Person‑centred care

This guideline offers best‑practice advice on the care of people with dementia and on support for their carers. There is broad consensus that the principles of person‑centred care underpin good practice in the field of dementia care and they are reflected in many of the recommendations made in the guideline. The principles assert:[2]

  • the human value of people with dementia, regardless of age or cognitive impairment, and those who care for them

  • the individuality of people with dementia, with their unique personality and life experiences among the influences on their response to the dementia

  • the importance of the perspective of the person with dementia

  • the importance of relationships and interactions with others to the person with dementia, and their potential for promoting well‑being.

The fourth principle emphasises the imperative in dementia care to consider the needs of carers, whether family and friends or paid care‑workers, and to consider ways of supporting and enhancing their input to the person with dementia. This is increasingly described as 'relationship‑centred care'.

Capacity and dementia

Treatment and care should take into account patients' needs and preferences. People with dementia should have the opportunity to make informed decisions about their care and treatment, in partnership with their healthcare professionals. If patients do not have the capacity to make decisions, healthcare professionals should follow the Department of Health's advice on consent and the code of practice that accompanies the Mental Capacity Act. In Wales, healthcare professionals should follow advice on consent from the Welsh Government.

Involving others

The views of people with dementia concerning who should and should not be involved in their care are important and should be respected. With the permission of the person with dementia, carers and relatives should normally have the opportunity to be involved in decisions about care and treatment. If the person lacks the capacity to decide who should and should not be involved, health and social care professionals must act in his or her best interests, bearing in mind the provisions of the Mental Capacity Act 2005.

Health and social care staff should take account of the views of carers and relatives who describe behaviour that could be in keeping with dementia. This information, in conjunction with an assessment of the person concerned, will help with diagnosis and deciding on care. It will also help in the estimation of the person's capacity to make decisions. People with dementia should continue to have the opportunity to make informed decisions about those aspects of their care and personal lives for which they retain capacity.

Good communication between care providers and people with dementia and their families and carers is essential, so that people with dementia receive the information and support they require. Evidence‑based information should be offered in a form that is tailored to the needs of the individual. The treatment, care and information provided should be culturally appropriate and in a form that is accessible to people who have additional needs, such as physical, cognitive or sensory disabilities, or who do not speak or read English.

Carers and relatives should also be provided with the information and support they need, and carers should be offered an assessment of their own needs.

[2] Kitwood TM (1997) Dementia Reconsidered: the Person Comes First. Buckingham: Open University Press; Brooker D (2004) What is person-centred care in dementia? Reviews in Clinical Gerontology 13: 215–22.