Understanding the Enriched Model of Dementia and the Role of Improvisation in Person-Centred Care.

D = EXPERIENCE OF DEMENTIA NI = NEUROLOGICAL IMPAIRMENT H = HEALTH B = BIOGRAPHY P = PERSO

The Enriched Model of Dementia, developed by Professor Tom Kitwood in 1997, marked a significant shift in the approach to dementia care.

Rather than focusing solely on neurological decline, Kitwood’s model placed emphasis on the holistic experience of the person living with dementia.

At its core, the model highlights the concept of personhood, recognising that individuals with dementia retain their identity, value, and need for meaningful connection, regardless of their cognitive impairment.

Kitwood identified five key factors that collectively influence how well a person lives with dementia:

Neurological Impairment – the physiological effects of dementia on the brain and cognitive function.

Physical Health – overall physical wellbeing, including comorbidities and physical limitations.

Biography – the individual's life history, including significant experiences, relationships, and cultural background.

Personality – enduring traits and characteristics that shape the individual’s responses and preferences.

Social Psychology – the quality of interpersonal relationships and social interactions.

While much attention has been given to medical and neurological factors, the importance of social psychology is often underestimated in care settings.

Social psychology refers to the environment of emotional support, respect, and validation created by those surrounding the person.

Kitwood asserted that the way caregivers interact with individuals living with dementia can either support or undermine their psychological wellbeing.

Tragically, many individuals with dementia continue to face stigma, marginalisation, and a lack of meaningful engagement. Their thoughts and feelings are frequently overlooked, leading to increased distress, confusion, and a diminished sense of self.

Applied improvisation offers a creative and compassionate approach to enhancing social psychology in dementia care. Rooted in principles of active listening, spontaneity, empathy, and non-verbal communication, improvisation helps caregivers remain present and responsive in their interactions. It promotes a culture of validation where the lived experience of the person is acknowledged and respected.

By integrating improvisational techniques into daily care practices, caregivers can foster more adaptable, person-centred relationships. This not only supports the emotional wellbeing of the person living with dementia, but also enhances the caregiver’s ability to navigate unpredictable or challenging moments with confidence and compassion.

The Enriched Model of Dementia reminds us that quality dementia care is not just about managing symptoms, it is about preserving dignity and nurturing meaningful human connection. Through understanding the full range of influencing factors, and embracing creative approaches such as improvisation, we can deliver care that is both clinically informed and deeply meaningful.