Reciprocity and caregiver competencies.

Despite the impact of dementia, people’s needs to connect with others and their environment remains. With progression of a dementia disease, a person will gradually be more dependent on assistance and care. In this study, we aimed to conceptualise our understanding of person-centred dementia care, theoretically based on Tom Kitwood’s ontology of personhood. A hermeneutic constructivist approach with four explorative phases allowed for a metaphorical way of working with implicit knowledge related to professional caregiving. We used Lego Serious Play™ for data collection and as a method for exploring, articulating, and conceptualising how we understood caregiver interactions. Based on our analysis, we developed a co-created, condensed model suggesting an ideographic understanding of person-attuned interactions in caregiving, emphasizing knowledge about personhood and reciprocity. We unfolded how professional caregivers represent an essential value in dementia care by providing a feeling of safety through person-attuned interactions, introspection and mentalisation. We found that caregiver competencies depend on resources, culture, and interdisciplinary collaboration, which puts a strong demand on continuous training and supervision and for political and societal priorities.