Holistic Dementia Care Approaches

Dementia is a broad term used to describe a range of cognitive impairments that affect a person’s memory, thinking, communication and daily functioning. It is not a specific disease but rather a collection of symptoms that can result from various underlying conditions that damage the brain. Dementia is most common in older adults, but it is not a normal part of ageing. Key characteristics of dementia include:

Memory loss: One of the earliest and most noticeable symptoms, memory loss is recognisable when individuals have trouble remembering recent events or familiar tasks. They may also forget where they live, people’s names and faces and other familiar details.
Cognitive decline: People with dementia typically experience difficulties with reasoning, problem-solving, decision-making and understanding information.
Language problems: People with dementia also experience challenges in finding the right words, following conversations or understanding language. As dementia progresses, they may no longer be able to communicate using language.
Changes in behaviour and mood: Dementia is also associated with increased confusion, irritability, depression, anxiety and sometimes inappropriate behaviour or personality changes.
Difficulty with daily activities: People with dementia may struggle with tasks like managing finances, cooking, driving or other activities that were previously done with ease.

The number of people with dementia is increasing, particularly because people are living longer. NHS England statistics show that 477,623 people had a recorded diagnosis of dementia in January 2024, but the NHS predicts that this figure will rise above a million by 2030. There are several types of dementia and the most common types are:

Alzheimer’s Disease: The most common form of dementia, Alzheimer’s disease is characterised by memory loss, confusion and disorientation. It typically progresses gradually and affects parts of the brain that control thought, memory and language.
Vascular Dementia: Vascular dementia is caused by reduced blood flow to the brain, often due to strokes or small vessel disease. Symptoms can vary widely but may include slowed thinking, problems with focus and trouble with coordination or balance.
Lewy Body Dementia: Lewy body dementia is marked by abnormal protein deposits in the brain, called Lewy bodies. It often causes fluctuations in cognitive abilities, visual hallucinations and problems with movement similar to Parkinson’s disease.
Frontotemporal Dementia: Frontotemporal dementia refers to a group of disorders that primarily affect the front and side parts of the brain and can lead to changes in personality, behaviour and language. It tends to occur at a younger age compared to other dementias.
Mixed Dementia: Mixed dementia occurs when a person has more than one type of dementia, most commonly Alzheimer’s disease and vascular dementia. It is more common in people above the age of 75.

Holistic dementia care is a comprehensive approach that goes beyond simply treating the medical symptoms of dementia. It focuses on addressing the person as a whole, integrating emotional, physical, mental and social aspects of their well-being. This approach acknowledges that each individual’s experience with dementia is unique and people with dementia require care that considers their personal history, preferences, values and needs.

Adopting a holistic approach can lead to significant improvements in the quality of life for individuals living with dementia. Some key benefits include:

Improved quality of life: By treating the individual rather than just the condition, holistic care promotes greater comfort, happiness and satisfaction in daily living.
Reduced behavioural issues: Focusing on emotional and social aspects can help minimise common dementia-related behaviours such as agitation, anxiety and confusion.
Improved well-being for caregivers: When caregivers understand the holistic needs of those they care for, it can lead to better communication, stronger connections and reduced caregiver stress or burnout.

Today, we will look at real-world success stories showcasing how holistic dementia care approaches have led to positive outcomes for both individuals with dementia and their caregivers. Through these case studies, we aim to highlight the effectiveness of holistic practices, including the lessons learned and best practices that can be applied to improve dementia care on a wider scale.

Case Study 1: Person-Centred Care in Residential Settings

The case study focuses on a medium-sized care home in the UK, Willowbrook Lodge. Willowbrook Lodge accommodates approximately 60 residents, most of whom are living with moderate to advanced stages of dementia, including Alzheimer’s disease and vascular dementia. Although all staff members were highly trained in dementia, the care home faced several challenges, such as high levels of anxiety among residents, frequent episodes of wandering and disruptive behaviours that showed the residents distress, including agitation and aggression. Staff members found it difficult to engage with the residents effectively, which led to frustration for both the caregivers and family members.

Following much debate and research, Willowbrook Lodge decided to implement a person-centred care model to address these challenges. The facility moved away from a standardised approach and focused on understanding each resident’s unique preferences, routines and emotional needs. Management met with each resident’s friends and family (where possible) to gain as much information about the individual’s life and what was important to them. Caregivers were trained to learn about the residents’ life histories, hobbies and favourite activities to create personalised care plans.

