The Relational Care Framework: Promoting Continuity or Maintenance of Selfhood in Person-Centered Care

• Published in: The Journal of medicine and philosophy Vol. 49; no. 1; pp. 85 - 101
• Main Authors: Tieu, Matthew, Matthews, Steve
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 13.01.2024
• Subjects: Dementia; Humans; Original Research; Patient-Centered Care - methods; Personhood; dementia; Tom Kitwood; personhood; identity; selfhood; person-centered care (PCC)
• ISSN: 0360-5310; 1744-5019; 1744-5019
• DOI: 10.1093/jmp/jhad044

Abstract We argue that contemporary conceptualizations of “persons” have failed to achieve the moral goals of “person-centred care” (PCC, a model of dementia care developed by Tom Kitwood) and that they are detrimental to those receiving care, their families, and practitioners of care. We draw a distinction between personhood and selfhood, pointing out that continuity or maintenance of the latter is what is really at stake in dementia care. We then demonstrate how our conceptualization, which is one that privileges the lived experiences of people with dementia, and understands selfhood as formed relationally in connection with carers and the care environment, best captures Kitwood’s original idea. This conceptualization is also flexible enough to be applicable to the practice of caring for people at different stages of their dementia. Application of this conceptualization into PCC will best promote the well-being of people with dementia, while also encouraging respect and dignity in the care environment.