Medicare hospice&nbsp.beneficiaries had a primary hospice diagnosis of&nbsp.Alzheimer’s Disease or non-Alzheimer’s dementia&nbsp.(CMS, 2013d). Many individuals with advanced&nbsp.dementia also have other severe medical&nbsp.conditions (Chen et al., 2007), and it is likely that&nbsp.substantial proportions of Medicare hospice&nbsp.beneficiaries with other primary hospice&nbsp.diagnoses also have dementia. Because many&nbsp.people with dementia are receiving care in each&nbsp.of these settings, it is essential for professional,&nbsp.paraprofessional, and direct care workers in these&nbsp.settings to understand what it means to provide&nbsp.person-centred care for people with dementia.

The concept of person-centred care as&nbsp.articulated in the IOM report quoted above&nbsp.certainly fits with the care needs of people&nbsp.with dementia. When moving from this general&nbsp.concept into day-to-day practice, however,&nbsp.questions arise about how to put some components&nbsp.of the idea into operation. In&nbsp.particular, how can care providers know the&nbsp.preferences, needs, and values of a person&nbsp.with dementia? How can they ensure that the&nbsp.person’s values guide all decisions&nbsp.about his or her care? To what extent,&nbsp.and exactly how can they involve&nbsp.families in care decisions without&nbsp.compromising the fundamental focus&nbsp.on individual autonomy and choice?&nbsp.And how can the person-centeredness&nbsp.of the care they provide be measured&nbsp.if the person is not cognitively capable of completing&nbsp.the survey questionnaires now being&nbsp.used to evaluate the patient experience of care?

Over the past twenty-five years, thinking&nbsp.about person-centred care for people with&nbsp.dementia has evolved, sometimes about&nbsp.the general concept of person-centred care for&nbsp.all people, but more often in a parallel but mostly&nbsp.separate track. In the United States, thinking&nbsp.about person-centred care for people with&nbsp.dementia has been strongly influenced by the&nbsp.ideas of Tom Kitwood and others in England&nbsp.(see Kitwood, 1997a, 1997b. Kitwood, 1988).&nbsp.The philosophy and care practices that incorporate&nbsp.these ideas and related ideas of U.S. dementia&nbsp.care experts and experts elsewhere are&nbsp.often referred to as person-centred dementia&nbsp.care. Compared with the large number of care&nbsp.providers employed in settings that serve people&nbsp.with dementia, the number who know about person-centred dementia care is relatively&nbsp.small. Yet the ideas put forward by Kitwood&nbsp.and others provide a strong conceptual basis,&nbsp.compelling insights, and valuable practice-based&nbsp.knowledge about person-centred care for&nbsp.people with dementia.

The current government and non-government&nbsp.initiatives to increase the availability of person-centred&nbsp.care for all people create opportunities&nbsp.to expand its availability for people with&nbsp.dementia. Achieving this outcome depends,&nbsp.however, on significantly raised awareness about&nbsp.the importance and value of person-centred&nbsp.care for people with dementia and broader understanding&nbsp.about how it can be implemented in&nbsp.day-to-day practice