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My main aim is to contribute to the exploration of the nature of the epistemic state of understanding. It seems that the most productive way in which this might be done is by (i) investigating what sort of conditions must be fulfilled in order for one to understand, and (ii) comparing understanding’s place in certain contemporary debates to the place that knowledge has in those debates. Regarding conditions for understanding, I will argue that there are two types of understanding that are most relevant to epistemology—objectual understanding and atomistic understanding. I will contend that atomistic understanding is entirely factive while objectual understanding is moderately factive, that objectual understanding admits of degrees, that both types involve some sort of grasp of explanatory relations, that both possess a measure of luck immunity, and that both are cognitive achievements with instrumental, teleological, contributory and (crucially) final value. It must be stressed that the general accounts of both types of understanding that I attempt to provide are not supposed to be exhaustive sets of necessary and sufficient conditions—I remain particularly open to the possibility that there are further necessary conditions that are as yet undiscovered, especially for objectual understanding. Regarding understanding’s place in contemporary debates, it is perplexing that existing work does not capitalise on the thought that treating understanding in conjunction with many of the most prominent issues in recent epistemology is a worthwhile project that could yield interesting and important results. I will summarise understanding's potential significance for a number of these topics, looking at all of the following (in varying degrees of detail): factivity, coherentism, norms of assertion, the transmission of epistemic properties, epistemic luck, the nature of cognitive achievement, and epistemic value. This last topic is one that I think is particularly important to an investigation into understanding, because it is quite plausible that there is a particularly strong revisionist theory of epistemic value focused on understanding. Such a view would be one on which knowledge is not finally valuable, but one by way of which we could nonetheless explain why we might pre-theoretically think that knowledge is finally valuable. Since revisionist views often involve a claim that we should think of a different, closely related epistemic state as distinctively valuable, it is natural to consider understanding as a prime candidate for the focus of such a theory.

This thesis explores how the general public understands and responds to dementia. In the context of this study the word ‘understanding' is used to convey the complex co-construction of knowledge and establishing of beliefs that constitutes public understandings of dementia. The study also examines the responses of members of the public to dementia, in the context of their understanding. Data were collected over a 12 month period and included a module in the Northern Ireland Life and Times (NILT) survey, five focus groups and nine interviews with participants from the focus groups. The survey module included thirty measures examining levels of knowledge and attitudes towards dementia. 1200 participants were targeted and the survey was administered by the Northern Ireland Research & Statistics Agency with a response rate of 58%. The focus groups and interviews provided the mechanism to gather a more nuanced picture, exploring the beliefs behind the attitudes and the self-reported responses of participants to people with dementia. Findings indicate that the general public has a reasonable knowledge of the symptoms and pathway of dementia in line with a bio medical model. However the findings also indicate that the general public holds a mix of theoretical and empirical knowledge and that this is often contradictory. A complex mix of scientific or medical information, experience, anecdote and assumptions contribute to the discourse. This information is stored and conveyed in the form of stories and a consequence of this interplay is that individual experiences told in the form of stories are generalised to become building blocks in the construction of what the general public understands dementia to be. The current construction of dementia among the general public is found to be both nihilistic and ageist with clear evidence that dementia is stigmatised. I will argue that that the relationship between dementia and ageing in the minds of the general public is a symbiotic one. Dementia has become a cultural metaphor for unsuccessful ageing marking entry to the fourth age. The stigmatising response of the general public is the result of a complex interplay of multiple factors. I have expanded on previous ideas of multiple jeopardy and intersectionality, suggesting that the stigma associated with dementia is unique and driven as much by emotional responses as by the social location of the person with dementia. I have borrowed Brooker’s (2003) term “Dementia-ism’ to describe this stigma. This thesis argues for a more complex and sophisticated approach to changing public attitudes and reducing stigma. Dementia-ism must be addressed with the same strength of purpose currently applied to sexism, racism and ageism.