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A person with dementia is gradually losing the capacity to think and problem solve, remember, use language and behave as they once did. However, the person-centred approach to caring for people with dementia asserts that the 'personhood' of each person is present despite this decline in abilities.

What is a person in the context of dementia and how do we understand the person who has dementia in philosophical terms?

June 12, 2007

Response from Saul Traiger on June 25, 2007

The person centered approach to psychotherapy is a widely used methodology. (See, for example, www.person-centered.org) In contrast with some other methods, the person centered approach leverages the patientís own resources in therapy, rather than relying on the authority of the therapist. As your question suggests, this approach may seem problematic for patients with dementia. Such patients have diminished cognitive (and possibly affective) resources. To what extent can such patients with contribute to their own psychotherapy? Clearly this is a matter of degree. As oneís abilities to reason, remember, and use language diminish, any form of therapy will be difficult to carry out. Person centered therapists who work with such patients are trained to take such limitations into account.

In philosophy there is the synchronic problem of personhood, namely what makes someone a person at a time, and the diachronic problem of personal identity, or what makes someone the same person at two different times. One could be a person at one time but not the same person at some two distinct moments of time. Of course this depends on oneís theories of synchronic and diachronic identity as well as the nature and severity of the patientís dementia. For example, if you hold that living human beings are persons (at a time and over time) in virtue of the possession of an immaterial soul, then individuals with dementia are still persons at a time and over time. If you hold that an individual must have a some level and/or type of cognitive functioning (e.g. memory, language) to be a person at a time, and must possess memories of his or her past in order to be the same person over time, then some individuals with dementia would not count as either persons at a time or the same person over time. The problem of personhood is one of the thorniest of philosophical issues, and one canít do justice to the range of possible answers to your question in the confines of this space. A good introduction to the issue is John Perryís little book, A Dialogue on Personal Identity and Immortality, (Hackett, 1978).


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