Autonomy and its relevance for the construction of personhood in dementia- a thematic synthesis.

BACKGROUND: This article examines the concept of autonomy in the context of person-centred dementia research and care, which is frequently being used but not clearly defined. Also, there is no clear conceptual relation between autonomy and personhood in this context. METHODS: Therefore, literature on person-centred dementia research and care was examined to answer the following question: How is the concept of autonomy discussed in person-centred dementia research and care literature? RESULTS: This analysis revealed heterogeneous perspectives on autonomy within the context of dementia. These were assigned to two different perspectives on personhood: one that links personhood to the existing cognitive abilities and the other one, that understands personhood relationally as the result of a socially constructed process. These results are discussed with regard to a nursing and care practice that could be considered as being deficit-oriented, but also with regard to the concept of social health in dementia. CONCLUSIONS: Derived from this analysis, there is a clear need for general conceptual sensitivity in this field. Also, an in-depth examination of the social constructionist approach to personhood in the context of dementia is warranted.

Ambiguous personhood: Paradoxes of social belonging in Danish nursing home care.

In oldest old age (generally considered to be from 85 years onwards), personhood is often called into question, impacting well-being as a result. Based on ethnographic fieldwork, this article examines the well-being of oldest old nursing home residents at the intersections of ageism, fraying personhood and fragile social belonging in Danish nursing home care. In Denmark personhood hinges on both independence and social belonging; or "fællesskab." We examine how these concepts are practiced in nursing home care. Taking its starting point in the distinction between the "inside world" of the nursing home and the "real world" outside, the article examines how processes of othering occur in nursing home care, imperilling resident personhood and opportunities for social belonging. We consider how oldest old residents navigate social belonging, finding it in turn life-sustaining and vexatious. We argue that tacit ageism permeates the nursing home, to the detriment of resident well-being, despite the best intentions of an aged care system that is structured to specifically maintain personhood.

'Robbed out of mind': Reflections on Alzheimer's and gendered subjectivity in select Indian literary narratives.

Neurological degeneration is a potent signifier molding older lives, divesting them of 'personhood' and making them a 'target of care'. This article delineates the depictions of Alzheimer's and its associated losses in select Indian literary narratives- Jalsobi: In the Shadow of Light (2018) and Girl in White Cotton (2019) and seeks to understand how 'ageing into disability' for older women has severe implications that marginalize their embodied existence, foisting a symbolic death. Through the fictional accounts, the article explores two primary threads of consideration - how the 'selfhood' gets eroded/reclaimed while experiencing cognitive impairment and how the shift from the patient-centric to the person-centric approach alters the relational care dynamics in the Indian context. It also attempts to situate the conception and representation of age-induced cognitive loss within the framework of critical disability studies, which understates the reductionist biomedical perspective and fosters an alternative, inclusive, and empathetic understanding of dysfunctionality.

Lessons for Ethics From the Kingdom of Fungi.

This article considers lessons about American (individual-centered) anthropocentric (human-centered) thinking that can be applied to how we confer dignity and moral status to beings other than humans. Interestingly, global bioethics might glean such lessons from fungi.

Is Dignity Still Necessary in Health Care? From Definition to Recognition of Human Dignity.

The concept of dignity is not, as some scholars claim, an unnecessary moral idea, and nor need it have religious overtones or be characterised by speciesism. In this article, I try to show that dignity can be defined and recognised. The starting point for the argumentation is the four typologies of dignity, which show that the term 'dignity' can denote significantly different concepts, and that the different concepts of dignity can have significantly different ontological senses. A unified typology of dignity allows for five categories to be distinguished: inherent dignity, dignity based on changeable qualities, moral dignity, bestowed dignity and comportment dignity. I take the first two categories of dignity as the object of the analysis, with which I seek to formulate a philosophical response to the charge of speciesism and to show on what basis it can be maintained that all human beings possess dignity. To this end, I distinguish between existential dignity, actual dignity, and potential dignity. Distinguishing these types of dignity becomes possible in the light of Aquinas' and Aristotle's views. In the final section, I point to two ways of recognising dignity. The first is based on certain narratives and emotional states ('ecumenical model of dignity'), while the second is related to a specific moral experience developed within ethical personalism.