Person-Centred Care vs Person-Led Care — Why the Difference Matters More Than Ever
In dementia care, language shapes practice long before policy does. When terms become interchangeable, expectations blur — and the people most affected by that confusion are often those least able to challenge it.
Over recent years, person-centred care has rightly become a foundation of quality care. Understanding someone’s history, preferences, emotional world and sources of comfort has transformed how many services support people living with dementia. At its best, person-centred care restores dignity, psychological safety and continuity of identity.
But a newer phrase is now entering the conversation: person-led care — and this is where clarity matters.
These terms are often spoken about as if they describe the same thing.
They don’t.
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 in a meaningful way, carers need:
- time not only to respond — but to wait
- flexibility in routine and tolerance of risk
- organisational permission to let the moment be led by the person rather than by timetables, staffing ratios or task lists
In environments where one Dementia Care Specialist supports many people at once, this distinction becomes critical.
A person’s story may be beautifully documented. Their preferences may be respected. Their environment may be thoughtfully adapted.
And yet their day-to-day experience may still be shaped — quite reasonably — 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 model of care, do we intentionally return autonomy to the person — and allow them to lead the moment of care?
It also asks organisations to look inward.
If carers are expected to practise person-led care:
- do they have the time and staffing to recognise what the moment is asking for?
- do they have the training and reflective space to interpret behaviour safely and compassionately?
- do they have permission to prioritise the person’s lived experience when it conflicts with operational rhythm?
Because when language moves faster than infrastructure, carers are left carrying ideals they cannot realistically operationalise — and families are promised experiences that systems struggle to deliver.
Person-centred care remains essential.
But person-led care cannot simply be layered on top of it through reframed wording or aspirational language.
If we are serious about people leading aspects of their care, we must be prepared to rethink:
- how care is organised
- how it is resourced
- how roles are supported
- and how practice is evaluated
Otherwise, “person-led” risks becoming the next well-intended phrase — admired, repeated, and gradually absorbed back 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.