Preserving Intimacy in Dementia Care. An ethical and technological approach towards an Ecology of Memory
(2025) Congrès biannuel de la Society for Philosophy of Technology — Location: Eindhoven (25.June.2026)
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- (en) Major neurocognitive disorders, commonly referred to as “dementia”, can be seen as a profound disruption of intimacy and its foundations – that is, as a destabilization of the relationship to oneself, others, and the surrounding environment. Indeed, dementia encompasses progressive, degenerative, and chronic conditions characterized by memory impairment and cognitive dysfunctions. These disorders progressively affect the individual's ability to perform daily activities, engage in social interactions, and maintain functional independence. Symptoms are frequently understood as a state of incapacity, which may also diminish the ability to form or maintain intimacy. Some authors conclude that it leads to a “loss of self” (Cohen and Eisdorfer, 2001) or “loss of personhood” (Sweeting and Gilhooly, 1997). This article aims to investigate how ethical practices, facilitated by technology, can help preserve intimacy and help mitigate the neuropsychological impairments associated with dementia. We argue that while dementia compromises an individual’s autonomy, it does not eliminate it. Rather, the preservation of autonomy requires external support from caregivers and the environment. We reviewed the existing literature to address the following research question: What types of care should be prioritized to empower individuals with dementia and optimize their functional capacity? To this end, we begin by examining the dominant paradigm that shapes dementia care. We characterize it as deficit-oriented due to its focus on incapacities. We then present an alternative paradigm that emphasizes what remains and persists in patients (Kitwood, 1997; Sabat, 2019), framing it as a possibility for empowerment. From this, we outline two primary ethical frameworks that underpin the paradigmatic models discussed—those centered on autonomy and vulnerability (Pelluchon, 2009)—arguing that both are still influenced by an incapacitating assumption. In response, we propose that a truly emancipatory approach should be grounded in a perspective informed by narrative ethics, which supports the subjectivity of the patient, conceptualized as an “ecology of memory”. To achieve this, we emphasize the integration of technological tools that assist in self-expression and memory preservation, even when cognitive impairments limit a person's ability to narrate their own story. These technologies, acting as memory prosthetics, such as digital memory aids (Hodges et al., 2006), “evocative objects” (Heersmink, 2022), and wearable devices (Buse and Twigg, 2014), alongside other emerging innovations, assist patients in recalling personal experiences and reconnecting with their identity. By incorporating such technologies, we can cultivate environments that support self-continuity, fostering intimacy and autonomy while maintaining a holistic approach to dementia care.
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Degreef, N. (2025, June 26). Preserving Intimacy in Dementia Care. An ethical and technological approach towards an Ecology of Memory. Congrès biannuel de la Society for Philosophy of Technology, Eindhoven. https://hdl.handle.net/2078.5/279337