Abstract
Evidence is presented concerning positive changes observed over the long term in 49 persons with dementia, the majority in the age range 77-90 years. While some changes may pertain to the restoration of previous personality patterns, others seem to be a genuine form of 'personal growth', related to a release from many years of over-adaptation. Suggestions are offered concerning the conditions that are necessary for such personal growth to occur, with an emphasis on the psychodynamics of the care process.