How PMEE works in practice
The PMEE Approach
The PMEE Approach is not a rigid protocol. It is a set of developing principles that guide how carers and care teams can create, recognise, observe and learn from experiences that are personally meaningful to people living with dementia.
01
Know the person
Meaningful experience begins with knowing who this person is — not just their care needs, but their history, their identity, their relationships, their roles, their values and what has mattered to them throughout their life.
This means going beyond the care plan. It means listening to family members, reading life history documents with genuine curiosity, and paying attention to the small things a person responds to — the music they hum along to, the photographs they return to, the topics that make them animated.
02
Recognise individuality
What is meaningful to one person will not be meaningful to another. PMEE resists the tendency to assume that a particular activity or approach will be meaningful simply because it is popular or because it worked for someone else.
This requires carers to hold each person's individuality at the centre of their thinking — to ask not 'is this a good activity?' but 'is this likely to be meaningful to this person, given what I know about them?'
03
Observe responses
People living with dementia may not always be able to express their experience in words. Observation becomes essential — noticing changes in posture, facial expression, eye contact, vocalisation, movement and engagement.
PMEE encourages carers to develop their observational skills — to notice not just whether a person participated, but how they appeared to experience the moment. Was there a change in their expression? Did they lean in or pull back? Did they become more animated or more withdrawn?
04
Support choice and agency
Meaningful experience is more likely when a person has some sense of agency — some ability to choose, to direct, to contribute. PMEE looks for ways to support choice even when cognitive capacity is limited.
This may be as simple as offering two options rather than one, following the person's lead in a conversation, or noticing when someone moves towards or away from an activity and responding to that movement as a form of communication.
05
Reflect on meaning
After an experience, PMEE encourages carers to reflect on what they observed and what it might mean. This is not about reaching definitive conclusions — it is about developing a habit of thoughtful attention.
Reflection might be individual or shared with a team. It might be brief — a moment of noticing — or more structured, using the PMEE case study template to document observations and hypotheses over time.
"The question is not 'did this work?' but 'what did this mean to this person, and how do I know?'"
A developing approach
The PMEE Approach is not finished. It is being developed through practice — through observation, reflection and learning from what is noticed in everyday care.
New principles, tools and frameworks will be added as the project develops. Where something is still being explored or remains uncertain, this will be stated clearly. The project does not claim to have all the answers — it claims only to be asking the right questions.