Observation and reflection
Measurement & Learning
How do we know when an experience has been personally meaningful? This section explores the indicators, tools and reflective practices that the PMEE Project is developing to help carers notice, record and learn from meaningful moments.
An important note
The tools and frameworks on this page are developmental and practice-based. They are not clinically validated instruments and should not be used as clinical assessments. They are offered as aids to observation and reflection — not as measures of clinical outcome.
Indicators of meaningful emotional experience
People living with dementia may not always be able to express their experience in words. The following indicators — both verbal and non-verbal — may suggest that an experience is holding personal significance.
Verbal indicators
Spontaneous vocalisation — humming, singing, speaking unprompted
Statements of recognition — 'I know this', 'I remember', 'That's mine'
Expressions of identity or role — 'I've always done this', 'That's how you do it'
Expressions of emotion — 'I love this', 'That's beautiful', 'I miss them'
Questions or curiosity — 'What is that?', 'Can I see?', 'Tell me more'
Narrative — unprompted stories or memories connected to the experience
Non-verbal indicators
Change in facial expression — softening, smiling, brightening
Increased eye contact or sustained attention
Change in posture — sitting more upright, leaning in, becoming more still
Purposeful movement — reaching out, touching, handling objects with care
Reduced agitation or restlessness
Sustained engagement — remaining with an activity longer than usual
Emotional response — tears, laughter, visible emotion
A simple observation framework
The following framework is offered as a starting point for structured observation. It is not a validated scale — it is a prompt for reflection.
1
Before
What do I know about this person that might make this experience meaningful to them? What is their history, their identity, their preferences?
2
During
What am I noticing? What verbal and non-verbal indicators are present? What is changing — or not changing — as the experience unfolds?
3
After
What do I think this experience meant to this person? What evidence supports that interpretation? What remains uncertain?
4
Learn
What will I do differently next time? What would I like to try? What would I like to understand better?
Reflective practice
Observation alone is not enough. PMEE encourages carers to develop a habit of reflection — of pausing after a meaningful moment to ask what it might mean and what it might teach.
Reflection can be individual or shared. A brief conversation with a colleague, a note in a care record, or a more structured case study can all serve as forms of reflective practice. The goal is not to reach definitive conclusions — it is to develop a habit of thoughtful attention.
"What did I notice? What might it mean? What will I do with what I have learned?"