title: How Dementia Affects Personal Dignity: A Qualitative Study on the Perspective of Individuals With Mild to Moderate Dementia.
abstract: OBJECTIVE
  This article examines how dementia affects personal dignity in individuals with mild to moderate dementia from their perspective.
  
  
  METHODS
  In this qualitative cross-sectional study, in-depth interviews were carried out with 14 individuals, aged 50-94, with mild to moderate dementia who lived at home. Verbatim transcripts were analyzed making use of the principles of thematic analysis.
  
  
  RESULTS
  Although mild to moderate dementia resulted in a diminished sense of personal dignity, in general participants still felt reasonably dignified. The decline in personal dignity was generally caused by cognitive impairments resulting in diminished autonomy and changes to the individual's former identity. However, the intensity with which the decline in personal dignity was experienced depended to a large degree on the social context of the individual, with a marked difference between the private sphere of the home and the external, social environment. The study gives recommendations how others can help to sustain personal dignity in people with mild to moderate dementia.
  
  
  CONCLUSIONS
  Given the considerable impact the social environment has on the personal dignity of people with mild to moderate dementia, it is important in caregiving not to confine attention to health-related or even any individual aspects alone, but also to take interpersonal aspects into consideration.
authors.affiliation: Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. eol@vumc.nl.
authors.forename: Isis E
authors.initials: IE
authors.lastname: van Gennip
authors.affiliation: Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: H Roeline W
authors.initials: HR
authors.lastname: Pasman
authors.affiliation: Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Mariska G
authors.initials: MG
authors.lastname: Oosterveld-Vlug
authors.affiliation: Department of General Practice, Section of Medical Ethics, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Dick L
authors.initials: DL
authors.lastname: Willems
authors.affiliation: Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Bregje D
authors.initials: BD
authors.lastname: Onwuteaka-Philipsen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000523:psychology*; D001294:Attitude to Health; D003072:Cognition Disorders / Q000523:psychology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D028723:Personhood; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology; D012649:Self Concept; D012931:Social Environment; D055815:Young Adult
keywords: Mild to moderate dementia; Person centered care; Personal dignity; Qualitative research