatrica Scandinavica (1988), 207213.

18 We acknowledge the insight of Mr Ian Mackie, Manager of Northern View Day Hospital, Bradford, in helping to clarify this point.

19 Erik, Erikson, in his theory of life-stages, sees the development of basic trust as the first task for the infant. Erikson, E., Childhood and Society. Penguin, Harmondsworth, 1965.

* Bradford Dementia Research Group, University of Bradford, England.

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Towards a Theory of Dementia Care: Personhood and Well-being

  • Tom Kitwood and Kathleen Bredin


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