Dementie en het levensverhaal: de balans tussen verleden en heden

This paper discusses the role of the life-story or narrative in the care for demented elderly. A dilemma in dementia care is whether caregivers should follow the former wishes or values of a patient, or should attend to his present wishes and needs. This dilemma is encountered both in case of advance directives concerning life-and-death decisions, and in everyday care. According to a narrative view, respect for persons requires caregivers to try to 'continue' the patient's life-story after the patient has lost the ability to do so himself. Though this view encounters a few problems, it is argued that careful interpretation of a patient's life story can indeed help to direct and guide care. However, when this leads to actual suffering or pain for the demented patient, former wishes or values as they are derived from the life-story, or even as laid down in an advance directive, should not prevail.