The audacity of hope: tyranny or liberation in dementia care

Abstract

The introduction of cognitive enhancing medication has created an expectation that drug treatment is a significant part of dementia management to the point that rate of cholinesterase inhibitor prescribing has been suggested as a quality standard.3 Whilst dementia is coming out of the wilderness to the mainstream, there is a risk of losing the supportiveness of the best quality dementia care in favour of a mechanistic, high-throughput mode of delivery of diagnosis and treatment initiation. Every diagnosis of dementia is laden with a meaning that is very much unique to that patient and his/her carers. Vital to that meaning is the experience of hope.