Dementia Care as a Moral Enterprise: A Call for a Return to the Sanctity of Lived Time

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Nursing home care continues to fall short of the vision of the 1987 Omnibus Reconciliation Act's to promote quality care, in spite of expenditures to develop finer assessments and regulations. This shortcoming is partly the legacy of a hospital model never designed to support long-term residents and of a cult of “task and time” that promotes instrumental care over intersubjective person care. This article calls for a return to the sanctity of unregulated time as lived and a blurring of the distinction between “life” and “care.” This shift will transform the concept of dementia care from a commoditizedindustry to a moral enterprise designed to support the person with dementia.

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