Instead of adhering to strict schedules, the staff adopted a more flexible routine that allowed residents to engage in activities they enjoyed, such as gardening, music sessions and arts and crafts. For example, one resident, a former schoolteacher, was encouraged to help with storytelling and memory-sharing groups, while another, who loved animals, regularly participated in pet therapy sessions with visiting dogs. A third resident who had always taken a lot of pride in her appearance was given the option to have weekly appointments with a hairdresser and her daughter and a staff member took her on fortnightly outings for manicures and other treatments.

The care home also set up several new clubs based on the residents’ interests, including bowls, gardening, baking and a jigsaw club. Residents were encouraged to follow their interests but also to try new things to see what they liked. Residents (where possible) and family members were also given the chance to suggest things they would like to do at the care home and the daughter of one resident, Joyce, suggested a classic film club, which was a huge hit on Friday nights. Although many of the residents were unable to communicate using language, their participation in these activities helped them to socialise in new ways.

The shift to a person-centred care model led to several positive changes at Willowbrook Lodge, including:

Improved resident engagement: Residents became more active participants in daily activities and began to show increased interest and involvement in social events. The connections and relationships between residents improved and because staff members were able to spend more quality time with residents, their relationships with the residents also improved.
Reduction in distressing behaviours: Episodes of wandering and agitation significantly decreased as residents were more settled and content with their daily routines. Although many residents couldn’t verbally express their happiness, staff and loved ones reported seeing positive changes.
Improved family satisfaction: Families noticed a marked improvement in their loved ones’ moods and behaviours, which led to greater trust and satisfaction in the care provided by the facility. Family and friends felt like their input was valued and listened to and reported that their loved ones seemed happier and more at ease in the care home environment.

The success of holistic care at Willowbrook Lodge highlights the importance of personalised care plans that cater to the individual needs and preferences of each resident. Knowing each resident’s background, interests and routines allows caregivers to offer meaningful activities that improve emotional and social engagement. This holistic approach not only improves the quality of life for individuals with dementia but also encourages stronger connections with their families and reduces distressing behaviours, which can make the caregiving experience more fulfilling for everyone involved.

Case Study 2: Integrating Technology and Non-Medical Therapies

This case study focuses on a dementia care facility in London that introduced a blend of innovative technologies and non-medical therapies to improve the care of its residents. The facility primarily serves individuals with moderate to severe dementia, many of whom have Alzheimer’s disease or Lewy body dementia. Traditional care methods were not fully addressing the cognitive and emotional needs of the residents and this realisation prompted the facility to seek alternative solutions to improve engagement, reduce anxiety and improve the overall quality of life of the residents.

The care facility implemented multiple strategies, including music therapy, art therapy, virtual reality (VR) and memory apps. These interventions were designed to create calming environments, stimulate memories and provide residents with alternative ways to communicate. Specific examples of the technologies and therapies used include:

Virtual Reality (VR) experiences: Residents used VR headsets to take immersive trips to familiar places, such as seaside towns or cities they had visited in their younger years. The aim was to trigger positive memories and reduce feelings of isolation or confusion.
Memory apps: Digital tools, including ‘Reminiscence Therapy Apps’ were introduced to help residents create and interact with personalised digital life stories, featuring photos, music and videos from their past. This helped stimulate conversation and connection between residents and their caregivers.
Music therapy: Regular music therapy sessions were conducted, focusing on songs from the residents’ youth to evoke memories and improve mood. This approach was especially beneficial for residents who had difficulty communicating verbally, as music provided a non-verbal means of expression.
Art therapy: Creative art sessions were also integrated, where residents could express themselves through painting or drawing. This not only provided a sense of accomplishment but also acted as a calming activity that helped reduce stress.

The integration of technology and non-medical therapies at the Mindful Care Hub led to notable positive outcomes, including:

Reduced anxiety and agitation: Residents who participated in VR sessions and music and art therapy showed a significant decrease in anxiety levels and instances of agitation. Caregivers observed that these activities had a soothing effect and helped to calm distressed individuals. The therapies helped residents cope with the emotional impact of their memory loss.
Improved mood and cognitive engagement: There was a marked improvement in residents’ overall mood and levels of engagement. The memory apps, in particular, facilitated more meaningful interactions with staff and family members, as residents were able to reminisce about their past with more clarity.
Positive feedback from families and caregivers: Families reported a greater sense of connection with their loved ones during visits, noting that their interactions felt more engaging and less emotionally challenging. Caregivers also expressed increased job satisfaction, as they were able to connect with residents on a deeper level.
Improved connection with others: Both art therapy and music therapy have been shown to help people with dementia make connections with others and stay connected with the world around them as it provides them with a way of communicating without words and expressing themselves and this was reported by both the staff and the residents’ family members. Residents enjoyed sharing music with others and showing off their art creations and family members were given the opportunity to join in with sessions, which helped them to maintain their bonds with their loved ones.

