Humans: an integrative review exploring dehumanisation in advanced dementia

Bøgmose, Jesper; Olivares Bøgeskov, Benjamin Miguel; Dening, Tom; Martinsen, Bente

Abstract

Background: People living with advanced dementia risk being seen as someone without personhood in contemporary societies, an understanding that has been described and challenged for decades in dementia scholarly literature. Such perception can be characterised as forms of existential dehumanisation, which still asserts itself in dementia care practices, adversely affecting the ethical and caring aspects of such care. Aim: To challenge dehumanisation in dementia care, we must first learn to recognise what foster it in caring relations. Thus, the aim of our study is to identify existing perceptions of care recipients living with advanced dementia, which elicit dehumanising attitudes among formal caregivers. Research design: We conducted an integrative review based on Whittemore and Knafl’s updated methodology. This allowed us to identify and analyse 26 articles incorporating both qualitative- and quantitative studies as well as theoretical- and grey literature all describing perceptions of care recipients living with dementia that lead to dehumanisation. Ethical considerations: Studying the darker sides in caring relations was to be beneficial in improving dementia care practices. Findings: Through an analytical process five themes that can sprout dehumanising attitudes in caring relations were identified, which include perceiving people living with advanced dementia as (1) absurd, (2) shadow, (3) perilous, (4) void, or (5) repugnant. We argue that these perceptions can be seen as unintentional and stem from a misled embodied perception, which caregivers should learn to recognise and consequently be able to resist through virtue ethics. Conclusion: Our study indicates that challenging dehumanisation is a practical matter of identifying and reacting in a timely way to ones misled embodied perceptions. We suggest the five themes offer a potential means to warn formal caregivers of impending dehumanising attitudes and help them to review how they ethically are thinking and perceiving the person living with advanced dementia.

Citation

Bøgmose, J., Olivares Bøgeskov, B. M., Dening, T., & Martinsen, B. (2024). Humans: an integrative review exploring dehumanisation in advanced dementia. Nursing Ethics, https://doi.org/10.1177/09697330241277989

• Journal Article Type: Article
• Acceptance Date: Aug 7, 2024
• Online Publication Date: Oct 24, 2024
• Publication Date: Oct 24, 2024
• Deposit Date: Oct 27, 2024
• Publicly Available Date: Oct 29, 2024
• Journal: Nursing Ethics
• Print ISSN: 0969-7330
• Electronic ISSN: 1477-0989
• Publisher: SAGE Publications
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1177/09697330241277989
• Keywords: Advanced dementia; dehumanisation; existential approach; formal caregivers; personhood; virtue ethics
• Public URL: https://nottingham-repository.worktribe.com/output/40984996
• Publisher URL: https://journals.sagepub.com/doi/10.1177/09697330241277989