Frameworks

Framework for Understanding Dementia

Understanding dementia is vital for providing quality care. Frameworks offer a structured approach for comprehending the condition.
The Biopsychosocial Framework considers biological, psychological, and social factors that contribute to an individual’s dementia and approach to care.
Biological factors include a person’s genetic predisposition, brain cell degeneration and physical health.
Psychological factors pertain to an individual’s mental health, personal history, cognition, and emotional state.
Cognitive psychology, the study of mental processes like “problem solving”, “judgment”, and “memory”, has a key role in comprehending dementia.
Social factors examine the impacts of an individual’s social relationships, economic status, and environment.
This framework promotes multi-faceted person-centred care, treating individuals as a whole, and not just their diagnosis.

Tom Kitwood’s Person-Centred Framework

Tom Kitwood introduced a Person-Centred Approach to dementia care focused on the person, not just their diagnosis.
This framework pays attention to individual experiences, emotions, life history, and relationships.
Kitwood emphasised unbefriended needs (“psychological needs”) such as comfort, inclusion, identity and occupation (having something to do).
He argued that dementia can be better managed if these needs are addressed, promoting better quality of life for people with dementia.
This approach reduces negative behaviours like aggression and improves communication between care providers and those they support.

Medical Framework

The Medical Framework views dementia from a biological perspective, aiming at diagnosing the disease and alleviating symptoms.
This model is largely concerned with the physical progression of the disease, its causes, and the development of treatment and prevention strategies.
It emphasises medical treatments, physical and occupational therapy, and other strategies to manage symptoms.
However, critics argue this framework often sidelines the significance of emotional and social aspects of care.

Social Model of Disability

The Social Model of Disability argues that people are disabled by the barriers in society, and not by any disorder or disease.
A societal change, rather than simply addressing symptoms, is integral. This may involve reducing stigma and improving access to services and facilities.
This model often synergises with person-centred approaches, advocating the importance of independence and involvement in the society for individuals with dementia.

Each of these frameworks offers a different perspective on dementia, and can optimise care when appropriately applied. A blend of different frameworks may be most effective, considering both the medical and personal needs of the person with dementia.