Communication and Interaction Archives - DementiaHub.SG https://www.dementiahub.sg/living-well-with-dementia/communication-and-interaction/ Singapore’s One-Stop Resource Portal on Dementia Wed, 26 Aug 2026 09:00:50 +0000 en-US hourly 1 https://www.dementiahub.sg/wp-content/uploads/2022/06/fav.png Communication and Interaction Archives - DementiaHub.SG https://www.dementiahub.sg/living-well-with-dementia/communication-and-interaction/ 32 32 PAL Series: Supporting Persons Living with Dementia at the Sensory and Reflex Levels https://www.dementiahub.sg/living-well-with-dementia/pal-series-supporting-persons-living-with-dementia-at-the-sensory-and-reflex-levels/ Mon, 11 May 2026 01:25:53 +0000 https://www.dementiahub.sg/?post_type=dementia&p=84587 This article shares the best way to support and engage with your loved one living at the Reflex and Sensory Level.

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In the final installation of the Pool Activity Level (PAL) Series, this article shares the best way to support and engage with your loved one living with dementia at the Sensory and Reflex Level using the Pool Activity Level (PAL) Tool. 

  1. Health Promotion Board. (n.d.). Let’s talk about Vascular Dementia. HealthHub. https://www.healthhub.sg/programmes/mindsg/vascular-dementia  
  2. Chiew, H. J. (2021, July 5). Young-onset dementia: Improving outcomes with early recognition at Primary Care. SingHealth. https://www.singhealth.com.sg/news/defining-med/Young-Onset-Dementia  
  3. Ng, Z. X., Yang, W. R. E., Seet, E., Koh, K. M., Teo, K. J., Low, S. W., Chou, N., Yeo, T. T., & Venketasubramanian, N. (2015). Cerebellar strokes: A clinical outcome review of 79 cases. Singapore Medical Journal, 56(03), 145–149. https://doi.org/10.11622/smedj.2014195  
  4. Ioannides K, Tadi P, Naqvi IA. Cerebellar Infarct. [Updated 2022 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470416/  
  5. Huang, J., Qiu, Z., Zhou, P., Li, J., Chen, Y., Huang, R., Li, C., Ouyang, X., Feng, H., Xu, H., Liu, D., Dai, Z., Zhu, J., Liu, X., Chen, H., & Jiang, Y. (2019). Topographic location of unisolated pontine infarction. BMC Neurology, 19(1), 1-6. https://doi.org/10.1186/s12883-019-1411-6  

What is the Sensory and Reflex Level

The Sensory and Reflex Levels represent the most advanced stages of dementia within the Pool Activity Level (PAL) framework. Although they share a focus on comfort, sensory engagement, and emotional connection, the two levels are distinct — your loved one’s abilities, awareness, and the kind of support they need will differ depending on their Level.  

At the Sensory Level, a person can still respond to simple one-step prompts, briefly explore objects with guidance, and show emotional engagement through facial expressions or sounds.
At the Reflex Level, voluntary movement is minimal, communication is largely reflexive (e.g. blinking, changes in breathing, grasping), and care is centered on comfort and presence rather than activity. 

Understanding which level your loved one is at helps you choose the right approach. Care at this level is centered around comfort, safety, sensory regulation, and emotional connection, rather than active participation. 

Use the cues below as a general guide: 

Area
Sensory Level
Reflex Level
Following Prompts
Responds to one-step prompts (“touch the scarf”)
Responds mainly through reflexes (blinking, grasping, breathing changes)
Eating / feeding
May still feed themselves with hand-over-hand or hand-under-hand support
Requires full assistance with feeding, positioning, and personal care
Communication
Uses single words or sounds to communicate
Communicates primarily through facial expressions or body tension

For a more accurate assessment, the PAL Checklist should be completed in consultation with a healthcare professional. 

How Caregivers can Support at the Sensory Level

The following shares how, as a caregiver, you can support your loved one at the Sensory Level: 

1. Use Repetitive, Sensory-Based Activities
  • Encourage activities that involve touch, sound, movement, and rhythm.  
  • Keep tasks simple, familiar, and hands-on. 
  • Example: feeling the texture of fabrics, rolling dough, or splashing water. 
2. Offer Demonstration and Hand-Over-Hand Support
  • Show what to do, do not just tell them what to do. 
  • Use hand-under-hand guidance if needed, then step back to let them explore. 
  • Example: Guiding their hands to paint or place a puzzle piece. 
3. Keep Activities Short and Structured
  • Provide clear starts and endings (e.g. “Let’s place these three blocks together”). 
  • Use one-step instructions, such as “Touch the ball,” “Feel the scarf”.
4. Use Positive Reinforcement and Emotional Connection
  • Smile, make eye contact, and offer gentle encouragement, such as ‘‘That looks Lovely’’, “Let’s try that again”. 
  • Respond warmly to emotional expressions like smiling and nodding. 
  • Avoid correcting the task and focus on their engagement in the activity not the outcome. 
5. Modify the Environment to Encourage Safe Exploration
  • Create a safe, clutter-free space, and stimulating space.
  • Offer objects they can explore safely like textured fabrics, large beads, tactile mats, and picture books. 
  • Remove hazardous items such as sharp scissors or knives, as they may not be able to distinguish safe materials from unsafe materials. 
6. Pace with Their Rhythm
  • Let them lead the pace, do not rush them during the activity. 
  • Watch for signs of boredom, fatigue, or distress, and gently shift the activity as needed. 
7.Use Familiar Objects with Emotional Meaning
  • Use objects from their past: a favourite scarf, a soft blanket, a familiar song. 
  • Even if they don’t “remember” cognitively, the emotional recognition may remain. 

