A Report From the National Academies of Sciences, Engineering, and Medicine
JAMA. 2021;325(18):1831-1832. doi:10.1001/jama.2021.4928
Millions of people are living with dementia throughout the US and around the world. Dementia care has improved since the 1970s, with significant declines in previously common, yet harmful, practices such as mechanical restraining devices, forced feeding techniques, and overuse of antipsychotic medications. These harm-reducing advances are not sufficient, however. Many people still lack access to high-quality care and are not living as well as they might. Racial and ethnic minorities and other disadvantaged groups continue to experience deep and persistent inequities, such as lower-quality care in nursing homes and greater use of feeding tubes.1,2 The COVID-19 pandemic has further exacerbated the social isolation, risk of abuse of older persons, and other challenges encountered by many persons living with dementia and their care partners and caregivers.3 To move forward, dementia care needs to build on previous advances in harm reduction by also incorporating more focus on promoting well-being, respecting personhood, and supporting people’s preferences, strengths, and abilities. Such an approach reframes aging to late life as a reward rather than something to dread.
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