Discovering the person with Alzheimer's disease: cognitive, emotional and behavioural aspects.

The person-centred approach to dementia care emerges from a new emphasis on the experience of the person with dementia. The person is seen as attempting to manage and cope with their difficulties, through a variety of coping mechanisms. Some are able to seek to maximize their cognitive capacities, and there are a number of strategies now available to assist in this process. However, the emotional aspects merit increased attention, with more awareness needed of the range of powerful emotions that may be present, and of the possibility of therapeutic interventions to alleviate symptoms of anxiety and depression. Many of the difficult behaviours seen in dementia may be understood more fully with an appreciation of their emotional underpinning, in feelings of anger, fear, insecurity and hopelessness. The interaction between caregiver strain and challenging behaviour also merits further exploration. The person-centred approach has many implications for practice, as well as for research. The perspective of the person with dementia, and outcomes reflecting that perspective, must be represented in research studies in dementia care. Caregivers, whether family members or paid workers, require additional support in order to recognize the person's needs and to meet them in ways which enable the person's identity and full human value to be upheld.