The rapidly expanding aging population presents an urgent global challenge cutting through just about every dimension of worldly life, including the social, political, cultural, and economic. Developing innovations in health and assistive technology (AT) are poised to support effective and sustainable health care in the face of this challenge, yet there is scant (but growing) discussion of the ethical issues surrounding AT for older persons with dementia. Demands for ethical frameworks that can respond to frontline dilemmas regarding AT development and (...) provision, and how the needs of aging persons themselves are defined throughout this development process, are increasing. This article suggests that fulfilling the promises of AT to provide effective and ethically informed solutions may demand shifting away from standard bioethical analyses that centralize the principle of respect for autonomy. An autonomy-centric paradigm is dubiously equipped to theorize the foundational ethical issues in dementia care and to effectively guide AT development and implementation. An agency-centered approach to dementia care, which could engage more adaptively with the perspectives and choices of older persons themselves while offering strong support to AT research and stakeholders, may offer an attractive alternative. (shrink)

Attempts to investigate and describe the distinctive spirituality of people with dementia suffer from a serious methodological difficulty in that, by the stage that dementia becomes the determining existential reality, communication is likely to be difficult or impossible. In this paper, the author uses a three stage process to elucidate this problem, its implications and constructive possibilities. First, a critical literature review is undertaken to evaluate the present state of research and explore its assumptions and methodologies. This is followed by (...) a concept analysis to identify possible suggestions in the speculative literature. Finally, each of these solutions is examined in turn for its implications for the definitions and of and discourse on spirituality in dementia care. (shrink)

Recent developments in the theory and practice of care for persons with dementia have reopened questions, traditionally explored by theologians, to do with the nature of personal identity and its dialectical relationship to social recognition. This new perspective on classical theological questions serves as a potential theological resource in contemporary western society, where God appears to have withdrawn from the prevailing public discourses. In this article, I explore the analogical potential of imagery of a ‘dementing God’, as a way to (...) describe the contemporary experience of western Christians, to develop appropriate responses to the current climate in public theology and to continue to talk of God in public, while respecting Bonhoeffer’s desire to celebrate a secular world in which humanity may ‘come of age’. (shrink)

Der Artikel untersucht den Zusammenhang zwischen Erinnerung, Vergessen und personaler Identität und wendet die Ergebnisse auf den Fall der Alzheimer-Demenz an. Während in der philosophischen Debatte Gedächtnis und Erinnerung zumeist im Kontext von Theorien zur diachronen Identität als formale Kriterien für die Zuschreibung von Identität über die Zeit aufgefasst werden, steht hier das Konzept der biographischen Identität im Zentrum. Es wird argumentiert, dass sowohl explizite als auch implizite Erinnerungen und das Wechselspiel zwischen beiden auf unterschiedliche Weise an der Konstituierung und (...) Aufrechterhaltung biographischer Identität beteiligt sind, und dass die Einbeziehung der empirischen Gedächtnisforschung für die philosophische Analyse von großem Wert sein kann. Auf dieser Grundlage kann für den Fall der Alzheimer-Demenz gezeigt werden, welche Elemente biographischer Identität durch die Erkrankung berührt werden. (shrink)