Specialised Early Care for Alzheimer's (SPECAL)

Background

SPECAL is a charity based in Oxfordshire that offers its own approach to the care of people with dementia. It provides a range of courses, services and advice for carers and family members. The theory and practice that it applies has been described in a book called Contented Dementia by Oliver James.

Alzheimer's Society's view of SPECAL

The Society has serious misgivings about the SPECAL approach because it takes away choice and control from people with dementia, its ethos is counter to the Mental Capacity Act and it claims to offer the only alternative approach to caring when in fact it is one of a number of approaches.

The SPECAL approach has some elements that do reflect best practice in personalised care. However, much of the SPECAL approach is deeply concerning to us because in our view it is contrary to the principles of the Mental Capacity Act and the best practice established by leaders in the field of dementia care. SPECAL in particular supports the view that it is acceptable in many instances to lie to people with dementia and to move away from offering them an effective range of choices.

Alzheimer's Society does not agree that avoiding asking questions is always appropriate. It's important to give people with dementia choice and control over their lives whenever possible. Good care should always focus on the wishes of the person with dementia and give them an opportunity to express their wishes. People should be supported and empowered to live in accordance with these wishes.

One of the reasons why SPECAL has been criticised heavily in the dementia care field is because it suggests a blanket approach to deception of people with dementia.

It is for these reasons that the Society will not publicly support efforts to spread the use of SPECAL. We believe that it is fundamentally damaging to the interests of people with dementia and carers.

The weakness of SPECAL is as yet there is only anecdotal evidence to show that it works. A fresh, independent scientific evaluation of SPECAL is essential prior to any further implementation.

Last updated: September 2009 by Clive Evers