Introduction
As a student pursuing an MSc in Dementia Studies, I am developing a personal care plan that anticipates potential future needs if I were to experience dementia. This written section accompanies the plan, providing evidence-based reasoning for my choices, grounded in both personal values and academic research. Drawing on Tom Kitwood’s influential theory of person-centred care, which emphasises maintaining the individuality and humanity of people with dementia (Kitwood, 1997), I will explain my preferences for activities such as joining a choir or drama group. These choices reflect my lifelong love for music and performance, which have shaped my identity and social connections. Furthermore, I will reference peer-reviewed studies to demonstrate the therapeutic benefits of these activities, highlighting their role in enhancing well-being, cognitive function, and social inclusion. This essay is structured to first explore my personal context, then integrate Kitwood’s theory, and finally evaluate the evidence for specific therapeutic interventions. By doing so, it aims to justify how these elements contribute to a holistic, person-centred approach in dementia care. Overall, this discussion underscores the importance of tailoring care plans to individual preferences while ensuring they are supported by robust evidence.
Personal Values and Preferences in Dementia Care Planning
In developing my care plan, my choices are deeply rooted in personal values, preferences, likes, and dislikes, which I believe should form the foundation of any effective dementia strategy. As an individual, I have always found immense joy and fulfilment in creative and communal activities, particularly those involving music and drama. For instance, singing in choirs has been a constant in my life, providing not only a sense of achievement but also opportunities for social interaction and emotional expression. Similarly, participating in drama groups allows me to explore narratives and roles, which aligns with my preference for storytelling and imaginative engagement. These activities are more than hobbies; they represent core aspects of my identity, fostering a sense of purpose and connection that I would want preserved even in the face of cognitive decline.
However, I am mindful of my dislikes, such as overly structured or solitary routines, which could exacerbate feelings of isolation in dementia. Therefore, my care plan prioritises group-based, expressive activities over more passive or individualistic ones. This personalisation is crucial, as it ensures that care respects my autonomy and life history. Indeed, neglecting such preferences could lead to what Kitwood describes as ‘malignant social psychology’ – environmental factors that undermine personhood (Kitwood, 1997). By incorporating these elements, my plan aims to mitigate potential distress and promote a positive quality of life. This approach is not merely intuitive; it is informed by a broader understanding of dementia care, where individual narratives play a pivotal role in therapeutic outcomes.
Integrating Kitwood’s Theory of Person-Centred Care
Tom Kitwood’s theory provides a theoretical framework that strongly supports the reasoning behind my care plan choices. Kitwood (1997) argues that dementia should not be viewed solely as a biomedical condition but as an experience shaped by social and psychological factors. Central to his model is the concept of ‘personhood,’ which he defines as “a standing or status that is bestowed upon one human being, by others, in the context of relationship and social being” (Kitwood, 1997, p. 8). This perspective shifts the focus from deficits to the preservation of identity, emphasising the need for care that nurtures emotional, social, and spiritual needs.
In applying this to my plan, activities like choir singing or drama align with Kitwood’s emphasis on positive interactions that counteract depersonalisation. For example, these group settings encourage ‘facilitation’ – one of Kitwood’s key positive person-work strategies – where caregivers support participation without imposing control, allowing individuals with dementia to express themselves authentically. My preference for such activities stems from their potential to maintain my personhood; as someone who values creativity, I would derive comfort from environments that echo my pre-dementia life. Kitwood’s theory also highlights limitations, such as how institutional care can inadvertently foster dependency, which is why my plan specifies community-based groups to promote inclusion.
Critically, while Kitwood’s ideas have been foundational in dementia care, they are not without critique. Some scholars argue that the theory may overlook structural barriers, such as access to resources in diverse populations (Bartlett and O’Connor, 2010). Nevertheless, in my context as a UK-based student, Kitwood’s framework remains highly applicable, informing choices that prioritise relational care over purely medical interventions. This integration demonstrates a balanced approach, drawing on theoretical strengths while acknowledging potential gaps.
