‘Being Dementia Friendly’ – Part One
By C. Angela Burrow, CDP, CADDCT
Dementia is not a normal part of aging and memory loss is not always a major symptom. Dementia is not a specific disease. It is an overall term that describes a wide range of symptoms affecting language, memory, problem solving, judgement, communication, mood and sensory perceptions. The most common type of dementia is Alzheimer’s Disease.
People living with dementia need to be understood and supported in their communities. Language and communication that focuses on abilities, not the deficits, of people living with dementia helps people stay positive, with feelings of self-worth with the ability to adapt and function in daily life.
WHAT NOT TO SAY TO SOMEBODY LIVING WITH DEMENTIA
“Remember when?”
While it can be tempting to try and jog the memory of somebody living with dementia, this kind of question is often a reminder of memories lost. This can be a frustrating or painful experience, and there’s also no evidence that training the brain in this way will help somebody hold on to memories. That’s not to say you should avoid talking about the past, but it’s better to lead the conversation and allow the person to join in.
Try this instead:
Instead of posing a question, try leading with ‘I remember when…’ instead. That way the person may be able to reminisce calmly without feeling embarrassed, and join in.
“I’ve just told you that”
Having to answer the same question several times can be frustrating, but repetition will happen. There is little benefit to passing on your frustration to somebody with dementia, and saying ‘I’ve just told you that’ only reminds the person of their condition.
Try this instead:
Be polite and as patient as possible. It’s important for somebody with dementia to feel they’re being listened to and understood.
“Your brother died 10 years ago”
A person living with dementia may forget about a past bereavement or ask for somebody who has passed away. Reminding them of a loved one’s death can be painful, even causing them to relive the grief they’ve already experienced. How carers should respond to this may vary for different circumstances, but it’s always good to show sensitivity.
Try this instead:
It may be better to come up with another reason for somebody’s absence. Changing the subject may not work, so actually engaging in conversation about the loved one can be effective. A deceased person still resides in their heart and soul after their physical presence is gone.
“What did you do this morning?”
Avoid asking too many open-ended questions, as it could be stressful for a person with dementia if they can’t provide the answer. While it might seem polite to ask somebody about their day, it’s better to focus on what’s happening in the present. It’s also important that people with dementia continue to make personal choices, but defining the options might be a helpful technique.
Try this instead:
Rather than ‘what would you like to drink?’, you could ask ‘do you want tea or coffee?’ or more simply, ‘do you want a cup of tea?’.
“Do you recognize me?”
It can be distressing when somebody with dementia doesn’t recognize you, but remember that the feeling is mutual. Asking the person if they know who you are can make them feel guilty if they don’t remember, or offended if they do.
Try this instead:
The way you greet somebody with dementia might change depending on the stage of their condition – judge for yourself, but keep it friendly. A warm hello could suffice, or it may help to say your name.
“Let’s have a cup of coffee now, then after that we can go for a nice walk and get lunch in that cafe you like in town.”
Long, complex sentences can be difficult to grasp for somebody with dementia. It’s difficult to process several ideas at once as cognitive abilities slow down, so it’s better to give directions or instructions one step at a time.
Try this instead:
Use short, simple sentences as much as possible. Avoid speaking in loud environments and wait until you have the person’s full attention before you start a conversation.
“Do you need some help with that, sweetie?”
Words like ‘sweetie’, ‘honey’ and ‘dear’ can be patronising for some people living with dementia. This is sometimes referred to as ‘elderspeak’ and can cause older people to feel infantilised.
Try this instead:
Always remember the person behind the dementia, using their name as often as appropriate. This helps keep their dignity intact and aids concentration too.