How Caregivers can Support at the Reflex Level

The following shares how, as a caregiver, you can support your loved one at the Reflex Level: 

1. Prioritise Comfort and Dignity
  • Ensure proper positioning to avoid pain or pressure sores (e.g., adjust cushions, support limbs). 
  • Monitor for facial expressions or body language that may signal discomfort (e.g, scrunched noses, clenched fists, etc).  
  • Keep the environment calm, quiet, and non-threatening. Remove clutter from tables and ensure the environment is not close to traffic. 
2. Use Gentle, Multi-Sensory Stimulation
  • Offer soothing touch, such as hand-holding or gentle hand massage. 
  • Use pleasant scents (e.g., lavender, citrus) sparingly. 
  • Play soft, calming music or familiar voices nearby. 
  • Use soft lighting; avoid harsh or flickering lights. 
  • Gently brush hair, wipe face, or apply lotion using slow, rhythmic strokes. 
3. Engage Through Familiar Sensory Cues
  • Speak in a calm, warm, familiar tone, even if they do not respond. 
  • Use soothing sounds, such as gentle singing, humming, or rhythmic tapping to their favourite songs. 
  • Place familiar objects in their hands (e.g., a favourite blanket or picture). 
4. Create a Calming, Predictable Environment
  • Minimise background noise (TV, machinery, loud talking). 
  • Maintain a consistent care routine to reduce anxiety or overstimulation. 
  • Avoid sudden movements, like jerking or moving around quickly. 
5. Be Present Emotionally and Physically
  • Maintain eye contact and use facial expressions, such as smiling to convey care and safety. 
  • Spend more time engaging in touch and connection as they are more effective than words at this stage. 
6. Monitor for Reflexive Responses
  • Watch for eye movements, hand grasping, vocalisations, or changes in breathing as signs of response. 
  • Even small reactions are important indicators of connection or discomfort. 

Goal at the Sensory and Reflex Level: 

To ensure the individual feels safe, soothed, and connected through basic sensory experiences, even when they can no longer actively participate. 

Activities for PLWD at the Sensory and Reflex Level

At the Sensory and Reflex Level of the Pool Activity Level (PAL), persons living with dementia are unable to initiate or participate in goal-directed activities. 

The focus at this level should remain on comfort, emotional connection, and sensory stimulation. 

Activities for the Sensory Level

Activities for the Reflex Level

Tips: 

  • Go slow and observe for even the smallest responses (e.g. blinking, eye movement, sighing). 
  • Activities should be simple, soothing, and familiar. 
  • Always check in and stop or adjust the activity when your loved one shows signs of distress or withdrawal. 
  • Take note of mouthing risk when using items like playdough, beads, easy-peel stickers. 

Conclusion

As a caregiver remember that being present is enough. You do not always need to fill the moment with activities, conversation, or stimulation. Sitting quietly beside your loved one, holding their hand, offering comfort, or simply sharing space together are meaningful forms of connection and care. 

References

  1. Pool, J. (2012). The Pool Activity Level (PAL) Instrument for Occupational Profiling (4th ed.). Jessica Kingsley Publishers. 

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]]> Making a Change by Using Person-Centred Language and Imagery for Dementia https://www.dementiahub.sg/living-well-with-dementia/making-a-change-by-using-person-centred-language-and-imagery-for-dementia/ Fri, 31 Oct 2025 06:51:28 +0000 https://www.dementiahub.sg/?post_type=dementia&p=74349 Using the right language consistently when talking about dementia or people living with dementia can go a long way in combatting negative societal attitudes and creating a truly inclusive society.

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Using the right language consistently when talking about dementia or people living with dementia can go a long way in combatting negative societal attitudes and creating a truly inclusive society. Recognising this, Dementia Australia released a set of language guidelines in 2018. Since then, a growing number of organisations and social service agencies have advocated for the use of person-centred language when talking about people who live with dementia. However, perhaps due to insufficient public awareness or the inconvenience involved in using longer terms, adoption of person-centred language is still limited.

Why does using person-centred language matter?

Language use has a significant impact on not just the way others view or treat people living with dementia, but also how people living with dementia perceive themselves and their relation to others. Many terms used to describe dementia and people with a dementia diagnosis are based on outdated or inaccurate understanding of the disease.

Common stigmatising local terms associated with dementia

Language frames our understanding of dementia as a disease and its root causes. Frequently using terms that describe its causes incorrectly or ascribe blame creates bias, which also fuels stigma. Cultural stigma is a set of “negative beliefs, prejudices and discriminatory structures” shared by a society (Link et al., 2001). The perception of dementia as something that needs to be hidden affects a person’s willingness to seek diagnosis, which limits their access to care options and support. This is concerning because early diagnosis and treatment can greatly improve outcomes for dementia.

People living with dementia may internalise stigma about their condition, which affects their self-esteem and well-being. This can cause them to withdraw from social interaction, which worsens dementia progression. Instead, using person-centred language encourages agency for persons living with dementia to manage their condition.

Stigmatising imagery used in the portrayal of dementia

A large-scale thematic analysis of books, films, television programmes, social media, and news items, conducted in December 2017 and updated in January 2019, revealed several common themes in depictions of dementia that may perpetuate cultural stigma.

There is often an emphasis on the biomedical framing of the disease and brain deterioration, compared to a holistic view of how dementia changes the lived experience of the person. The address “person living with dementia” is preferable to “Alzheimer’s patient” because dementia is a long-term condition. It is more helpful to focus on living well with dementia after their diagnosis than focusing on their status as a patient, since there is currently no known cure for dementia.

