Psychological dimensions of dementia

This report, from the British Psychological Society's Dementia Advisory Group, presents a psychological perspective on the nature and experience of dementia and outlines the extensive contribution that psychologists make in this field. It highlights a number of areas where action is needed to improve understanding and care and makes recommendations for commissioning services. The document reflects universally applicable principles of good psychological practice, while recognising that there are differences between the four UK nations in policy and strategy emphasis, and in service delivery.

The term 'dementia' describes a group of conditions which lead to progressive changes in the structure and function of the brain. These changes in turn alter how people think and behave and their ability to manage everyday life. Dementia therefore has a profound psychological impact on the people who experience it and on their families. As every individual is different, the impact is different for each person. 

Psychological research has made, and will continue to make, a significant contribution to our understanding, diagnosis and treatment of dementia. In addition, it can contribute to the development of programmes aimed at reducing the risk of developing dementia. Psychologists are instrumental in the developing focus on asserting and upholding the human rights of people with dementia and ensuring their active and meaningful involvement in decisions about their own lives and in planning and evaluating the services they receive. Focusing on the person rather than the disease leads to an emphasis on what helps people to live well with dementia.

This report presents a psychological perspective on the nature and experience of dementia and outlines the extensive contribution that psychologists make in this field. It highlights a number of areas where action is needed to improve understanding and care, and makes recommendations for commissioning services. The document reflects universally applicable principles of good psychological practice, while recognising that there are differences between the four UK nations in policy and strategy emphasis, and in service delivery.

The best way to diagnose, treat and support people with dementia is through multi-disciplinary teams that include psychological support alongside doctors, nurses and therapists. In many places services do not meet this standard. There is an urgent need to address the gap in provision, and make sure people with dementia and carers receive appropriate psychological support alongside other treatment. Psychologists also contribute to the training of health and social care staff who support people living with dementia and their family carers. Access to psychological understanding and expertise is essential for those living with dementia and for their families and carers at every stage, from diagnosis to end of life care.

Psychologists are well-placed to ensure an emphasis on an individual, person-centred approach in each case as well as being uniquely qualified to carry out specialist assessments and interventions. Psychological interventions play a key role in improving the wellbeing of people with dementia and their family and carers. Improving people's experience of dementia means improving the support they get to process how they feel, and how they understand and think about the condition, their future and their relationships. Maintaining a sense of control, identity and connection is a key focus as dementia progresses. Without it, there is a risk that the person will experience a sense of isolation and dislocation at a time when the resources to protect against this threat are lacking.

Enhancing the contribution of psychological expertise and skills could have wide reaching benefits, including fewer people with dementia, more timely diagnoses, reduction in the need for medication, reduction in psychological distress and behavioural difficulties, reduction or delay in admissions to residential care, increased staff knowledge and expertise, increased carer wellbeing and improvement in quality of life for people living with dementia.

Download our discussion paper on the Psychological Dimensions of Dementia