The term “patient-/person-centered care” is currently used in healthcare to denote the focus on involving the patient in his/her care following initiatives by organizations, such as the Institute of Medicine (IOM) in the United States, to increase the quality and effectiveness of care. However, person-centered care (PCC) has been used as an approach in the design and delivery of care for individuals with dementia since the late 1990s to enhance the quality of care and the quality of life for individuals with dementia. The term person-centered, rather than patient-centered, care is used in this context due to its widespread acceptability and its holistic and personalized ethos (Love and Pinkowitz 2013). Pioneered by Tom Kitwood and Kathleen Bredin in the late 1980s and early 1990s in the United Kingdom (UK), PCC values the individual and honors and facilitates the expression of his/her autonomy. PCC is more than simply individualized care; it is ensuring that all interpersonal interactions between the person and the staff are understood in relation to how the person feels and how they enhance the person’s sense of well-being. As noted by Barbosa et al. (2015), forms of PCC approaches include the following: behavior-oriented approaches, such as simplified tasks and simple one-step instructions; emotion-oriented approaches, such as reminiscence and validation therapy; cognition-oriented approaches, such as reality orientation; and stimulation-oriented approaches, such as recreational, art, and music therapies and multisensory stimulation.

Beginning with the work of Kitwood and Bredin, experts in the UK have successfully proposed many policy initiatives leading to the successful application of PCC across the entire trajectory from diagnosis to death. Members of the Bradford University Dementia Group developed Dementia Care Mapping (DCM) from Kitwood’s model as a method to map out care for individuals and for the setting as a whole; and this method has been used to plan, deliver, and evaluate care, indicating positive outcomes as well as areas in need of change and/or improvement (Brooker 2015). The group also developed a training program for primary care practitioners, and there has been movement to incorporate PCC in hospitals as well. Brooker advanced DCM in 2007 with her person-centered dementia care (PCDC) model known as the VIPS framework. This model focuses on valuing the person, individualization of care, the perspective of the person, and a supportive social environment (Brooker 2015).

In the UK, the National Institute for Health and Clinical Excellence (NICE) and the Social Care Institute for Excellence (SCIE) collaborated to develop guidelines and standards for quality care, and the first evidence-based guideline on dementia was published in 2007 (NICE and SCIE 2007). The guideline pointed to the need for training of both health and social staff in order to provide this quality care, such as that developed by the Bradford Dementia Group, and the collaborative has continued to work on the articulation of standards and the measurement of outcomes. In the United States (US), the Dementia Initiative, formed in 2012, issued the white paper titled “Dementia Care: The Quality Chasm,” which laid out a four-part framework for person-centered dementia care. These four parts included the core values and philosophy of the person, the structure of the long-term care service and support settings in which the person lives (note that this does not include those persons receiving care by family members or friends), the operational practices of the structure that support person-centered care, and the individualized practices that are used in interacting with the person (Dementia Initiative 2013). In response to worldwide requests by governments and Alzheimer’s associations for more efforts focused on improving the quality of dementia care services, the World Health Organization (WHO) held its first conference on dementia in 2015. WHO’s Global Action on Dementia report (World Health Organization 2015), which calls for greater emphasis on quality care of persons with dementia at the global level, resulted from this meeting of experts across the globe.

When moving from a concept into daily practice, questions arise about how to put PCC into action, beginning with the question of how care providers can know the preferences, needs, and values of a person with dementia. This is followed by the questions: How can they ensure that the person’s values guide all decisions about his/her care? How and to what extent can they involve family members without compromising the fundamental focus on individual autonomy and choice? How can person-centered care be measured if the person is unable to complete the questionnaires being used to evaluate patient experience? (Maslow 2013). Thus, the implementation of PCC requires careful and thorough consideration of many factors.

Since valuing the person is the fundamental principle of PCC, it is vital for the caregiver to listen, observe, and use multiple sources to learn about the person’s history, values, and preferences, and what brings them joy, and then use that knowledge to plan and provide care in a trusting relationship (Molony and Bouma 2013). Care is built around the person’s strengths and honoring the person’s personhood and autonomy, which implies the necessity of offering and not denying opportunities for the person to make choices. These opportunities can be modified according to the person’s cognitive/emotional/communication/physical abilities. The organization must be supportive of the care initiative from the top down. In order to provide PCC, the focus of the organization must shift from the completion of tasks within set time frames to that of prioritizing the understanding of the person’s experience in the planning and provision of care (Kitwood 1997). Among other issues, this requires that the organization be willing and able to provide and support appropriate training and modify staffing patterns, programs, and the environment.

Several frameworks/models of PCC have been developed. One of these is the VIPS framework originally designed by Brooker in 2007. This framework consists of: V, for valuing people with dementia and those who care for them; I, for treating people as individuals; P, for looking at the world from the perspective of the person with dementia; and S, for a positive social environment in which the person living with dementia can experience relative well-being (Brooker 2015). Guidance on the implementation of PCC in the long-term care setting is outlined in the framework, with an emphasis on the necessity of staff education on how to practice PCC. Another is the ABLE model of PCC, which was first conceived as a quality improvement project. This model incorporates Montessori principles and has four areas of focus: A, for abilities and capabilities of the person; B, for the background of the resident; L, for leadership, culture change, and education of staff; and E, for physical environment changes (Roberts et al. 2015).