Dementia is also often likened to a natural disaster or epidemic, using metaphors like “rising tide” and other apocalyptic terms. This enforces the view that dementia should be feared and that people living with dementia are passive victims of the condition, when in fact progression can be prevented with social interaction and cognitive engagement. The term “epidemic” also implies that dementia is contagious, which encourages misperception of dementia and avoidance of persons living with dementia.

This not only causes undue public fear of persons living with dementia, but it also ascribes blame to the person and undermines public awareness efforts of dementia prevention.

Other terms often used include “victims” or “sufferers”. These terms limit our view of people living with dementia to that of requiring pity or compassion, rather than being able to contribute meaningfully. Images used to depict dementia often portray persons with dementia as an ‘empty shell’ or as a disembodied set of hands, which dehumanises the person living with dementia and decreases emotional connection to them.

In a survey of persons living with mild dementia, 46% were reluctant to share their diagnosis because of concerns that they would be “talked about like they were not there” (Burgener and Buckwalter, 2018). When people do not understand dementia, they are more likely to exclude persons living with dementia from conversations and instead speak directly only to caregivers. Hence, we can expect that increasing public awareness will increase the inclusion of people living with dementia. 65% of visitors to the “People of Dementia” blog, which published personal stories of people living with dementia and how life was like for them before and after the diagnosis, agreed that they felt more comfortable interacting with persons living with dementia after reading the blog (Jamieson et al., 2017).

 

Terms to Avoid

Preferred Terms

Why this term needs to be avoided and changed

Orang gila (“crazy person” in Malay)

Orang yang menghidapi demensia

Dementia is not a form of psychosis, although some forms of dementia may cause people to experience hallucinations.

Demented

Living with dementia

Gone case

Changed behaviours

It implies that the person living with dementia is beyond help, when symptoms can actually be managed with care.

Menggila (“out of control” in Malay)

Expressing unmet needs

Behavioural symptoms can often result from an inability to express unmet needs.

unpredictable

siao (“acting crazy” in Mandarin)

Senile

Diagnosed with dementia

This term inaccurately implies that dementia is because of old age.

痴呆症

(a derogatory term use to describe dementia in Mandarin）

Dementia

This term implies that people living with dementia are unintelligent and absent-minded. Especially in the early stage of dementia, disorientation is an occasional state rather than a characteristic.

 

How do we use appropriate language when referring to persons living with dementia?

Language used about persons living with dementia should be clear, normal, jargon-free, inclusive, and centred on the person, not the disease. In addition, language can be made more dementia-inclusive by:

  • Using first-person language
  • Eliminating pejorative terms that have negative connotations
  • Choosing inclusive language – acknowledging someone’s circumstances, but avoiding disempowering narratives (e.g. uses a wheelchair vs. wheelchair-bound)
  • Avoiding labels
  • Avoid leading with social identifiers (e.g. race or language)
  • Avoiding language that attributes responsibility to persons for their condition
  • Avoiding verbs that undermine the person’s experience of the disease

(Adapted from Healy et al., 2022)

In the long term, using person-centred language instead of stigmatising language will correct public perception of dementia and reinforce that persons living with dementia should be treated with respect. This includes their inclusion in medical discussions, designing care treatment plans and programmes, and co-participation in research.

Being mindful of the words and imagery we use to talk about dementia and people with dementia, is one of the most important steps we can take as individuals to build a dementia-inclusive society.

Additional Resource

Dementia Language Guidebook 

Dementia Singapore and the Lien Foundation collaborated to produce a dementia language guidebook titled Changing Words, Touching Lives, which was inspired by Dementia Australia’s Dementia Language Guidelines. It lists the preferred words and phrases for describing dementia in Singapore’s context, as well as terms to avoid which are applicable in all situations. This ranges from casual conversation to publicity materials relating to dementia as a disease and persons living with dementia.

References

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]]> Understanding the Four Pillars of Humanitude https://www.dementiahub.sg/living-well-with-dementia/understanding-the-four-pillars-of-humanitude/ Sat, 07 Sep 2024 03:02:42 +0000 https://www.dementiahub.sg/?post_type=dementia&p=56679 Listen Min Read As dementia progresses, the needs of those living with the condition evolve, requiring caregivers to adapt and find new ways to

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As dementia progresses, the needs of those living with the condition evolve, requiring caregivers to adapt and find new ways to connect and support their loved ones. This journey can be challenging but also rewarding, as it offers an opportunity to enhance the quality of life through caregiving. The Humanitude methodology provides a structured approach, based on four key pillars—Gaze, Speech, Touch, and Verticality—to address these changing needs effectively.

This article will explore the four pillars of Humanitude and provide practical tips on incorporating these pillars into your caregiving practices.

What is Humanitude™?

Humanitude is a care methodology developed by Yves Gineste and Rosette Marescotti, specifically designed to improve the quality of life for persons living with dementia. It combines a philosophy of care with practical techniques that emphasize respect, empathy, and connection. The four pillars of Humanitude—Gaze, Speech, Touch, and Verticality—are central to this approach. Each pillar represents a fundamental aspect of human interaction, helping caregivers foster positive relationships and support the emotional and physical needs of those in their care.

Benefits of Humanitude

Scientific research and outcomes have highlighted several key benefits of Humanitude care for persons living with dementia, delirium, and cognitive impairments:

  • Improved ability to perform activities of daily living (ADL).
  • Greater participation in daily activities.
  • Enhanced physical movement and independence.
  • Overall improvement in well-being.
  • Decreased ill-being.

For caregivers working in healthcare, practicing Humanitude has been associated with:

  • Reduced burnout
  • Increased empathy
  • Improved attitudes

Applying the Four Pillars of Humanitude: Do's and Don'ts

1. Humanitude Gaze

Gaze is a fundamental non-verbal pillar of Humanitude, essential for building emotional connections. It stimulates oxytocin, the hormone associated with love and bonding. The Humanitude Gaze is characterised by being axial, long, near, and horizontal. However, it is important to personalise this technique to suit the individual needs and preferences of each person. 