Evidence for the Therapeutic Value of Choir and Drama Activities
To substantiate my choices, it is essential to reference empirical evidence on the therapeutic benefits of choir and drama groups for people with dementia. Research consistently shows that music-based activities, such as choir participation, can enhance cognitive, emotional, and social well-being. A study by Särkämö et al. (2014) found that regular singing in groups improved mood and reduced behavioural symptoms in dementia patients, with participants exhibiting better verbal memory and attention spans compared to controls. This is arguably due to music’s ability to stimulate neural pathways, bypassing some cognitive impairments associated with dementia. In my care plan, involvement in a choir would therefore not only align with my love for singing but also provide evidence-based benefits, such as decreased agitation and increased life satisfaction.
Similarly, drama therapy offers therapeutic value through role-playing and improvisation, which can foster self-expression and social bonds. Jaaniste et al. (2015) reviewed drama interventions in dementia care, concluding that they promote emotional regulation and a sense of agency, often leading to reduced feelings of isolation. For instance, participants in drama groups reported heightened engagement and improved relationships with caregivers, aligning with Kitwood’s person-centred principles. These findings are particularly relevant to my preferences, as drama allows for creative exploration that mirrors my interest in performance arts. However, it is important to note limitations; not all studies account for individual variability, and benefits may be short-term without sustained participation (Clare et al., 2020).
Government and health authority reports further support these activities. The UK’s National Institute for Health and Care Excellence (NICE) guidelines recommend non-pharmacological interventions like arts therapies for managing dementia symptoms, emphasising their role in personalised care (NICE, 2018). Additionally, a report from Alzheimer’s Society (2020) highlights how community choirs can combat loneliness, a common issue in dementia. By choosing these activities, my plan draws on such evidence to ensure therapeutic efficacy, while reflecting my values. This evidence-based approach addresses complex problems in dementia care, such as maintaining quality of life, by selecting interventions with proven outcomes.
Conclusion
In summary, this accompanying written section has outlined the reasoning for my dementia care plan, blending personal values – such as my affinity for choir and drama – with Kitwood’s person-centred theory and supporting research. Kitwood’s emphasis on preserving personhood justifies the inclusion of activities that nurture identity and relationships, while studies like those by Särkämö et al. (2014) and Jaaniste et al. (2015) provide concrete evidence of their therapeutic benefits in enhancing mood, cognition, and social inclusion. These choices not only reflect my individual preferences but also demonstrate an awareness of evidence limitations, such as the need for ongoing participation. The implications are clear: personalised, evidence-informed care can significantly improve outcomes in dementia, promoting dignity and well-being. As a student in this field, this exercise reinforces the value of integrating theory, research, and self-reflection in care planning, ultimately advocating for a more humane approach to dementia management. By prioritising such strategies, we can move towards care systems that truly honour the person behind the condition.
References
- Alzheimer’s Society (2020) Arts and dementia: Using participatory music making to improve acute dementia care. Alzheimer’s Society.
- Bartlett, R. and O’Connor, D. (2010) Broadening the dementia debate: Towards social citizenship. Policy Press.
- Clare, L., Wu, Y.T., Teale, J.C., MacLeod, C., Matthews, F., Brayne, C., Woods, B. and CFAS-Wales study team (2020) ‘Potentially modifiable lifestyle factors, cognitive reserve, and cognitive function in later life: A cross-sectional study’, PLoS Medicine, 17(3), p. e1003045.
- Jaaniste, J., Linnell, S., Ollerton, R.L. and Slewa-Younan, S. (2015) ‘Drama therapy with older people with dementia—Does it improve quality of life?’, The Arts in Psychotherapy, 43, pp. 40-48.
- Kitwood, T. (1997) Dementia reconsidered: The person comes first. Open University Press.
- National Institute for Health and Care Excellence (NICE) (2018) Dementia: assessment, management and support for people living with dementia and their carers. NICE guideline [NG97].
- Särkämö, T., Laitinen, S., Numminen, A., Kurki, M., Johnson, J.K. and Rantanen, P. (2014) ‘Clinical and demographic factors associated with the cognitive and emotional efficacy of regular musical activities in dementia’, Journal of Alzheimer’s Disease, 49(3), pp. 767-781.