The success of these strategies demonstrates that combining technology and non-medical therapies with traditional care significantly improves the quality of life for individuals with dementia. These interventions not only reduce anxiety and improve mood but also encourage greater cognitive engagement and emotional connections between residents and their caregivers. This approach highlights the potential of innovative, holistic strategies to transform dementia care and provide a more enriching and supportive environment for those living with the condition.

Case Study 3: Family and Caregiver Involvement in Home Care

This case study focuses on the Richardson family, a family in Manchester who cared for their husband and father, Tony, at home after he was diagnosed with early-stage Alzheimer’s disease. The family was determined to provide care that went beyond Tony’s medical needs and wanted to maintain his quality of life and independence for as long as possible. They faced challenges in balancing caregiving responsibilities with work and personal life while also dealing with Tony’s increasing memory loss, mood changes and confusion.

Tony’s daughter, Jenny, read about holistic dementia care online and after doing a lot of research and speaking to experts, the family decided to try and implement it at home. To implement holistic dementia care in a home setting, the Richardson family worked closely with a team of professional caregivers to create a supportive, calming and familiar environment for Tony. Their approach involved several key elements:

Collaboration and communication: The family and professional caregivers developed a detailed care plan that was continually adjusted based on Tony’s evolving needs. Regular family meetings were held to discuss Tony’s condition, share progress and adapt strategies as needed.
Caregiver training: The family received training from dementia care specialists on how to handle challenging behaviours, communicate effectively with Tony and create a positive daily routine. They were taught techniques for managing his anxiety and memory lapses without causing frustration or distress.
Home modifications: To support Tony’s independence, the family made practical changes to their home, such as installing clear signage to help him navigate, using contrasting colours to highlight doorways and important areas and creating a memory board that listed daily tasks and activities.
Focus on emotional and social well-being: Activities that Tony enjoyed, like gardening, watching cricket and listening to 1950’s jazz music, were incorporated into his daily routine. The family also encouraged social interaction by arranging regular visits from friends and involving Tony in family gatherings, which helped him feel valued and included.

The holistic approach taken by the Richardson family led to several positive outcomes, including:

Maintained independence: Tony was able to maintain a degree of independence for much longer than initially expected, continuing to engage in his favourite activities and make decisions about his daily routine.
Reduced caregiver burnout: Regular communication and a shared approach to care significantly reduced the stress and burnout experienced by both the family and professional caregivers. The structured support allowed each family member to balance their caregiving role with other responsibilities.
Improved emotional connections: The emphasis on emotional and social well-being led to stronger bonds between Tony and his family members. They noticed that Tony was more engaged and responsive during conversations, often smiling and sharing memories triggered by familiar music or activities.

Additionally, because Tony’s needs were being better met, he was happier and there was reduced emotional stress for his family members. Tony was able to stay at the home he loved so much with his family for much longer than would have been previously possible. Even when Tony’s condition began to worsen over time, the family continued to care for him at home, with extra support from the community team. Knowing that staying at home as long as possible was Tony’s greatest wish, his family and friends were relieved they could fulfil this while still maintaining a high level of care and keeping him safe.

The experience of the Richardson family highlights the importance of involving families and caregivers in the dementia care process. Regular communication, support and caregiver training are essential components of successful home-based care. This approach not only helps maintain the individual’s independence and dignity but also creates a supportive environment that improves emotional connections and reduces the burden on caregivers. Family involvement in decision-making and care planning is vital to creating a holistic care experience that truly addresses the needs of both the person with dementia and their loved ones.

The Role of Environment in Holistic Dementia Care

This case study focuses on a dementia care facility in Worcestershire that transformed the care home environment to create a more supportive and calming space for its residents. The residents at the care home have varying stages of dementia, including Alzheimer’s disease, vascular dementia and frontotemporal dementia. The facility was initially designed with a standard clinical layout, which often caused confusion, anxiety and restlessness among the residents, possibly because of its similarity to a hospital and its lack of homely touches. Recognising the impact of physical surroundings on well-being, the management decided to incorporate a dementia-friendly design to better meet the needs of their residents.

