| Summary: | Dementia is a terminal brain disease which can be thought of as progressing through three stages: early, middle and late. Past research asserted that as dementia progressed, people lost the capacity for awareness of themselves, others and their situation. However, emerging research has suggested that individuals can retain some capacity for awareness until the end of the disease process (Clare, 2010). Clare (2010) postulated that awareness operates hierarchically at increasing levels of complexity. She proposed a framework from which awareness can be understood and researched and identifies the biopsychosocial factors that influence its expression (Clare, 2004). There is a lack of research investigating awareness as perceived by staff carers in specialist Elderly Mentally Infirm settings. Therefore, this current study utilises Clare’s (2010) framework to investigate staff perceptions of awareness in the moderate to late stages of dementia, using a Grounded Theory methodology. Understanding staff perspectives is important as responding appropriately to the needs of individuals with dementia is central to promoting quality care. This study found that some staff members in specialist EMI settings, who provide direct care for people in the moderate to late stages of dementia, perceive residents to be unaware of themselves, others or their context. These findings are discussed in relation to current literature and the implications for clinical practice and staff training are outlined. A methodological critique acknowledges limitations of awareness research and of the current study and it is concluded that further research on awareness is vital for improving person-centred care in dementia.
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