In dementia care, language shapes practice long before policy does. When terms become interchangeable, expectations blur — and the people carrying the weight of that confusion are often those least able to challenge it.
Over recent years, person-centred care has rightly become a cornerstone of quality care. Understanding someone’s life story, preferences, routines, and sources of comfort has transformed how many services support people living with dementia. At its best, person-centred care restores dignity, emotional safety, and continuity of identity.
But a newer phrase is now entering the conversation: person-led care. And this is where clarity matters.
Person-centred care and person-led care are not the same thing — and treating them as though they are risks diluting both.
Person-centred care shapes support around the person over time.
Person-led care requires the person to actively lead the moment in which care takes place.
That difference is not philosophical. It is practical, structural, and demanding.
To practise person-led care meaningfully, carers need time — not just to respond, but to wait. They need flexibility — not just in routines, but in risk tolerance. And they need organisational systems that allow moment-to-moment decision-making to sit with the person, rather than defaulting to timetables, staffing ratios, or task lists.
In environments where one Dementia Care facility is supporting many people at once, this distinction becomes critical. A person’s history can be beautifully documented, their preferences respected, and their environment thoughtfully adapted — yet their day-to-day experience may still be largely directed by operational necessity. That is not a failure of care; it is the reality of systems designed for scale.
Calling this person-led care does not make it so.
True person-led care asks a harder question:
Where, within our care model, do we intentionally give autonomy back to the person to lead the moment of care?
It also asks organisations to look inward. If carers are expected to practise person-led care, are they being given the time, staffing, training, and permission to recognise what that moment is asking for — and to respond to it appropriately? Or are we placing aspirational language onto systems that cannot realistically sustain it?
There is a risk here — not of poor care, but of misplaced expectations. When language moves faster than infrastructure, carers are left carrying ideals they cannot operationalise, and families are promised experiences that systems struggle to deliver.
Person-centred care remains essential. Person-led care, however, cannot be layered on top of it without structural change. If we want people living with dementia to genuinely lead aspects of their care, we must be prepared to rethink how care is organised, resourced, trained for, and evaluated.
Otherwise, person-led risks becoming the next well-intended phrase — admired, repeated, and quietly absorbed into the same constraints it was meant to challenge.
This article forms part of a wider evidence-informed position on language, autonomy, and person-led dementia care.
A formal position paper by LAUNEX LTD, drawing on lived experience, rights-based frameworks, and current research.