Do's

  • Horizontal: Establish eye contact at the same eye level as the person
  • Front: Approach the person from where they are looking
  • Long: Maintain eye contact for a longer duration
  • Near: Stay close, ideally within 25 cm

Don'ts

  • Vertical: Avoid looking down from above. 
  • Sideways: Refrain from glancing sideways, as it can be perceived as disinterest. 
  • Brief: Don’t make eye contact fleeting.
  • Distant: Avoid looking from more than an arm’s length away.
2. Humanitude Speech

Speech is a vital pillar of Humanitude, marked by a low, soothing tone, calm melodic intonation, and positive reinforcement. These elements work together to create a reassuring and validating environment, making interactions more comforting and supportive. 

Do's

  • Low Tone: Use a low tone of voice
  • Melodic Intonation: Speak with a gentle, rhythmic tone
  • Calm and Soothing Delivery: Keep your speech slow and composed. 
  • Positive Reinforcement: Use encouraging language

Don'ts

  • Harsh or Loud Tone: Avoid raising your voice or using a harsh tone
  • Dismissive Phrases: Refrain from using short, dismissive phrases like “what!”
  • Negative Words: Avoid negative language, such as criticising someone for being “slow”.
3. Humanitude Touch

Touch is a non-verbal method to communicate care and comfort, described in Humanitude with characteristics such as wide, soft, slow, frequent, caressing, and embracing. 

Do's

  • Wide: Use a relaxed, open palm to make contact, slightly wide apart, creating a feeling of warmth and embrace. 
  • Soft: Touch should feel like caressing a baby—gentle and reassuring. 
  • Slow: Move your hand slowly to convey patience and care, akin to pacifying a baby.
  • Start on Accepted Areas: Begin with socially accepted areas like the hands, shoulders, or forearms.

Don'ts

  • Claw: Avoid gripping with fingers
  • Fast: Don’t rush your touch; quick movements can be startling. 
  • Small Surface: Avoid using only fingertips or pointy surfaces, which can feel sharp or uncomfortable. 
  • Scarce: Don’t shy away from or avoid touch; consistent, gentle contact is important. 
4. Verticality

Verticality is a key pillar of Humanitude, vital for maintaining a person’s self-esteem and physical health. Since we naturally walk on two feet, staying upright helps foster a sense of confidence, health, and freedom. It reduces bedridden rates and promotes overall wellbeing. 

Do's

  • Upright Care: Whenever possible, provide care while the person is standing or sitting up, rather than lying down. 
  • Encourage Movement: Aim for the person to stand or walk for at least 20 minutes a day, even if in short sessions.

Don'ts

  • Avoid Unnecessary Lying Down: Refrain from providing care while the person is lying down if they can sit up or stand with assistance.

To see these principles in action, watch the video below.

The Four Pillars of Humanitude: Gaze, Speech, Touch and Verticality
Source: Humanitude Singapore

Watch Rosette Marescotti guide a caregiver in using Humanitude techniques to encourage a woman living with dementia to go for a walk. This video showcases the transformative impact of the four pillars.

Watch video

Conclusion ​​

Humanitude provides a structured approach to dementia care in Singapore, ensuring that caregivers are equipped with the tools and knowledge to create these meaningful connections. The four pillars of Humanitude can significantly enhance caregiving experiences for both yourself and the person in your care. These techniques are not just about providing care; they are about creating moments of connection, understanding, and compassion. 

In your journey as a caregiver, remember that every interaction is an opportunity to affirm the dignity and humanity of your loved one living with dementia. With the right approach, you can turn challenges into opportunities for connection and growth, ensuring that your loved one feels valued and supported at every stage of their journey.

To learn more about Humanitude™, visit the Humanitude™ Singapore website to explore a variety of resources, including videos and insights into Humanitude care. If you are a healthcare professional, you may consider signing up for the Humanitude™ Care Action-Training course to discover a relationship-centred approach to caring for persons living with dementia. For caregivers, you may consider signing up for the Humanitude™ Caregivers Training courses.   

AUTHOR BIO

HUMANITUDE SINGAPORE

Humanitude Singapore is part of Humanitude International Network of providers for training programmes on Humanitude Care Methodology. Since 2019, Humanitude Singapore has been providing Humanitude training for a thousand of healthcare professionals in Singapore, from various care settings, including acute hospitals, community hospitals, nursing homes and day care centres. Through various collaborations in the healthcare communities, Humanitude Singapore has become a trusted partner with a shared vision of enhancing the well-being of caregivers and vulnerable care recipients, including persons living with dementia.

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]]> Tips for Communicating with Persons Living with Dementia https://www.dementiahub.sg/living-well-with-dementia/tips-for-communicating-with-persons-living-with-dementia/ Mon, 24 Oct 2022 12:04:53 +0000 https://www.dementiahub.sg/?post_type=dementia&p=15383 As the condition of a person living with dementia progresses, the way in which others communicate and interact with them should also change in order to tailor the interaction to their needs, and to make the most of each conversation or interaction.

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How Communication Can Be Affected at Different Stages of Dementia

As the condition of a person living with dementia progresses, the way in which others communicate and interact with them should also change in order to tailor the interaction to their needs, and to make the most of each conversation or interaction.

