3.1 Compare a person-centred and a non-person-centred approach to dementia care

This guide will help you answer 3.1 Compare a person-centred and a non-person-centred approach to dementia care.

Dementia care approaches have a massive impact on the quality of life for individuals living with dementia. Two contrasting approaches are commonly discussed: the person-centred approach and the non-person-centred approach. These approaches influence the way care is delivered, with significant differences in focus, outcomes, and the well-being of the individual.

What is a Person-Centred Approach?

Person-centred care focuses on the individual as a whole person, rather than just seeing their condition or diagnosis. It respects their preferences, values, history, and unique personality. This approach takes into account the person’s emotional needs, social connections, and personal identity.

This type of care encourages carers to build meaningful relationships with the person they are supporting. Decisions are made with the person rather than for them whenever possible, helping maintain their sense of control and dignity.

Key features of this approach include:

• Treating each person as an individual with unique needs and preferences.
• Involving the person in decision-making.
• Acknowledging the person’s life history and using it to guide care.
• Creating a positive environment that promotes their well-being.

What is a Non-Person-Centred Approach?

A non-person-centred approach focuses primarily on the symptoms and medical aspects of dementia rather than the person’s individuality. Care is often task-driven, and the emotional or social needs of the person might be overlooked in favour of completing daily routines efficiently.

This approach tends to standardise care, meaning that everyone receives similar support with less regard for personal preferences or relationships.

It often involves:

• A focus on tasks such as feeding, dressing, or medication administration.
• Less attention to the individual’s emotional and psychological needs.
• Limited involvement of the person in decisions about their care.
• Rigid routines that prioritise efficiency over personalisation.

Emotional and Social Impact of Person-Centred Care

Person-centred care improves the emotional well-being of people living with dementia. It reduces feelings of frustration, isolation, and fear, as their needs are recognised and respected. When individuals feel valued, they are more likely to engage and interact.

For example:

• Using life stories or personal interests can stimulate positive emotions. Playing a favourite song or reminiscing about family milestones can comfort and reassure someone with dementia.
• Encouraging independence, such as allowing someone to choose their clothes, maintains a sense of normality and dignity.

Socially, this approach builds trust and strengthens relationships between carers, the person, and their family. It helps create moments of connection, which is especially important when verbal communication becomes difficult.

Emotional and Social Impact of Non-Person-Centred Care

Non-person-centred care, on the other hand, can make people feel like their identity is being ignored. It may cause distress, frustration, or confusion, as their individuality isn’t taken into account.

For instance:

• A lack of choice in daily routines, like being told when to eat or sleep without consultation, can lead to resistance or agitation.
• Focusing only on tasks may result in missed opportunities for meaningful interaction, leaving the person feeling isolated or lonely.

The lack of emotional engagement can strain relationships, not just between the person and their carers but also with family members who feel their loved one isn’t being seen as an individual.

Impact on Dignity and Respect

Dignity and respect are central to a person-centred approach. This method values the person for who they are now, even as dementia progresses.

For instance:

1. Allowing the use of familiar routines from the person’s life before care can maintain a sense of continuity and value.
2. Celebrating small achievements, like brushing their hair or participating in an activity, promotes self-worth.

Non-person-centred care often overlooks dignity. Standardised routines or dismissive treatment can leave individuals feeling undervalued. For example, automatically labelling someone as “challenging” for expressing distress ignores the reason behind their behaviour, which could stem from unmet needs or poor communication.

Flexibility in Care Plans

Person-centred care plans adapt to the individual’s changing needs. As dementia progresses, their ability to communicate or participate may change. A person-centred approach ensures care evolves to support them appropriately, always acknowledging their preferences.

Non-person-centred care lacks this flexibility. Care remains rigid and may not address ongoing changes in the person’s condition. For example, if someone develops a sensitivity to noise but continues to be cared for in a loud environment, their discomfort will likely worsen.

Physical Well-Being in Person-Centred Care

While emotional and social well-being are vital, person-centred care also supports the individual’s physical health in a meaningful way. Because it looks at the whole person, carers are often better able to recognise subtle signs of pain, illness, or discomfort.

For example:

• If someone suddenly stops eating, a carer with a person-centred approach might investigate whether the person dislikes the food provided or has dental pain.
• Physical activity can be encouraged in line with their interests, such as walking outside if they enjoy nature.

In non-person-centred approaches, these signs may go unnoticed as care focuses only on completing daily tasks.

Behaviour Management

Behavioural changes such as agitation or aggression are common in individuals with dementia. These behaviours are often the result of unmet needs or poor communication.

Person-centred care aims to understand the triggers behind behaviours. Instead of dismissing someone angrily shouting as “challenging,” the carer may explore whether it stems from fear, confusion, or discomfort.

Non-person-centred care often tackles behaviours punitively or dismissively. For example, placing someone in isolation or restricting their movement might address the symptom but doesn’t deal with the underlying cause.

Impact on Carers

Carers benefit from person-centred approaches because it allows for stronger, more rewarding relationships. It can reduce stress and increase job satisfaction as they see the value of their efforts in the improved well-being of the person.

Non-person-centred approaches can lead to increased frustration for carers. Task-focused routines can be monotonous, and the lack of meaningful connections with the individuals they support may leave carers feeling emotionally drained.

Examples of Person-Centred and Non-Person-Centred Practices

Person-Centred Practices:

• Asking someone which clothes they prefer to wear each day.
• Involving them in preparing a meal they once enjoyed cooking.
• Planning activities or outings based on their hobbies or interests.
• Adjusting schedules to fit their natural patterns, such as letting a night owl sleep later in the morning.

Non-Person-Centred Practices:

• Dressing someone in the first outfit available without consulting them.
• Feeding them foods they dislike without considering their preferences.
• Insisting everyone participates in the same activity regardless of interest.
• Enforcing strict bedtimes that do not align with the person’s natural sleep cycle.

Legal and Ethical Importance

In the UK, the principles of person-centred care are promoted by legislation and ethical guidelines. The Care Act 2014 and the Mental Capacity Act 2005 emphasise the importance of providing care that respects an individual’s autonomy, choices, and dignity.

Non-person-centred care risks breaching these legal and ethical obligations. Neglecting the individual’s needs or preferences could lead to complaints, investigations, or even sanctions against care providers.

Final Thoughts

Person-centred care is recognised as best practice for dementia care. It puts the individual and their well-being at the core of all decisions. This approach supports emotional, social, physical, and psychological health while maintaining dignity and respect.

While non-person-centred care may provide basic needs like feeding or dressing, it fails to acknowledge the individual as more than their illness. This approach can lead to increased distress and a lower quality of life for the person.

By prioritising person-centred care, workers can provide support that not only meets professional standards but creates a positive, respectful, and meaningful experience for people living with dementia.