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Human capabilities in advanced dementia: Nussbaum's approach
Catharina Melander1, Stefan Sävenstedt1, Britt-Marie Wälivaara1
1Division of Nursing, Department of Health Sciences, Luleå University of Technology, Luleå, Sweden.
International Journal of Older People Nursing
|October 10, 2017
Summary
Applying Martha Nussbaum's capability approach to advanced dementia care enhances dignity by focusing on practical reasoning and affiliation. Nursing staff support is crucial for enabling these human capabilities and ensuring a dignified life.
Area of Science:
- Gerontology
- Bioethics
- Philosophy of Care
Background:
- Supporting individuals with advanced dementia who exhibit challenging behaviors presents difficulties in meeting their needs and ensuring a dignified existence.
- Problematic behaviors in advanced dementia can stem from unmet needs and hinder the pursuit of a dignified life.
Purpose of the Study:
- To investigate the applicability of Martha Nussbaum's human capabilities approach to promoting dignity for individuals with advanced dementia residing in nursing homes.
- To identify how the capability approach can inform care practices for advanced dementia patients experiencing behavioral challenges.
Main Methods:
- An ethnographic methodology incorporating participatory observation was employed.
- Martha Nussbaum's capability approach served as the analytical framework.
- Data were collected from four women with advanced dementia and problematic behaviors in a Swedish nursing home during 2015.
Main Results:
- Individuals with advanced dementia struggled with life planning and the human capability of practical reasoning.
- Social exclusion risked hindering the human capability of affiliation for these individuals.
- Dignified living for advanced dementia patients necessitates nursing staff presence and tailored support to facilitate human capabilities.
Conclusions:
- Fostering opportunities for practical reasoning and affiliation is paramount, as these capabilities underpin all others.
- Care must extend beyond basic needs to encompass other capabilities vital for a dignified life, guided by Nussbaum's capability approach.
- Attending to expressions and needs, and guiding individuals towards dignity, are essential components of care for advanced dementia patients.
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