Supporting Someone with Dementia

If a loved one is living with dementia, it can pose many challenges to them and those who care for them. Family and caregivers face many challenges when caring for a loved one with dementia, especially in relation to communicating with them and supporting them safely and respectfully, whilst also preserving their dignity.

Supporting someone with dementia can be emotionally and physically challenging, but it is important to ensure  they have a safe, comfortable, and functional space, surrounded by loved ones or people who care for them It is also crucial to be supportive and learn strategies to communicate, while considering the inherent duty of care and dignity of risk. 

Living with dementia can have emotional, social, psychological, and practical impacts on a person. These effects can be difficult to manage, especially whilst learning to adjust to them. 

What is the Best Way to Help Someone with Dementia?

Personal relationships and social environments are essential to life, regardless of if they live with dementia.  Nonetheless, when a person lives with a condition causing dementia, their mental and physical health can significantly improve simply by having a clean, comfortable, and familiar place to call home, and being surrounded by love and support. 

When supporting a person with dementia, it’s important  to have some level of understanding of the condition and the impact it has on them. Particularly, it’s important to understand  their feelings and thoughts towards their illness and situation, as these govern their daily behaviours. 

A person living with dementia may experience a different world than what most people are used to. Lead with empathy and do your best to see things through their unique perspective. This approach  will help you to communicate more productively, while also providing your patient an opportunity to engage with others.

Make sure that your loved one feels valued and included. You can do this by sharing stories with them, listening to their stories, interacting with them, and asking them questions to keep their mind sharp and as alert as possible. While these interactions are essential, it’s also important to let your patient rest as needed.

Each individual in the world is unique, with their own life history, personality, likes, and dislikes, so keep this in mind when caring for someone who is living with dementia. They will likely respond well to their favourite foods, possessions, and TV shows. It’s important to focus on what your loved one still has, not on what they may have lost. You can also focus on what the person is feeling on a daily basis, rather than what they do or don’t remember.

How do you Emotionally Support Someone with Dementia?

Emotionally supporting someone with dementia can be tough, especially if you are also emotionally involved. One important thing to remember is to never dismiss their worries; listen and show that you are there for them. Try to enjoy the moment and avoid spending time contemplating the future or their disease’s progression. A sense of humour can also help to lighten the mood when it’s appropriate and your loved one is in good spirits.

People living with dementia continually need loving and safe relationships and a safe space. It’s important to remember that every person is different, and patients may vary in their response to the illness. These differences may include their cognitive presentation, as well as how they give and receive affection. It is important to be compassionate and empathetic to what they respond well to, and what they may need to help them feel comfortable and safe.

What are Good Examples of Supporting the person with dementia to make decisions?

People with dementia may have difficulty making their own decisions, but there will also be occasions where they can make decisions for themselves and it’s important to recognise and enable that as much as possible. For example, some people living with dementia may not have the cognitive function to make decisions about their medical treatment, but they can make decisions about their meal plan and what they watch on TV. This may also vary over time and depend on the severity of their condition. 

There may be times throughout the course of the condition where they are unable to make a decision, but, later on in the day or the week, they become aware and can have clear thought processes. As dementia progresses, the decisions an individual can make, as well as their capacity to make these decisions, may change. 

People must be supported to make their own decision wherever possible and you can support them to do so by:

• Giving them all the information they need to make an informed decision
• Allowing them time to think it over or talk it through with a professional, expert, or someone they trust
• Explaining things in a way that is easier to understand
• Ensuring their hearing aid is working or their glasses are on if they use them as this may provide more clarity or psychological comfort
• Using pictures to help them visualise something such as a meal
• Choosing the best time of day to talk about the decision – maybe there is a general time frame where your loved one is more lucid

If for some reason you don’t agree with the decision your loved one makes, it’s important to take dignity of risk into account. Dignity of risk is the principle that self determination and the right to take reasonable risks are essential for dignity and self esteem, particularly in the aged community. Read more about dignity of risk on our blog, here.

What do Dementia Patients Need?

First and foremost, people living with dementia will require support both physically and mentally. The level of support will vary depending on their diagnosis and prognosis of their condition, though each individual will have a different presentation.

Eventually, at least a minimum level of support will likely be required with daily living activities. This may include activities such as shopping, preparing meals, hygiene routines, transportation, financial management, and medical management. It is important to focus on what a patient can do rather than what they can’t, and support them in doing activities, rather than doing things for them. In doing so, it is important to reinforce their dignity of risk and their need to continue growing and making their own decisions based on their needs and goals.

People living with dementia sometimes experience heightened levels of anxiety, fear, and mistrust . This  is important to remember when providing support to a loved one. They may also become resistant to care or even combative. This behaviour can be caused by chronic or unvoiced pain or pent up frustration with their situation. This discomfort can often be eased with exercise or some type of movement, such as walking and moving around, as it helps relieve tension

How should you communicate with a person with dementia?

Communication with someone living with dementia often requires patience, understanding, and good observational and listening skills. The communication style of your loved one will likely change as their condition progresses. They may have difficulty finding the right words, and may repeat familiar words and describe objects instead of saying their name. They may also easily lose their train of thought, and speak less, relying on gestures instead of words 

While taking all of this into account, a few strategies that might help you understand each other better include:

• Don’t make assumptions about a person’s ability to communicate; their abilities may also change frequently.
• Speak directly to the person, rather than their caregiver or companion.
• Take time to listen to the person as they express their thoughts, feelings, and needs.
• Engage them in a one-on-one conversation in a quiet space with minimal distractions.
• Speak slowly and clearly.
• Maintain eye-contact while showing that you care about what they have to say; it may also help them to focus.
• Give them plenty of time to respond so they have time to think about what they want to say.
• Ask one question at a time.
• Be patient and offer reassurance.
• Stick to yes or no questions rather than open ended ones.
• Avoid arguing with the person if they say something you disagree with, try not to challenge them.
• Offer manageable step by step instructions for tasks.
• Visual clues and written notes can be very helpful.

In the later stages of dementia, your loved one may prefer to use non vocal communication, at this point  around the clock care may be required. To successfully communicate at this stage, be sure to approach them from the front and identify yourself, and encourage non verbal communication such as touch, smells, tastes or sight. Consider the feelings behind words or sounds, as the emotions being expressed may be more important than what is said.

Treat your loved one with the dignity and respect they deserve. It’s ok if you don’t know what to say; your presence alone means the world to them.