The argument of this chapter is as follows. Senile dementia has been constructed by a cluster of discourses, of which the dominant one is grounded in medical science. This discourse, however, is far less coherent than it is commonly taken to be. Our understanding of dementia and dementia care can be reconstructed in relation to a discourse which gives central place to personhood and interpersonal relations. The creation of such a discourse challenges both material interests and psychological defences.