Early Stage

The person living with dementia

⇒ Is able to follow and maintain meaningful conversations with difficulty in articulating certain words

⇒ May display some difficulties in giving/receiving instructions and understanding difficult ideas

⇒ May ask questions to confirm information frequently or repeat conversations

⇒ Able to communicate in brief social interactions with difficulty functioning in prolonged social settings

⇒ Difficulty with following lengthy conversations

⇒ May follow what is said, but forget it after a brief period

⇒ Jokes and sarcastic remarks can be confusing, and may provoke sensitive feelings towards context

⇒ May feel overwhelmed by excessive stimulation

Moderate Stage

The person living with dementia

⇒ May be able to follow simple one-step instructions

⇒ May start to show more difficulty in following and maintaining conversations

⇒ May understand written information in a word-by-word process

⇒ May have decreased use of words for conversations

⇒ May repeatedly ask questions

⇒ May withdraw from the interaction if interaction is demanding

⇒ May experience personality and behavioural changes; E.g. suspiciousness and delusions which may hinder meaningful conversations

Advanced Stage

The person living with dementia

⇒ May not be able to articulate meaningful statements

⇒ May start to repeat after the person in the conversation

⇒ May experience difficulty with verbal communication as ability to recall vocabulary may be reduced

⇒ May not be able to understand simple words being spoken to them

⇒ May express themselves verbally in patches or strings of words and sounds

⇒ Conversations may be disconnected

⇒ May not be aware of conversations directed to them, and may not be able to talk with others at all

⇒ May rely more heavily on visual cues, context, tone of voice, and touch to understand what others are communicating to them; use of non-verbal communication methods is recommended

⇒ May lapse into a familiar language used in their native country or their mother tongue

Adapted from: Communication Skills with Persons with Dementia by Khoo Teck Puat Hospital and Living with Dementia: A Resource Kit for Caregivers (Providing Care) by Agency for Integrated Care

How to Communicate With Persons Living With Dementia

For Caregivers

Interacting with the CARE approach

Source: Dementia-Friendly Singapore Initiative

Speaking with persons living with dementia

This video provides some suggestions on how caregivers can speak with persons living with dementia.

Source: ForgetUsNot Project by LIEN Foundation

Caregiving in public spaces

A caregiver’s sharing of a past experience where she and her mother, who lives with dementia, were interacting with members of the public.

Source: ForgetUsNot Project by LIEN Foundation

General Tips for Interaction With Persons Living With Dementia

As the condition of a person living with dementia progresses, the way in which others communicate and interact with them should also change in order to tailor the interaction to their needs, and to make the most of each conversation or interaction.

1. Do not test the memory of persons living with dementia by asking them what they did recently.

Because of the disease, they are not able to remember many things. You will frustrate them by asking, “Don’t you remember?” Use memory aids like diaries, clocks or calendars to help them know what they have done and will be doing later.

2. Simplify activities and communication.

Break an activity down into simple, step-by-step tasks. The person will be able to focus on one step at a time and complete the activity. Keep sentences short and simple.

3. Offer reassurance and praise.

This will increase the person’s self-esteem and reinforce positive behaviour.

4. Do not argue with the person living with dementia.

What they see, hear or recall may not be the same as what you saw, heard or know.

5. Identify and remove triggers to unhelpful behaviour.

For example, if the person wants to go out of the house each time he sees shoes by the door, keep the shoes out of sight.

6. Identify underlying reasons for behaviour changes.

Try to establish if they have any underlying needs that they cannot express. For example, they could be showing these behaviour changes because they feel too warm or tired. They might also need a drink or use the toilet. If they seem uncomfortable, it could be a medical problem.

7. Keep up with social activities.

Most persons with dementia would benefit from physical or social activities regardless of the severity of their condition. Social activities ensure that they remain in contact with other people and offer a sense of well-being. Those at mild to moderate stages of dementia would enjoy being with family and friends in small gatherings as they would still be able to converse. 

Recreational activities such as card games or hobbies could be enjoyable to them too. However, persons at a more advanced stage of dementia would more likely prefer a one-to-one interaction as they would need more visual and verbal cues.

8. Enjoy safe, outdoor activities.

Care needs to be taken to prevent falls when the person with dementia is walking in public spaces — steps, stairs, roads and crowded shopping malls — especially if they have osteoarthritis, heart problems or had a stroke previously.

Public spaces where there are even footpaths and seats available for rest would be ideal for them to visit. Some activities they could participate in include visits to neighbourhood parks and community gardens, tai chi/qigong with a community group, or the Memories Cafe or the Family of Wisdom programme organised by Dementia Singapore.

Adapted from: HealthHub.sg

Tips for Conversations With Persons Living With Dementia

Face to face interaction

Approach the person from the front.

Attract the person’s attention.

Maintain eye contact.

Tone and volume of voice

Speak slowly and clearly. 

Use a tone of voice that is gentle, calm, and reassuring.

Use positive and good-natured humour to lighten the mood.

Avoid using at a higher pitch and loud voice.

If the person living with dementia has hearing difficulties, consider encouraging them to use hearing aids, and use pictures/diagrams to help facilitate the conversation.

Conversation topics and activities

If you are having a chat with a person living with dementia, these are some suggestions for what you can do:

Talk about shared experiences: You can recount your experience about a certain event or memory. This may trigger memories in the person living with dementia.

Look at photographs together: You can look at photos from books and newspapers to get a conversation going.

Look at memorable items together: If the person living with dementia has items that are especially precious to them, you can look at them and talk about them.

Read together: If the person is able to read, you can ask them whether they would like to read a favourite book of theirs. You can also read their books to them and share your thoughts about them.

Listen to music together: You can play popular music or music that is special to them from an earlier period in their life, and talk about this music with them, mentioning the names of the musicians and the pieces of music. You can also sing or move to the music together.

Phrasing of sentences

Keep sentences simple, short, and direct. 

