Introduction

Understanding of dementia has evolved considerably over the past few decades, from considering serious cognitive impairment as an expectable part of the ageing process, to recognising dementia as a biomedical phenomenon, and then towards the importance of seeing beyond the bio-physiological issues to the person behind the label. It is time for the emergence of a fourth moment: centring dementia experiences, as shaped and constrained by broader sociopolitical systems, discourses and life events.

The aim of this book has been to broaden the dementia debate by outlining an approach that can take understanding and practice into this fourth moment. It has considered the situation of people with dementia from an explicitly sociopolitical perspective and identified and discussed issues beyond health and social care. Discussion has highlighted the narrowness of the current agenda in the dementia field and aimed to raise the stakes in terms of thinking about the status, experiences, responsibilities and entitlements of men and women with dementia. It has sought to reposition people as active citizens, as opposed to only welfare recipients, and to show the contribution people with dementia can and do make to everyday life. Simultaneously, it has argued the need to revise understanding of social citizenship in order to account for neuro-cognitive changes that may interfere with conventional participation and involvement.

We acknowledge that there are undoubtedly limitations and deficiencies in our thinking and that some of the ideas explored in this book are in their infancy, and arguably quite radical for this field. In particular, we accept that in certain circumstances ideas about social citizenship might jar with other key debates in the field, including, for example, those around safeguarding vulnerable adults and balancing the rights of people with dementia with the rights of others. Enabling the social citizenship of people with dementia is a complex area and this book is recognised as only a start to the discussion. We have tentatively aimed to open up debate about people with dementia in order to explicitly consider another aspect of people's situation.

In this conclusion we will draw together the dominant themes that underpin this book and highlight some of the key messages that the field might take forward.