Dementia is conventionally defined in terms of neurological changes in the brain and an inevitable and progressive decline in the individual's cognitive powers and functional ability. However, this 'biomedical' model fails to recognize other important factors within the dementing process, such as the social and care context within which the dementing person lives. It is argued that appropriate care interventions can have a considerable impact on the progress of dementia. Data from an evaluation of three experimental homes for the elderly mentally ill show that some degree of 'rementia', the regaining of lost cognitive and functional abilities, is possible for some individuals. This evidence is used to argue for a more positive approach to dementia care. KEY woms-Dementia, rementia, residential care, social models.
The increasing numbers of older people within world populations and the economic and service implications of a related increase in the numbers of cases of dementia has been the focus of considerable attention among policy-makers and researchers (Ineichen, 1987;Keen, 1993;Schneider et al., 1993). Faced with a 'rising tide' (HAS, 1982) of dementia sufferers, it is perhaps understandable that the policy debate has been mainly concerned with issues of service levels and cost implications.
Beyond this question of 'how much?', relatively little attention has been given to the question of 'what kind' of care should be provided for dementia sufferers. Surveys of standards of residential care have painted a fairly depressing picture (Ames, 1990;Booth, 1985; Counsel and Care, 1991). While instances of abuse and neglect may be the exception rather than the norm, the quality of life of residents