Evidencing Kitwood’s Personhood Strategies: Conversation as Care in Dementia

The purpose of this chapter is to highlight the communication and language strategies involved in key positive care interactions identified by Kitwood (1997a) as central to affirming personhood of individuals with dementia. We focus upon the enactment of these strategies in the challenging environment of long-term care. In these facilities, residents typically are in the moderate or severe stages of dementia; staff are necessarily task-oriented; and very little knowledge is available about the residents prior to disease onset. Communication features of the positive care interactions are illustrated through transcript selections from recorded conversations in a long-term care facility with one individual in the moderate stage of dementia. As person-centered conversations lead to reciprocity, contributions on the part of the person with dementia are also shown. The real value of the examples of positive care interactions is that they reinforce the position that individuals with dementia, even those who are in the more advanced stages, retain communicative competence and are active contributors to interpersonal relationships. Moreover, the examples serve to debunk the myth that individuals with dementia in long-term care facilities are nonfunctioning, passive communicators.