Dr Elizabeth Milwain, Freelance Psychologist specialising in Later Life
Research investment has increased
Public profile of dementia is also rising
Increasing number of reports, policies and
other drivers
Increasing number of celebrities and other
high profile people talking about dementia
The general public are starting to ask
questions and want to know more
Battle of the ‘models’ is making things worse:
 Biomedical
▪ dominates research and health care
 Psychosocial
▪ dominates frontline education of the dementia care
workforce and some aspects of social care
They would say this is not an either/or issue –
they want the benefits of both models:
 Cause – mostly biomedical
 Cure – mostly biomedical
 Care – mostly psychosocial
People need to understand dementia is an organic
condition and understand the nature of the
neurological damage
MUST link from the textbook facts to the inner
experience of the person with dementia
People get real ‘eureka’ moments from quite simple
bits of factual material
When the brain is taught in the right way it has a big
impact on the attitudes essential to the personcentred approach
Elizabeth Milwain - [email protected]
Dysexecutive behaviour:
 Purposeless
 Disinhibited
 Stereotyped, repetitive
 Inflexible
 Inefficient
 Distractible
 Loss of initiative (apathy)
 Self-centred
Elizabeth Milwain - [email protected]
Care providers provide better care if they:
 Understand the basic organisation of the human
brain and how dementia impacts on its functions;
 Understand what this means for the experience
and behaviour of people with dementia;
 Including how the brain damage is in constant
interaction with psychological and social factors
D = NI + H + B + P + SP
Not rigorous
Anecdotal from feedback of delegates
Small 6 month surveys suggest benefits
Those who have commissioned have
commissioned again
201: Understanding dementia
202: Person-centred approaches
205: Communication & relationships
207: Diversity, equality & inclusion
PERSON with dementia not person with
Do we need irrefutable research evidence
before we change our approach?
Martin Buber:
 I-it
 I-Thou
It is an undeniable fact, though hard to describe in intelligible
terms, that there are some people who reveal themselves as
present.....when we are in pain or in need....while there are
other people who do not give us this feeling, however great
is their goodwill.
The truth is....the material gift, the visible action, do not
necessarily witness to presence....Presence is something
that reveals itself immediately and unmistakeably in a look, a
smile, an intonation or a handshake.
Take every I-thou opportunity
What we do is important, but how we do it is just
as important
It does not cost extra time or extra money
‘Every little helps’
Will add up into a big difference in how people
feel about living with dementia
If you would like to know more, please get in touch
Dr Elizabeth Milwain
• 22 Bankfield Drive
• Shipley
• West Yorkshire BD18 4ADth
• [email protected]
• 01274 583364 (home)
• 07766 220725 (mobile)

Elizabeth Milwain Brain power in dementia care education