Avoid lengthy conversations that require complex thinking. Break down tasks with clear, step-by-step instructions.

Use simple words that the person living with dementia can understand.

Ask questions one at a time as multiple questions can be overwhelming.

Ask close-ended questions answerable with a “yes” or “no.”

Ask, “Would you like some coffee?”

Avoid asking, “What would you like to drink?”

When providing the person choices, limit the number of choices to two.

Be patient

Allow the person living with dementia adequate time to respond. Do not interrupt or finish sentences unless they ask for help to complete a sentence.

If they do not respond, repeat yourself in a gentle, calm, and reassuring manner.

Take time to listen to what the person living with dementia feels, thinks, or needs.

Be supportive

Offering comfort and reassurance can encourage them to share their thoughts to you.

Sometimes, the emotions expressed are more important than what they say. Look for the intentions behind words or sounds. Observe their body language.

It is okay if you do not know what to do or say; your presence is the most important indication of support to the person living with dementia.

Treat the person living with dementia with dignity and respect

Avoid talking down or facing away as if they are not there.

Keep eye contact as much as possible and acknowledge your understanding of their expression and words.

Do not exclude them from conversations with others.

Adapted from: Communication Skills with Persons with Dementia by Khoo Teck Puat Hospital and Living with Dementia: A Resource Kit for Caregivers (Providing Care) by Agency for Integrated Care

Communicating with Persons Living with Dementia in End-of-Life Stages

Tips for interaction

⇒ Maintain eye contact as much as possible with the person living with dementia.

⇒ Talk about things of interest to them or reminisce about things from the past, even if you do not think they can follow what you are saying. They may respond to the tone of your voice and feel a level of connection with you even if they may not understand what you are saying.

⇒ Use appropriate physical contact such as holding hands or a hug to reassure them that you are there for them.

⇒ Take your time and look for non-verbal signals.

⇒ Non-verbal communication – gestures, body language, facial expression and touch – can help facilitate communication.

Visiting Relatives and Friends Who Live With Dementia

Understand Dementia

Understanding how dementia develops will allow you to better understand what your loved one is going through. It will help you to understand some of the behaviours or feelings your loved one is experiencing.

Always Introduce Yourself

Greet your loved one by introducing your name and how you are connected to them. Sometimes your loved one may have forgotten, and they may develop anxiety from trying to recall who you are.

Make the Visit Fun!

Make the visit fun by taking something with you: an old photo, a memento from a past trip together, or an item from olden days. Reading from a magazine or newspaper also helps to engage your loved one and gives both of you something to do together. Use music to lift your loved one’s mood. Music can create an atmosphere of relaxation or fun whether it is played from a CD or on an instrument. It can help your loved one recall past memories, or simply to have a good time!

Acknowledge Your Loved One’s Feelings

Have an open mind and be flexible: Your visit may not go according to how you have planned, but that is all right. Have an open mind on how your visit with your loved one goes, adapting to your loved one’s energy levels, mood, etc. Dementia can cause your loved one to experience feelings of anxiety, anger and agitation. Acknowledge how your loved one feels to provide some assurance.

Adapt Your Communication Style

Explore other methods of communication other than talking. Hold your loved one’s hand, give him/her a hug, a shoulder rub or hand massage to complement or replace conversation. 

Communicate clearly by asking closed ended questions instead of open ended questions. Listen patiently and allow him/her time to respond. With dementia, your loved one’s ability to express himself/herself may be affected. Try not to finish his or her sentence. Instead, listen patiently as he/she speaks and searches for the right words.

Keep in Touch

Often, it is assumed that with memory loss, interaction with loved ones and friends holds little or no purpose. However, offering your loved one your time and presence helps to sustain their emotional wellbeing! Be comfortable with silence as it is not a bad thing. Savour each other’s presence and your time with each other.

The following short film contains a skit with examples of how members of the public should not interact with a person living with dementia who appears to be lost in public.

How Not to Interact With Persons Living With Dementia

The following short film contains a skit with examples of how members of the public should not interact with a person living with dementia who appears to be lost in public.

Source: Health Promotion Board

The following video contains negative examples of how members of the public interact with a person who appears to have dementia and is lost when in different settings. It also provides alternative examples of how members of the public can help in the same situations by recognising the ABCDs of Dementia Progression

Source: Dementia-Friendly Singapore

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1. Communicating with someone with dementia

References
  1. Khoo Teck Puat Hospital. (2010). Communication Skills with Persons with Dementia. Retrieved November 21, 2019.
  2. Health Promotion Board (n.d.). How to Communicate With a Loved One With Dementia. HealthHub.sg. Retrieved May 3, 2021, from https://www.healthhub.sg/live-healthy/994/how-to-communicate-with-a-loved-one-with-dementia
  3. Agency for Integrated Care. (2018). Living with Dementia – A Resource Kit for Caregivers, Providing Care. https://www.aic.sg/resources/Documents/Brochures/Mental%20Health/4%20Books/Book%203%20-%20PROVIDING%20CARE.pdf
  4. Agency for Integrated Care. (2018). Living with Dementia – A Resource Kit for Caregivers, Planning Care. https://www.aic.sg/resources/Documents/Brochures/Mental%20Health/4%20Books/Book%202%20-%20PLANNING%20CARE.pdf

The post Tips for Communicating with Persons Living with Dementia appeared first on DementiaHub.SG.

