Personhood and dementia: revisiting Tom Kitwood’s ideas

Abstract

Person-centred care is often cited as an aim of gerontological nursing and promotion of personhood is said to be the basis for person-centred care. As such, it forms a cornerstone value for many gerontological nurses, particularly those working in dementia care. Tom Kitwood's ideas and definition of personhood are widely referred to in the literature and used in the dementia care field. More recently, there is a move to critique and partially reject Kitwood's ideas on personhood. This paper has three aims: (i) to explore some central ideas around key theories of personhood (ii) to critique Kitwood's work on personhood. (iii) To summarize current critiques of Kitwood's ideas and provide a response that outlines why Kitwoods' ideas are still relevant. It is suggested many critiques ignore Kitwoods' ultimate purpose; that of moral concern for 'others'. However, the main criticism put forward in this paper is that, rather than completely rejecting personhood theories, Kitwood locates his work on what it means to be a person within a traditional Cartesian personhood framework, albeit from a revised or pragmatic viewpoint. Finally, it is suggested that definitions of persons and personhood need to take account of the body and time (corporeality and temporality) and gerontological nursing may want to reassess how much allegiance is given to basing nursing frameworks on the concept of personhood.

Using appreciative inquiry to implement person-centred dementia care in hospital wards

“…Moreover, there is a debate whether these frameworks need to be specific to a particular target group or can be generalised to different care settings and cultures. Nevertheless, others (Epp, 2003;Dewing, 2008) argued that Kitwood's theories do not necessarily need to be rejected but only refined. Additionally, evidence indicates that PCC strategies can positively influence persons with dementia, informal and formal caregivers (Edvardsson et al, 2008).…”

“…Nevertheless, his ideas have been criticized with regards to the methodology adopted (Dewing, 2004) in drawing his conclusions and the application of PCC principles in practice (Adams, 1996;Dewing, 2008). Dewing (2004) suggested that PCC frameworks seem to focus on two cardinal aspects namely knowing the person and relationship-centred care.…”

Grief, Anger, and Relationality

“…In turn, these practices were associated with staff's stringent self-management of empathy, self-protective practices and 'similar fate fear,' and their discomfort with the involvement and reactions of family. Postintervention analysis indicated that the play evoked significant changes in a "relationality" orientation (Dewing, 2008;Nolan, Ryan, Enderby, & Reid, 2002) by staff. That is, improvements were observed in how staff related to family care partners and other family members, and in how they supported clients' sexual orientations and their needs for intimacy expression and sociability.…”

Optimisation of dementia care in care homes: Dementia care framework (innovative practice)

“…The term personhood has long been used within dementia care literature and is defined as the 'attributes that make up being a person' (Kitwood, 1997;Dewing, 2008). Personhood is 'a standing or status that is bestowed upon one human being, by others, it implies recognition, respect and trust ' (Kitwood, 1997).…”