Dr Kailas Roberts is a consultant psychiatrist and psychogeriatrician with over ten years‘ experience in the field of old-age psychiatry. In this guest post, he provides some helpful advice for those providing care to people living with dementia.
Having dementia can create a number of challenges, both for the person with the condition, but also for their carer. In order to understand the optimal way of providing care, it is helpful to remember several things.
The first is that each person’s experience of dementia is unique. There is no one-size-fits-all template for care, and the emphasis should be on understanding the specific difficulties and needs that caring for a person may involve.
For example, some may have memory impairment as the only real concern, and they will understand at the moment what is being said to them. For others, their memory may be a lesser issue, but their ability to communicate their concerns or understand the words that are being spoken to them may be compromised. Knowing the relative cognitive strengths and weaknesses can make the caring process a lot easier.
Something else to consider is that needs change over time. This may mean from day to day, but also over the longer term as dementia progresses. A previously successful approach may no longer work, and it may be necessary to try something new. Being creative in your approach, and being willing to try out new strategies, is very helpful. The fact that the symptoms someone experiences as part of dementia do change can actually be helpful for coping as a carer – just because a person may be experiencing agitation, anxiety or even paranoia at one point in time does not mean it will last forever even though the cognitive abilities continue to decline.
It is also important to try to understand as much about the person for whom you are caring. All sorts of variables influence how someone lives life with dementia, including what life experiences they have had, and their underlying personality. Knowing this helps you tailor your approach to care.
If you know someone is by nature a quiet, retiring person, for instance, then putting them in a noisy communal area for a whole afternoon is likely to be distressing for them. A naturally sociable individual on the other hand may benefit from this level of stimulation. Likewise, if the person has experienced a lot of psychological trauma over the years, and been treated badly by others in their life, they may need a lot more reassurance that your provision of care is well-meaning. In my work, I often lament the lack of knowledge that professional carers have about the person they are caring for. Truly understanding the person can make a huge difference to how you approach them, and to their quality of life.
Communication is another key issue to get right. Patience is a must when interacting with someone with cognitive or language problems. The tone of voice used may be as important as what is being said, and much of how you feel as a carer is conveyed in your non-verbal behaviours – the way you hold yourself (crossing arms may seem defensive, quick movements may seem threatening) and your facial expression may govern how someone perceives you. A soft, gentle and reassuring tone with open body language is generally best unless there is an imminent risk of harm.
Lastly, a huge part of being an effective carer is managing your own stress and mental health. Caring for someone with dementia is associated with a higher risk of psychological and physical health problems. It’s critical you monitor how you are going and to talk to someone if you are feeling exhausted, frustrated, anxious or depressed. Ensure that you are covering the basics – try to keep physically active, prioritise your sleep and eat healthily: These things can make all the difference.