When Caring Becomes a Calling: Psychological Growth in Dementia Healthcare Professionals
The Depth and Rewards of Dementia Care
For the nurses, doctors, chaplains, and allied health professionals who dedicate their careers to supporting people living with dementia, the rewards are genuine. So too are the challenges. These health professionals navigate a complex terrain: the professional and moral challenges of working within systems not always designed for individualised care, and the quiet sting of a profession that many in mainstream medicine regard as second-tier.
And yet — something remarkable happens for some of these healthcare professionals. Over time, and often through the very challenges they face, many of them report something that looks less like burnout and more like wisdom. Not despite the difficulty, but in part because of it.
This article explores what the research tells us about psychological growth in senior health professionals working in dementia care — and what their experiences can tell us about meaning and purpose, adaptability, and what it means to truly give to another person.
What the Research Shows
A 2015 qualitative study by Walmsley and McCormack, published in the journal Dementia, offers a rare window into this experience. The researchers conducted in-depth interviews with senior healthcare professionals — directors of aged care services, nurses and nurse unit managers, palliative care GPs, and care home chaplains — who had from 9 to 42 years of experience in dementia care across south-eastern Australia. One overarching theme was identified — Honouring Stigmatised Self — supported by four sub-themes describing: Systemic Stigma, Invalidated, Self-Respect, and Moral Integrity and Growth in these senior healthcare professionals.
Systemic Stigma
These senior healthcare professionals described aged care as systemically marginalised — historically associated with 'benevolent asylums' for the 'senile' and 'incurable,' and still perceived by many in mainstream medicine as a professional backwater. From their experience, aged care was often characterised by poor remuneration, less opportunity for training, high workloads, and a medical model not always equipped to the nuanced, relational nature of dementia care, in turn creating a gnawing sense of professional devaluation.
One participant recalled her first ward placement in the 1970s — a place still called “The Hospital for the Incurables” (Walmsley & McCormack, 2015, p. 1692) — and the inner disquiet it stirred: a feeling that those in her care deserved better. This sense of moral unease, rather than fading, became a motivating force for the next four decades of her career.
Invalidated
Many participants experienced peer invalidation and professional marginalisation when they attempted to bring a more person-centred, relational approach to their work constrained within a medical model of care. Advocating for individualised care could attract criticism from colleagues, and one GP experienced criticism, loss and rejection at the hands of professional bodies. This invalidation included loss of accreditation — willingness to engage at the forefront of daily aged care within care homes left him reduced as a practitioner unable to supervise equally compassionate new registrars in this field. Rather than silencing them, this invalidation deepened their reflective practice.
Self-Respect, Moral Integrity, and Growth
Paradoxically, it was through these struggles that these practitioners arrived at a more authentic sense of professional identity. Over time, their professional identity had evolved from that of an “uninvolved carer” to a confident “relational supporter” who saw their patients as people with agency, not passive recipients of care (Walmsley & McCormack, 2015, p. 1696).
By recognising their wealth of knowledge and experience, negativity in these professionals gave way to domains of psychological growth that over time included optimism, humility, innovation, and self-respect. Rather than sit in blame of circumstances now recognised as lying beyond their control, these professionals chose to redirect energy towards opportunities for personal growth. For some, this crystallised into something approaching a spiritual calling.
What This Means for a Career in Dementia Care
This research has particular resonance for senior healthcare professionals in dementia care who are navigating the long arc of a demanding and rewarding career.
As a society, we are living longer. Dementia is becoming part of the landscape of ordinary life for more families than ever before. The quality of care people with dementia receive depends not only on policy and funding, but on the psychological wellbeing of the professionals who provide it.
The Walmsley and McCormack findings offer a useful reframe: that moral difficulty, professional friction, and even invalidation need not be detrimental. When professionals have the reflective space to process these challenges, challenges can become catalysts for genuine growth.
Can working in aged care lead to psychological growth?
This study by Walmsley and McCormack (2015) found that these senior health professionals in dementia care, despite systemic stigma and moral distress, experienced meaningful psychological growth over the course of their careers. This growth included greater self-respect, humility, optimism, and innovative thinking — qualities that emerged through the very challenges they faced, enriching both their professional practice and personal lives.
The Science of Growth Through Adversity
The psychological framework underlying these findings draws on the established concept of post-traumatic growth (Tedeschi & Calhoun, 1996, 2004) and the work of Joseph and Linley (2005, 2006), who propose that individuals are inherently oriented toward growth — that our psychological architecture, under the right conditions, can transform adversity into wisdom, despite concurrent distress and challenges.
