Person-Centered Approaches to Dementia

When you are caring for someone with dementia it is important to promote person centered care and know how to support them the best way possible.

A person centred approach will help prevent behavioural and psychological symptoms of dementia. Person centred working is vital when planning, which is something that is ongoing when someone has dementia due to the constant changing nature of the condition.

When planning, the following person centred working strategies should always be employed:

• Valuing the relationship between planning and services.
• The importance of relationships and interactions between all involved.
• Identifying actions to be carried out.
• Resolving issues.
• Assessing the cost and use of resources.

The overriding aspect to all of these principles is that person centred planning should involve the individual and, where appropriate, their carers as much as they are possibly able to contribute. Any kind of care and support should be tailored and delivered in line with the individual’s preferences and wishes so that their perspective is respected and they are treated with care, empathy and dignity throughout the process.

What does a person centred working involve?

Overall, person centred working involves the following:

• Recognising individuality.
• Maximisation of independence.
• Enabling choice.
• Enabling social relationships.
• Valuing the individual.
• Providing the opportunity for stimulation.
• Empowerment.
• Inclusion.
• Looking at the person as a whole, i.e. seeing them in a holistic way and not just in terms of their condition.

A person centred approach to dementia

Person centred working is vital when planning, which is something that is ongoing when someone has dementia due to the constant changing nature of the condition.

When planning, the following person centred working strategies should always be employed:

• Valuing the relationship between planning and services.
• The importance of relationships and interactions between all involved.
• Identifying actions to be carried out.
• Resolving issues.
• Assessing the cost and use of resources.

The overriding aspect to all of these principles is that person centred planning should involve the individual and, where appropriate, their carers as much as they are possibly able to contribute. Any kind of care and support should be tailored and delivered in line with the individual’s preferences and wishes so that their perspective is respected and they are treated with care, empathy and dignity throughout the process.

What to keep in mind when caring for someone with dementia

In order to try and overcome as many of these barriers to communication as possible, The Alzheimer’s Society recommends that those people who provide care and support for someone with a form of dementia keep in mind the following:

Before speaking with someone:

• Ensure the environment is appropriate, for example not too loud or dark.
• Ensure the individual is fully paying attention.
• Sit to where the individual can clearly see you.
• Body language should be open and relaxed.
• Don’t start a conversation if it is going to be rushed.
• Speak to someone when they are most alert.
• Ensure that they don’t have any unmet needs before starting, i.e. check that they are not hungry or thirsty.

How to speak to someone with dementia

It is important to know how to best speak to someone with dementia and get the best response from them.

• Ensure that speech is clear and calm.
• Speak at a slower pace but not one that would insult or patronise the individual.
• Use short sentences.
• Don’t raise your voice.
• Try to keep a sense of humour when mistakes are made and laugh with the individual.
• Ensure the individual is included, where appropriate, in conversations with other people.

What should I say to someone living with dementia?

It is important to know what to say to someone living with dementia, this way they won’t get as confused or frustrated.

• Do not ask multiple questions one after the other.
• Stick to just one idea at a time.
• Make information manageable by breaking it down.
• Ask closed questions that can be answered with just ‘yes’ or ‘no’ when the individual is being asked to make a decision.
• Rephrase something rather than repeating it.
• Try not to contradict and correct someone who is confused about what is real and what isn’t such as happens in later stages of dementia.

How to listen to someone living with dementia

It is important to learn how to listen to someone with dementia, keeping close attention to their body language too.

• Listen carefully to every word and try to encourage someone to speak.
• If you can’t understand what the individual is saying, tell them what you think you have understood and gauge if this is correct by their body language.
• Enable the individual to have a lot of time to respond.
• Enable individuals to express their feelings.

Use of body language and physical contact with someone who has dementia:

• Learn what the individual is trying to say through their body language.
• Make sure your words and facial expressions match.
• Use physical contact to provide reassurance, such as holding the individual’s hand.
• Never stand too close to someone or stand over them if they are sitting.

The physical care needs for someone living with dementia

The physical care needs of the individual may be attended to by others who can help them to get in and out of bed, to shower and wash, go to the toilet and ensure that they are eating proper meals at appropriate times and taking any appropriate medication as well. It is sometimes found that individuals who have dementia and who are still living at home neglect aspects of their physical care, sometimes because they simply cannot remember what they need to do or how they need to do something.

Family members may find a rota system to be useful so that everyone knows who is helping, what they are helping with and when. For example, someone’s daughter may always come and help in the morning on her way to work, she helps the individual to get out of bed and to prepare their breakfast. Not only does this provide the reassurance that the individual is being monitored but it can help build family relationships as well because everyone is playing a part in the care of their loved one.