Conceptualising dementia

The way dementia is conceptualised influences the wellbeing and treatment of people living with the condition. The traditional neuro-degenerative model has increasingly been challenged. Significant contributions include the 1970’s concepts of malignant social psychologv and personhood, the 1990’s drive to engage with the social model of disability, and the recent development of the social citizenship approach. Not only has this new paradigm widened the conceptual lens through which dementia is viewed but it has incorporated issues, beyond the biomedical, that extend our understanding of dementia as a situated condition and lived experience. It is situated in relationships, a lifecourse and a socio-political context and is shaped by inequalities and limited engagement with rights and social justice. Dementia is a multi-dimensional phenomenon and requires a response that addresses its clinical, psychological, social and political dimensions. The new paradigm helps re-focus policy, care and research on the person rather than the condition; relocates the ‘problem’ from the individual to societal structures, attitudes, policy and services; demands new forms of critical practice; and engages with the perspectives of people living with dementia. Whilst there are dementia specific policies in the UK they have limited legal traction and are not integrated with other relevant policies.