The care facility made several targeted changes to its environment to reduce stress and improve comfort and the sense of feeling at home for the residents:

Sensory gardens: The facility developed a secure, accessible sensory garden filled with fragrant plants, colourful flowers and seating areas. This garden offered residents a peaceful outdoor space to engage with nature, stimulate their senses and enjoy physical activity in a safe environment. The sensory garden also had a separate vegetable patch and a gardening area for residents who wanted to get involved.
Improved lighting and colour schemes: The care home used warm, natural lighting throughout its interior spaces to reduce glare and shadows that can be disorienting for people with dementia. Hallways and rooms were painted with calming colour schemes, with contrasting colours used to highlight important areas such as doorways, handrails and communal spaces.
Noise reduction: Efforts were made to minimise unnecessary noise by installing sound-absorbing materials in common areas and limiting the use of loud alarms. This quieter atmosphere helped to create a sense of calm, prevent overstimulation and prevent the facility from sounding too clinical and hospital-like.
Clear signage and wayfinding: The facility introduced large, clear signs with simple language and images to help residents navigate their surroundings more easily. This included signs for bathrooms, dining areas and individual rooms, which reduced confusion and encouraged independent movement.
Homely touches: Management focused on adding as many homely touches to the residents’ bedrooms and the communal areas as possible. Family members were encouraged to bring in décor, photographs, accessories and beloved items from the residents’ homes to decorate their bedrooms. For residents without loved ones, staff members helped them to pick items for their bedrooms. In communal areas, the staff added homely touches, including cushions, artwork and flowers. They also created a photo wall and took pictures of the residents at special events, such as the Christmas party, to help create a sense of family.

The environmental modifications resulted in several observable benefits for its residents, including:

Reduced stress and anxiety: Residents showed a noticeable decrease in anxiety and agitation levels. The sensory garden, in particular, became a favourite place for many to relax, which led to more peaceful behaviour throughout the day. The improved environment also helped newer residents to feel settled much quicker, as the care home felt more like a home than a facility or hospital.
Improved mobility and independence: Improved lighting and clear wayfinding enabled residents to move around the facility more confidently and safely, reducing their dependence on caregivers for simple tasks like finding their way to the dining room or outdoor areas.
Positive impact on mood and engagement: The calming colour schemes and secure outdoor spaces encouraged residents to participate in activities like gardening, walking and socialising, which led to an overall improvement in mood and engagement with their surroundings. Residents even started a gardening club, planting flowers around the grounds and beginning to grow vegetables to be used in the kitchen.

The success of the holistic approach highlights the importance of creating dementia-friendly environments that promote safety, independence and well-being. Thoughtful design elements such as sensory gardens, calming colour schemes, clear signage and noise reduction can have a significant impact on reducing stress and improving the quality of life for individuals living with dementia. An environment tailored to their needs allows residents to feel more secure, confident and supported, ultimately contributing to their holistic care and overall happiness.

Conclusion

The success stories presented in these case studies illustrate the transformative impact of holistic dementia care. Whether through personalised, person-centred care in residential settings, the integration of technology and non-medical therapies, strong family and caregiver involvement in home care or thoughtful environmental modifications, each approach led to significantly better outcomes for individuals living with dementia. These holistic strategies helped reduce distressing behaviours, improve mood and cognitive engagement, improve emotional connections and support greater independence for those affected by the condition.

If care providers, families and healthcare professionals embrace these holistic approaches in dementia care, prioritise personalised care, involve loved ones in the caregiving process, utilise technology and creative therapies and create dementia-friendly environments, the overall quality of life for individuals with dementia can be greatly improved. Learning from these successful examples and continuously adapting care practices can lead to more compassionate and effective dementia care.

It is recommended that caregivers, care homes and healthcare professionals seek additional training in holistic care techniques. By expanding their knowledge and skills, they can offer more innovative and person-centred approaches that address not only the medical needs but also the emotional, social and psychological aspects of dementia. Exploring available resources, including workshops, support groups and online tools, will help enhance the quality of life for people living with dementia and provide better support to their families and caregivers. Adopting these holistic strategies will ultimately create a more empathetic, engaging and supportive care environment for those affected by this challenging condition.