What is dementia? implications for caring at the end of life

Dementia is understood in a number of different ways within different fields of practice, e.g. health and social
care. In Western society, predominantly biomedical ideas of dementia influence the experiences of people
who have dementia. Limitations of biomedical models of dementia have led to the development of other ways
of understanding dementia. These include the social-psychology, critical gerontology and disability models.
However, such models are also limited, particularly in the context of advanced dementia and dying. This article
demonstrates that the way dementia is understood is important with regard to the care considered possible
or appropriate at the end of life. A move away from polarised understandings of dementia is proposed in
favour of a broader understanding that offers therapeutic potential to those with advanced dementia at the
end of life. Ways in which such a broader understanding might influence end-of-life care are explored, including
the importance of relationships in supporting the sense of self of a person with dementia and the role
of physical care as a way of developing positive relationships.