The culture change movement advances an alternative to a biomedical model of dementia care. The Pioneer Network, a group of professionals within long-term care committed to a transformation of care for older adults, defines culture change as a “national movement… based on person-directed values and practices where the voices of elders and those working with them are considered and respected. Core person-directed values are choice, dignity, respect, self-determination, and purposeful living” (Pioneer Network, 2012).
The movement seeks to address multiple components within institutional structures, including physical environment, relationships, attitudes and values, and organizational practices. Thomas Kitwood (1997), a pioneer in person-centered dementia care, identified the following seven components of the biomedical geriatric care culture that require transformation:
- A shift towards viewing dementia as a form of disability rather than as progressive destruction of personality and identity.
- A shift to viewing caregivers and people living with the disease as sources of relevant knowledge, rather than doctors and scientists.
- The refocusing of research efforts on improving quality of life rather than focusing solely on biomedical treatments and prevention efforts, that often take the form of solely pharmacological interventions.
- A focus on caregiving efforts that address preservation of personhood rather than focusing only on physical care.
- An emphasis on the unique abilities, interests, values, and strengths of each individual rather than focusing primarily on cognitive decline.
- View of behaviors as attempts at communication of needs, rather than as problems that need to be managed or diminished through pharmacological intervention.
- Acknowledgement of the feelings that arise in caring for people with dementia; these feelings are sources of valuable insight, and may lead to the development of more genuine, empathic relationship with people living with dementia.
For more information, check out:
Thomas Kitwood (1997) Dementia reconsidered: the person comes first. New York, NY: Open University Press.
G. Allen Power (2010) Dementia beyond drugs: Changing the culture of care. Baltimore, MD: Health Professions Press.
Athena Mclean (2007) The person in dementia: A Study of nursing home care in the US. Toronto, Ontario: University of Toronto Press.