]]> Applying the K.I.N.D Gesture & C.A.R.E Approach https://www.dementiahub.sg/living-well-with-dementia/applying-the-k-i-n-d-gesture-c-a-r-e-approach/ Mon, 10 Oct 2022 07:23:31 +0000 https://www.dementiahub.sg/?post_type=dementia&p=8816 We may encounter persons living with dementia in different situations depending on our social or work roles. Watch this prize-winning video produced by Vinn Bay and Tee Boon Leng as part of the Alzheimer’s Disease International (ADI) conference in March 2009. As you watch, take note of how some members of the public interact with the person living with dementia who is lost in her neighbourhood, and how she feels because of these interactions.

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We may encounter persons living with dementia in different situations depending on our social or work roles.

Watch this prize-winning video produced by Vinn Bay and Tee Boon Leng as part of the Alzheimer’s Disease International (ADI) conference in March 2009. As you watch, take note of how some members of the public interact with the person living with dementia who is lost in her neighbourhood, and how she feels because of these interactions.

Source: Health Promotion Board

Here are resources on how to apply the K.I.N.D Gesture and C.A.R.E Approach if you meet them in some scenarios listed below.

Though some of these resources are made for persons in specific social roles such as caregivers or service staff, they are also useful videos for the general public to watch since they may be similar to other scenarios encountered by anyone.

Understanding how people interact with persons living with dementia in different capacities also allows us to understand how we as a community can work together to build a more inclusive community.

In Retail & F&B Settings

Retail Settings

This video shows how the K.I.N.D Gesture and C.A.R.E Approach of interacting with persons living with dementia can be applied in retail settings.

These are some scenarios where retail staff may encounter persons living with dementia:

Scenario 1: Someone has difficulty handling money at the point of purchase

What to do

Approach them in a friendly manner

Offer your help

If they are paying by cash, offer to help them count the right amount.

If they are paying by a card or mobile application that requires a Personal Identification Number (PIN) which they may have forgotten, politely suggest that they pay by cash instead.

You can also offer to keep their items first so they can return to purchase them when they have enough cash or recalled their PIN. 

What not to do

Rush the person during payment.

Show signs of annoyance or impatience with gestures, facial expressions, or voice, such as folding arms, frowning, or raising your voice. 

Scenario 2: Someone has forgotten to pay for their items before exiting the store

What to do

Approach them with a smile.

Ask politely if they may have forgotten to make a payment for the item.

If they are unable to pay, help to contact their family members for assistance.

Alternatively, retain the item and let them go.

Maintain a calm and polite demeanour. 

What not to do

Raise your voice at them.

Scold and accuse them of stealing as this will cause them distress. 

Scenario 3: Someone looks confused and unsure of the items which they wish to buy

What to do

Approach in a friendly manner

Assist them to identify the items by using visual cues such as the store’s specials and advertisements as appropriate.

If the store stocks the item, bring them to the specific area at which it is displayed.

If the item is not available in store, let them know that it is not available.

Suggest alternative products if appropriate.

 

What not to do

Ignore or brush them off.

Ridicule or embarrass them. 

Scenario 4: Someone repeatedly purchases the same item(s) within a short span of time (e.g. a few times on the same day)

What to do

Politely remind them that they have bought the same items before.

If they realise that they do not need the items, help them return the items to the shelves.

If this is a recurrent issue (e.g., if the person comes back over many days), politely request for their family members’ contact details to inform them.

Note: Only request for them, with their consent, to present you with any identification that they may have. Do not physically search them without their consent. 

What not to do

Question them about why they are buying the same items repeatedly.

Attempt to correct them if they insist they had not made those purchases. 

Food & Beverage (F&B) Settings

This video shows how the K.I.N.D Gesture and C.A.R.E Approach of interacting with persons living with dementia can be applied in F&B settings.

Source: Dementia-Friendly Singapore Initiative

These are some scenarios where F&B staff may encounter persons living with dementia:

Scenario 1: Someone requests for an item that is not on the menu

What to do

Explain that the item is not available.

Show them the menu again and offer options that are similar to their requests.

It could be helpful to write the order down on paper to verify the order with them.

If the customer looks unable to decide or is confused, offer a seat where they can wait and calm down and take some time to decide. 

What not to do

Show signs of impatience such as folding arms, raising your voice, or frowning when taking orders. 

Scenario 2: Someone claims that their order is wrong when it is being correctly served to them

What to do

Politely show them a record of the order, such as the order chit.

What not to do

Show signs of impatience such as folding arms, raising your voice, or frowning when taking orders. 

Scenario 3: Someone has trouble articulating or deciding their orders

What to do

Let them take their time.

Show them that you have their full attention by listening attentively, e.g. by repeating their order back to them.

You may try to assist if they have problems finding the right words for their orders.

You can cue them by using the menu and have them point to the item. 

What not to do

Rush them to order their food.

Show annoyance, impatience, or a condescending attitude. 

Public & Private Transport Settings

These are some scenarios where staff working in transport settings may encounter persons living with dementia:

Scenario 1: Someone gives an address that does not exist

Scenario 2: Someone does not disembark at the terminal or looks disorientated

What to do

Stay calm and patient.

Ask the person where they would like to go, and if possible, ask them to describe their destination.

If the address they provide does not exist, inform them politely.

If the address they provide is valid, guide them to the appropriate train/bus/taxi service. You may try to work with your transport teams to guide the person living with dementia safely back home, especially if the person’s route may involve multiple instructions and require coordination between personnel at different stations.

If they are unable to decide and look confused, offer help by asking them for the contact details of their family members.

If their address is available, offer to bring them home.

If no address can be found, stay calm and contact the police for help.

Note that you may only request for them to present you with any identification they may have. Do not physically search them without their consent. 

What not to do

Ask them to get off the vehicle.

Leave them on their own without helping them.

Show annoyance or impatience such as frowning or raising your voice. 

Scenario 3: Someone has insufficient balance on their fare cards and are confused about what to do

What to do

Bus captains may suggest that they pay by cash and help them to count the correct fare.

