Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia.
Plunkett Center for Ethics, Australian Catholic University, Sydney, Australia.
J Med Philos. 2024 Jan 13;49(1):85-101. doi: 10.1093/jmp/jhad044.
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.
我们认为，当代对“人”的概念化未能实现“以人（person）为本的关怀”（PCC，一种由汤姆·基特伍德开发的痴呆症护理模式）的道德目标，并且对接受护理的人、他们的家人和护理人员都有不利影响。我们区分了人格和自我，指出在痴呆症护理中，真正处于危险之中的是后者的连续性或维持。然后，我们展示了我们的概念化，它优先考虑痴呆症患者的生活体验，并将自我理解为与护理人员和护理环境建立关系而形成的，这最能捕捉到基特伍德的最初想法。这种概念化也足够灵活，可以适用于不同痴呆阶段的人的护理实践。将这种概念化应用于 PCC 将最能促进痴呆症患者的福祉，同时也鼓励在护理环境中尊重和尊严。
