The effects of care facility environments on personhood in dementia at the end of life

This qualitative study explored the role of two care facility environments on personhood at the end of life for residents living with advanced dementia. This study was grounded in the literature on end of life care and dementia, discourses on personhood and the concept of creating a therapeutic environment for those with dementia. Data were generated through ethnographic observations of twelve residents with advanced dementia, interviews with thirteen of their formal carers and a secondary data/archival analysis of relevant organizational policies. Data analysis revealed that the immediate resident-carer encounter (doing-to and being-with) significantly affected personhood at the end of life. In addition, carers’ understanding of personhood, end of life and person-centred care contributed to the challenge in the practical application of these concepts to caring for persons with advanced dementia. Further, elements within the work environment context itself also affected personhood at the end of life.