People with dementia-related illnesses and limitations now make up a large proportion of residents in nursing homes. That is why special and specific care and support concepts are important for this care group. We work according to such a concept at the GFO care center in Königswinter.

For people with advanced dementia, active engagement with the life phase of old age - as in the case of activating care - is not possible. A dementia disease is comparable to a permanent, never-ending experience of crisis. Living with dementia means living in uncertainty and often in fear. To perceive oneself as a person is hardly possible anymore without help. These people need orientation in the "here and now". They therefore live in small residential communities within our care center.

The care and support of residents suffering from dementia is based on the ethical and anthropological approach postulated by Tom Kitwood in the mid-80s (Dementia, The Person-Centered Approach in Dealing with Confused People, 2008). Tom Kitwood considers neurological impairments, health condition and physical capacity, life history, personality, and social psychology as potentially influencing the way a person with dementia acts, feels, and thinks.

According to Kitwood, the care of elderly people suffering from dementia is essentially about experiencing oneself as a person and not as an object, despite the drastic changes. Every person, no matter how severely demented, possesses an absolute value in themselves that requires us to treat each other with deep respect, with dignity. The core idea is that the relationship with the caregiver is the most important "medicine" for people with dementia. "Contact with dementia.... can and should lead us out of our usual patterns of excessive busyness, emphasis on the cognitive, and chattiness into a way of being in which emotion and feeling are given more space" (Kitwood, Dementia, p. 23).

Central components of this approach are basic human needs, the desire for identity, attachment, affirmation, inclusion, security. At the center of this are love and appreciation. Influenced by our Christian image of man, we try to give people with dementia what they need so that they can live well and feel comfortable in the facility. This attitude is expressed, among other things, in appreciative communication (integrative validation).

The care and activation services for people with dementia should therefore be oriented less to the cognitive limitations and more to the existing resources and abilities as well as the individual needs.

Personal hygiene takes place with guidance and is supported or taken over if necessary. Care planning according to daily structure is created and evaluated with the inclusion of all biographical knowledge and - if possible - with the involvement of relatives.

The familiar daily routine with its requirements provides the best orientation for people with dementia. The daily routine in the residential group is oriented as far as possible to the life history, habits and preferences of the individual combined with special promotion of memory functions through holistic memory training. By actively involving the residents in daily routines, memories are awakened and, as far as possible, their ability to orient themselves is preserved.

The care services thus consist in particular of the integration of the individual resident into the common daily activities through participation (e.g. in meal preparation, cooking, setting the table, washing up, dusting, folding the laundry, watering the flowers, sweeping), which are integrated into a fixed and meaningful daily structure. Living together in a residential community meets these requirements to a special degree.

The employees use the integrative validation according to Nicole Richards as an appreciative communication about life topics. Talking about life themes supports the personhood of the resident. This form of validation is the common thread that runs through the care of people with dementia.