Rethinking dementia as a queer way of life and as ‘crip possibility’: A critique of the concept of person in person‐centredness

Abstract

The concept of person-centeredness has become in many instances the standard of health care that humanises services and ensures that the patient/client is at the centre of care delivery. Rejecting a purely biomedical explanation of dementia that led to a loss of self, personhood in dementia could be maintained through social interaction and communication. In this article, we use the insights of queer theory to contribute to our current understanding of the care of those with dementia. We critically discuss the concepts of person and personhood that have become the cornerstone values of person-centred care for persons with dementia (PWD). Some critics, using queer theory as a theoretical approach, contend that person-centred care often (unwittingly) reproduces heteronormative roles in trying to sustain life histories. In doing so, they argue, regendering of PWD is sometimes enforced by care providers who try to safeguard this biographical continuity. Cultural theorist Linn Sandberg also mentions that other axes of domination such as race and class are not conceptualised in personcenteredness approaches, and neither are power asymmetries. Thus, in our article, we revisit the concept of person-centred care as a first step in proposing another way to think about 'beings with dementia' (to avoid the term person). Believing that queer theorists have fallen short in questioning the idea of person or personhood as such, we will build on and broaden Sandberg's critique by demonstrating that queer and crip theory can be understood as a fundamental critique of the (Western) subject and processes of subjectivation. We argue that dementia can be conceptualised as a radical break not only with gendered roles and embodiments, but with many of the norms that make us recognisable subjects. Conceptualising dementia in this way turns it into what Sandberg called an 'emancipatory space' and not merely a pathology

Farewell to humanism? Considerations for nursing philosophy and research in posthuman times

“…There is a range, from critiquing humanist American nursing theory for its narrow conception of environment (Kalogirou et al, 2020), to a radical disruption of the concept of human. For example, Foth and Leibing (2021) dispute nurses’ most basic assumptions about what it means to be human when they theorize dementia as a queer way of life:

dementia can be conceptualised as a radical break not only with gendered roles and embodiments, but with many of the norms that make us recognisable subjects. Conceptualising dementia in this way turns it into … an ‘emancipatory space’ and not merely a pathology.

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“…Foth and Leibing's (2021) view of cognitive impairment as something with emancipatory potential is an example of how unfamiliar, radical, and even frightening (as one conference attendee described her reaction when Foth presented similar ideas at the 2021 IPONS conference) nursing posthumanist discourse can be. I have reviewed a few examples from a growing body of nursing posthumanist scholarship as a starting point.…”

“…Increasingly, in the context of these discussions, nurse authors turn to philosophical and theoretical perspectives contrasting, and severing ties with, traditional humanist beliefs. Preparing for this presentation, I reviewed a small sample of (mostly) Nursing Philosophy articles published since 2020 and discussing or citing posthumanism (Adam et al, 2021; Dillard‐Wright, 2022; Foth & Leibing, 2021; Kalogirou et al, 2020; Smith et al, 2022; Tanioka et al, 2021). This selection by no means represents all posthumanist nursing discourse; however, as the reader will glean from these publications, posthumanism is not a single or unified perspective but rather a constellation of theoretical positions with variations and subtleties specific to the sources cited in nursing articles.…”

Person‐centred conversations in nursing and health: A theoretical analysis based on perspectives on communication

“…Leplege et al, 2007) and an idealizing and stereotyped view of the person. Equally, however, it may also reproduce stereotypes (Foth & Leibing, 2022; Imafidon, 2022; Smith et al, 2022; Tieu et al, 2022). Thus, person‐centredness must be related to the circumstances and conditions of our time and can be seen as a centrally ethical positioning for the shaping of healthcare practice and promotion of health.…”