Continuity, change and care: a sense of self in a residential care home

This paper draws on findings from an international study of promising practices in care homes: Reimagining long-term residential care: an international study of promising practices. Across all six countries in the study, the maintenance of personal identity, regarded as important to avoiding institutionalisation, is a core feature of the approach to care in the homes studied,. Encouraging residents to bring with them cherished possessions, such as photographs and ornaments, and displaying memory boxes for people with dementia can be understood as strategies to achieve this aim. At least in part, these practices reinforce a backward facing view of personal identity – that identity is what the resident has done and been prior to moving into the home. Less well understood is the potential of care to enable personal development and change. This study has identified approaches to care that have such potential. Underpinning these is a more fluid conceptualisation of personal identity in which a continuing sense of self can be maintained, including in people with dementia (Kontos and Naglie 2007). This conceptualisation requires attention to emotional and sensory as well as cognitive dimensions of identity.
Kontos, P. and Naglie, G. (2007). ‘Expressions of personhood in Alzheimer’s disease’: An evaluation of research-based theatre as a pedagogical tool. Qualitative Health Research 17(6): 799–811.