Importantly, this is not a story about toxic positivity or romanticising hardship. The distress these professionals experienced was real. But research consistently suggests that distress and growth can co-exist — and that as positive meaning-making takes hold, distress begins to diminish (Joseph, 2011).
What supports this process? Walmsley and McCormack point to work environments that nurture autonomy, competence, relational connection, and reflective time. When healthcare professionals are able to bring reflexivity to their practice, to form genuine connections with those in their care, and to act from a place of personal integrity rather than systemic compliance, something shifts.
"By wisely acknowledging career experience, growthful domains of self-respect, optimism, humility and innovation defined professional practice and personal choices." (Walmsley & McCormack, 2015, p. 1685)
This reflects what wellbeing research consistently tells us about flourishing in midlife and beyond: that personal agency, meaningful relationships, and the capacity for reflection and adaptation are among its most reliable foundations (Ryff, 1989).
The Upside Framework
The experiences described by these dementia healthcare professionals brought positive change in domains, central to our work at Upside Stories.
Mental & Emotional Health
The central thread of this research is psychological growth — the capacity to process moral distress, navigate professional invalidation, and emerge with a stronger, more integrated sense of self. These professionals modelled what healthy psychological coping looks like in demanding work: not the absence of difficulty, but the willingness to bring purposeful meaning to it.
Meaning & Purpose
For many participants, their work was deeply connected to a sense of purpose — even, for some, a sense of calling. Research consistently shows that meaning is one of the most powerful buffers against psychological distress across the lifespan (Ryff, 1989). When work feels connected to something larger than oneself, it sustains us through even the most difficult chapters. See our earlier article on how purpose and meaning shape healthy ageing.
Belonging
These health professionals who thrived described moving from a stance of detached expertise toward genuine relational connection — with the individuals they supported, the families, and their own professional communities. This relational orientation, this willingness to be present and connected, is at the heart of both good dementia care and good psychological health.
Think of a time in your life when something professionally or personally difficult eventually contributed to a deeper sense of who you are. What conditions made it possible for you to find meaning in that experience?
Finding Meaning Through Our Work
The health professionals in Walmsley and McCormack's study did not set out to grow. They set out to support others — and found, over years of moral wrestling and relational depth, that the work had shaped them into more expansive versions of themselves.
There is something quietly radical in this finding. In a culture that celebrates quick medical fixes and treatment outcomes, these professionals remind us that some of the most important growth happens slowly, through friction, and in the space between what we hope to offer and what a complex system allows.
Whether you work in dementia care, support a family member living with dementia, or are simply thinking about what it means to live and age well — the invitation here is the same: to honour what we have learnt from our challenges and explore meaning in our work.
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References & reading
Joseph, S. (2011). What doesn't kill us: The new psychology of posttraumatic growth. Basic Books.
Joseph, S., & Linley, P. A. (2005). Positive adjustment to threatening events: An organismic valuing theory of growth through adversity. Review of General Psychology, 9(3), 262–280. https://doi.org/10.1037/1089-2680.9.3.262
Joseph, S., & Linley, P. A. (2006). Growth following adversity: Theoretical perspectives and implications for clinical practice. Clinical Psychology Review, 26(8), 1041–1053. https://doi.org/10.1016/j.cpr.2005.12.006
Ryff, C. D. (1989). Happiness is everything, or is it? Explorations on the meaning of psychological well-being. Journal of Personality and Social Psychology, 57(6), 1069–1081. https://doi.org/10.1037/0022-3514.57.6.1069
Tedeschi, R. G., & Calhoun, L. G. (1996). The Posttraumatic Growth Inventory: Measuring the positive legacy of trauma. Journal of Traumatic Stress, 9(3), 455–471. https://doi.org/10.1007/BF02103658
Tedeschi, R. G., & Calhoun, L. G. (2004). Posttraumatic growth: Conceptual foundations and empirical evidence. Psychological Inquiry, 15(1), 1–18. https://doi.org/10.1207/s15327965pli1501_01
Walmsley, B. D., & McCormack, L. (2015). Stigma, the medical model and dementia care: Psychological growth in senior health professionals through moral and professional integrity. Dementia, 15(6), 1685–1702. https://doi.org/10.1177/1471301215574112
