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Posted: 11th March 2014

"The precious string of pearls, of memories, that is our life, is breaking, the pearls are being lost. But by finding new pearls, those created in the struggle with dementia, we can put together a new necklace of life, of hope in our future." (Bryden, 2005)

PEARL is an accredited scheme for which residential homes can work towards, aiming to complete in 6 - 12 months. It is an approach based around Brooker's VIPS model to person-centred dementia care and was developed by Four Seasons Care Homes.


V = Values people – Values and promotes the rights of the person
I = Individual’s needs – Provides individualised care according to needs
P = Perspective of service user – Understands care from the perspective of the person with dementia
S = Supportive social psychology – Social environment enables the person to remain in relationship

Professor Dawn Brooker:



Four Seasons Care Homes have developed and implemented the PEARL scheme at 8 homes in the pilot scheme in 2007/8. Caroline Baker worked on the initial criteria for the 158 areas that the staff have to develop towards.

PDF on the statistical benefits of the approach:

"In the study involving 16 accredited homes (the first study involved eight homes), antipsychotic medication reduced on average by 48 per cent, with the highest reduction being 84 per cent in one home.

Wellbeing was improved amongst 46 per cent of residents, being defined against a set of criteria including resident interactions, ability to communicate needs and choices and a sense of purpose.

The use of anxiolytic medication to alleviate anxiety was reduced by 40 per cent and the depression score was reduced in 30 per cent of residents, with an attendant reduction in anti-depressant medication.

Other benefits highlighted by the study were reduced requirement for hypnotic medication, weight gain among resident and a 32 per cent reduction in falls, attributed to increased alertness.

It was significant that as the use of antipsychotic medication decreased, the use of analgesics increased, following assessment utilising the Abbey Pain Scale. This phenomenon suggests that pain is under-recognised (and under-treated) in dementia care."


More on PEARL:


Caroline Baker: - talk at the care show in Birmingham, Nov 2014

Further Reading

Dementia Villages