Humanizing approaches to dementia care may extend patients' lives

Through an intensive comparative study of two nursing home units using contrasting approaches to dementia care for elders with severely disturbed behaviors, Central Michigan University professor of anthropology Athena McLean has found that "humanizing" approaches to dementia care may not only extend quality of life for patients, but also their length of life.

In McLean's recently published book, "The Person in Dementia: A Study of Nursing Home Care in the U.S.," she discusses the dramatic contrasts in the outcomes of the two approaches to dementia care: a rigid task-oriented maintenance approach emphasizing disease progression and a flexible person-sustaining approach attentive to elders' communication and individual needs.

McLean found dramatic differences between life quality of the patients at the two nursing units. The patients at the unit that focused on "personhood", or looking beyond physical and reasoning abilities to a person's will and relationship with others, were found to be happier, had an overall improved quality of life and even lived longer. Those at the unit emphasizing disability and pathology tended to have their personal needs ignored, were heavily medicated and often failed to thrive.

"These findings address issues that medicine can't answer," said McLean. "They are valuable not only for improving the general quality of life for these elders, but also for the long-term outcome based on how they are treated and cared for. These elders require attention, time and a lot of caring interaction."

McLean's findings also demonstrated how relations among professional and administrative staff within a facility can significantly affect the quality of the dementia care elders receive.

"I want people to see that dementia need not evoke the terror that the term Alzheimer's usually raises and that there is still hope in cases that many think are lost," said McLean. "Good caregivers are leaving the profession because they are underpaid and unappreciated. It needs to be understood by policy makers, family members and clinicians alike that money needs to be put into retaining quality caregiving staff, instead of only fancy facilities, which is currently the trend."

McLean is a cultural and medical anthropologist who spent more than ten years conducting full-time research before coming to CMU. Her studies of medicine and aging include examination of issues in international aging and the psychiatric consumer/survivor movement in the United States.