In search of 'the good life' for demented elderly.

Abstract

It may seem paradoxical to speak of the 'good life' for demented elderly. Many people consider dementia to be a life-wrecking disease and nursing homes to be terrible places. Still, it is relevant to ask how we can make life as good as possible for demented nursing home residents. This paper explores what three standard philosophical accounts of well-being--subjective preference theory, objectivist theories, and hedonism--have to say about the good life for demented people. It is concluded that the relevant differences between the various philosophical theories manifest themselves not so much in their general account of the substantial content of 'the good life' but in a number of specific controversies. These concern the nature of well-being, the necessity of endorsement by the patient, the value of experience and the need for experiences to be rooted in reality. Moreover, it is argued that further research should pay detailed attention to the process of dementia and to the effects of this process on patients' identities, self-conceptions, capacities, preferences, values and the like, and that a narrative approach which incorporates the factor time may offer a more comprehensive account of the good life for demented elderly.