ABSTRACT
A s discussed in chapter 1, the philosophy of dementia management has evolved substantially over the past few decades. Prior to the late 1990s, the therapeutic potential of persons with dementia had been rather pessimistic due to the degenerative nature of dementia. Clinicians provided supportive services only to the families of persons diagnosed with dementia because there were no known effective interventions for reversing the inevitable decline in cognitive and behavioral symptoms. Two of the driving forces for the changes in philosophical approaches to the management of dementia include the World Health Organization’s (WHO) development of the International Classifi cation of Impairment, Disability, and Handicap (ICIDH; WHO, 1980), now the International Classifi cation of Functioning, Disability, and Health (WHO, 2001) and the Omnibus Budget and Reconciliation Act of 1987 (OBRA; American Health Care Association, 1990). These infl uences sparked a new attitude toward working with persons with dementia, with an increased focus on maintaining independent functioning for as long as possible and enhancing the quality of life of persons with dementia as well as their caregivers.
