The understanding and management of people with dementia have largely been determined by a particular view of the condition which readily fits with attitudes about their diminished worth. It relates to a mechanistic notion of impaired capacity and an essentialist concept of persons. Some of the contradictions and adverse consequences of this position are explored, and a contrast is then made with a different and more positive approach. This focuses on the continuity of the person as a whole and how it can be sustained by ongoing dynamic relationships. Attention is also drawn to the complexity of interactions between the neurological and psychosocial processes involved, and how, when handled in a constructive way, there is the possibility of enabling ‘rementia’. The conceptualisation of dementia and ways of dealing with people who are affected should therefore be redirected to nurturing the person, rather than attending to particular facets of dementia in terms of loss. This analysis is also relevant to other chronic conditions and involves returning to and reinvigorating an older complex of ideas, which combines moral and epistemological dimensions.