Practical guidance for those supporting a person with dementia
Looking after someone with dementia is a journey that progresses over time. The condition can have a large impact on the person with dementia and also those who care for them, as both have to adjust to the social, emotional and psychological changes that it brings.
Donna Hanlon, Dementia Coach for Priory Adult Care has outlined what to possibly expect when caring for someone with dementia, providing practical guidance to help you understand the condition and how to support the person so they can maintain a good quality of life.
It is important to remember that every person living with the condition goes through a different journey. Their experience will not only be shaped by dementia, but also by their own lifestyle, diet and their physical capabilities. As every person with dementia has their own history, experiences, likes and dislikes, it is important to be flexible in the way you care for them and to think about the type of care that they need to make sure they get the right level of support.
Helping with their daily routine
How you can help someone with their daily routine will depend on the person and the type of dementia they are living with. The points below are just some of the ways to offer support:
- Make appropriate signs using both pictures and words so it is clear where the bathroom, kitchen and living rooms are
- Leave a calendar or notices out which say when meal times are or what time you’re visiting
- Offer regular access to snacks and drinks, as sometimes people may not be able to recall when it’s time to eat
- Leave items of interest out so they are easy to find. Activity items should be fail-free, such as reading newspapers and magazines. Also leave out photo albums with the names of people, who they are and dates written on the back of photos
- Adapt hobbies to the person’s current level of ability so they can still participate. For example, instead of painting an entire canvas, choose a smaller version or encourage them to paint one small area at a time
- Keep activities and hobbies to times that suit the person. As dementia progresses, some people may no longer be interested in spending an hour or so completing a specific hobby and may only enjoy the first 20-30 minutes
Behaviours and emotions associated with dementia
When caring for someone with dementia, you will likely see alterations in their emotions and behaviours. These changes can vary considerably depending on the type of dementia a person has been diagnosed with, as well as their lifestyle, personality and physical limitations.
Some of the most common behaviours and emotions you may see when caring for someone with dementia include:
- Memory loss or significant gaps in recalling recent events
- Disorientation regarding times, days and places
- Inability to complete a task that requires sequencing actions such as getting dressed, making a cup of tea or cooking dinner
- Changes in sleeping pattern
- They may accuse or confabulate
- Become fearful
- Changes in behaviour
- They may develop apathy, anxiety and/or depression
- They may be unable to visually process objects
- Some people living with dementia may feel humiliated and push loved ones away when they offer support
- They may hallucinate or their perception may change
- People may forget the names of those closest to them
- Inability to manage finances
- Irritability and frustration at not being able to complete tasks or losing items
Recognising how the person feels can help you understand the impact that dementia is having on them and the best ways you can provide support. Changes in behaviour may also mean that their needs aren’t being met, so it is important to look into these responses to identify any issues.
Communicating with a person that has dementia
People with dementia can often have difficulties communicating, causing them to lose confidence or withdraw from social situations. However, it can be important to talk to them in order to help them express themselves and help you get a better understanding of how they are feeling.
When talking to someone with dementia, there are general guidelines that may help aid good communication. These include the following:
- Think about their physical requirements. Do they have glasses or hearing aids that can help? Are these in good working order and fit for purpose?
- Use clear terminology the person is familiar with
- Get to their eye level with good lighting before talking
- Use phrases that are appropriate to their level of ability
- Flash cards with both words and pictures may be useful
- Eliminate any unnecessary noises or distractions such as the TV or radio
- Show the person the item you are discussing
How to ease a person with dementia’s stresses and frustrations
At times the person living with dementia may display a stress or distressed reaction, which can be as equally distressing for the person caring for them. There can be many factors that can cause someone with dementia to become stressed, such as a particular environment, person or people, TV show, lighting, mirrors, patterns on items, a picture or even a simple word that may have been misunderstood.
When a person with dementia becomes frustrated, you can offer support in the following ways:
- Acknowledge what they are trying to say, as to them whatever they are trying to say is very real
- Do not argue – what the person is saying is right for them at that moment in time
- Do not try to bring them back to our reality. Enter their reality – the person may be unable to recall their short term memories from the past few years and may believe they are now back living at a time where they were much younger
- Try and establish what it is they may be trying to say and complete it
- Regularly exercise and keep active – this may help to maintain skills for longer
- Try to help maintain good diet and fluid intake – experiment with different meal options such as finger food if remembering how to use a knife and fork is difficult
- Ensure the environment is dementia friendly. Have sign on doors, use contrasting colours to emphasise important areas or items such as toilet doors, toilet seats and crockery. Also, try to avoid using lots of mirrors and strong patterns
- Reduce unnecessary noise/distractions
- Make sure they maintain good social contact with family and friends
- Sometimes you may need to find a distraction. Try to reminisce about the good times - pull out an old photo book
- Use phrases such as “what do you think” and “how do you feel”, as asking direct questions which require facts may enhance someone’s stress or distress
How to best manage particularly troubling stress or distress reactions
As the dementia progresses, a person could possibly develop behaviours that challenge. Remember that they are not simply behaving badly, but that the behaviour may be a result of the dementia, an underlying health problem, their general environment or the care that they are receiving.
The below may help to find a possible way to support someone who may be displaying a stress or distress reaction:
- First and foremost, acknowledge what the person is trying to say
- Convey that you want to help
- Use reflective listening, where you paraphrase and restate the feelings and words of the person so that feel understood and have the opportunity to focus their ideas
- Offer reassurance, understanding their needs
- Reduce distractions
- Stay calm, neutral, show willing and be empathetic
- Watch for non-verbal communication
Always look to seek medical advice if ‘out of the normal behaviour’ occurs or continues as there may be an underlying medical cause such as an infection or mental health need.
Reaching out for support
If you have any doubts about how to provide support to someone living at home with dementia or are looking for further information, please seek advice from the Alzheimer’s Society. They can provide you with practical guidance, and will also be able to put you in touch with any additional support or services needed.
You can also turn to Priory Adult Care and our short term care services. We understand that you may need a break from caring for a loved one, and our respite service gives you the opportunity to recharge you batteries while your loved one stays at a temporary retreat with 24 hour care.
We also have care homes across the UK that have been developed to meet the needs of residents with dementia, where our compassionate team provide specialised services to ensure that those in their care can maintain both their independence and dignity.
If you would like to find out more about the services available at Priory Adult Care, you can make an enquiry online. You can also call us on 0808 208 2147 to speak to someone directly.