Norman, Ian

Background and rationale SPECAL is a model of care for people with dementia based on a novel conceptualisation of memory and how this changes in dementia. Carers adapt their communication style to prevent distress and promote well‐being for the person with dementia. However, there is limited scientific evidence on the effectiveness of SPECAL. Aim This study explored mechanisms of SPECAL through a qualitative enquiry with family carers.

SPECAL is a person-centred approach to the care of people with dementia which could also have the potential to reduce carer stress and lead to improvements in quality of life for people with dementia and their carers. The approach prioritises meaning over detail. It has 'three golden rules' for the care: do not ask direct questions, learn from the expert by listening and discovering what is important to the person with dementia, and do not contradict. This article describes the origins and rationale of SPECAL.

This article presents findings from a research study that examined, by observation and interview, the nature of care as a form of social organization in the homes of people with dementia whose care was at least partly provided by relatives or friends. Twenty situations were included in which the carers and people with dementia were interviewed. Each participating pair was observed for an average of nine hours. Change was perceived, on the whole, in negative terms for both caregiver and the person with dementia.