MRT station staff may direct them to the top-up machines and guide them.

If the person is not carrying money or fare cards, contact the nearest passenger service. centre/interchange for help.

Request for the person’s identification (e.g. I.C., EZ-Link card, NCSS card, or other cards) to contact their family members and get help.

If no one is available, remain calm and contact the police. 

What not to do

Rush the person to pay up.

Show annoyance or impatience such as frowning or raising your voice. 

Scenario 4: Eating and drinking on public transport

What to do

Politely show them the relevant signs in the bus or train for them to better understand what you are trying to tell them.

Politely remind them that they are on public transport.

If they continue to eat or drink, ask for help from HQ or supervisors. 

What not to do

Scold them or confiscate their food and/or drink.

Ask them to get off the vehicle and leave them on their own without helping them. 

For Bus Operators

This video shows how bus operators can interact with persons living with dementia.

Source: Dementia-Friendly Singapore Initiative

For Train Operators

This video shows how train operators can interact with persons living with dementia.

Source: Dementia-Friendly Singapore Initiative

For Private-Hire Vehicle Operators

This video shows how private-hire vehicle operators can interact with persons living with dementia.

Source: Dementia-Friendly Singapore Initiative

Bank Settings

These are some scenarios where staff working in bank settings may encounter persons living with dementia:

Scenario 1: The person forgets their Personal Identification Number (PIN) and/or signature

What to do

If the person forgets their PIN, politely ask if they would like to sign instead.

If they are unable to sign (as per bank records) or appear confused, request for their family members’ contact details or search the bank’s records to inform the family and request for their help.

Allow the person time to enter their PIN or sign. 

What not to do

Rush them to make a decision.

Show annoyance or impatience such as frowning or raising your voice. 

Scenario 2: Someone has trouble articulating their requests

What to do

Let the person take their time to think.

Politely ask if they would like to make a deposit, withdrawal, or a transfer.

Ask for their identification document, and check their transaction history to be able to guide them.

Use bank pamphlets as a way to cue them and find out about their requests. 

What not to do

Rush the person while they try to articulate their request.

Show annoyance or impatience such as frowning or raising your voice. 

Scenario 3: Someone comes in repeatedly within a short span of time (e.g. a few days) to withdraw substantial amounts of money

What to do

Politely inform them that they have made similar withdrawals earlier.

If they cannot recall having done so, show them their transaction records.

If necessary, consider showing them the CCTV footage of their recent visits. 

What not to do

Create the impression that they are being stopped from withdrawing money.

Attempt to correct them if they insist that they had not visited the bank earlier. 

Scenario 4: Someone mistakes the bank for another bank, or one that they used to go to in the past

What to do

Politely inform the person of your bank’s name and provide directions to their bank.

In the event that the bank is unfamiliar or is no longer in existence, bring them to a quiet area and contact their family members for help.

Ask for help from a supervisor if needed. 

What not to do

Brush the person off or ignore them.

Ridicule the person. 

Places of Worship

These are some scenarios where people in places of worship may encounter persons living with dementia:

Scenario 1: Someone performs prayers or rituals incorrectly or repeatedly

Scenario 2: Someone repeatedly visits places of worship or loiters around the premises looking lost

What to do

Start a casual conversation to find out whether they stay nearby.

If necessary, assist by bringing them back and make a note of this to the full-time staff in case this happens again.

If you notice that they continue to appear distressed or disorientated, try to find out the contact details of their family members and offer help.

You may need to contact the police if family members cannot be contacted.

Note that you may only request for their identification; do not physically search them without their consent. 

What not to do

Attempt to correct them even if they have performed the rituals wrongly.

Make them feel that they are not welcome.

Question their rationale for coming to the place of worship. 

One Day of Navigating Community Spaces as a Person Living With Dementia

Persons living with dementia participate in community spaces just as other community members do.

The following video shows an example of how one such person may navigate community spaces while living with their condition. It shows both positive and negative examples of how others may respond after recognising the ABCDs of Dementia Progression.

As you watch the video, place yourself in the shoes of the community members encountering this person living with dementia, and see the differences simple actions can make to these persons living with dementia.

Source: Dementia-Friendly Singapore Initiative

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]]> Making Festive Celebrations Dementia-Friendly https://www.dementiahub.sg/living-well-with-dementia/making-festive-celebrations-dementia-friendly/ Wed, 19 Oct 2022 10:30:44 +0000 https://www.dementiahub.sg/?post_type=dementia&p=13033 Festivities are typically a time for joy and celebration across all cultures. However, it might present as a stressful time for both caregivers and persons with dementia due to a disruption in their usual routine. Here are some practical tips on how you can make the time an enjoyable one for all family members.

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Festivities are typically a time for joy and celebration across all cultures. However, it might present as a stressful time for both caregivers and persons with dementia due to a disruption in their usual routine.

Here are some practical tips on how you can make the time an enjoyable one for all family members:

1. Consider the food

Food is often a highlight in family get-togethers. Ensure that the food being served can also be savoured by your loved one. Try to serve bite-sized finger food, or soft foods for those with difficulty swallowing.

2. Planning the day

Try to keep to your loved one’s usual routine as much as possible. Schedule in some rest time for your loved one if an entire day of bustle might be overwhelming. Stagger the timings for visiting if you have many relatives coming as it might be overwhelming for your loved one.

3. Preparing for the festivities

What are the usual routines you do with your loved one during the festivities? Try to involve them with simple activities, such as rolling the dough when baking festive goodies, or folding paper decorations. The preparation process can also help to orientate your loved one and get them excited for the upcoming celebrations.

4. Communicate with your relatives

Invite your relatives to spend some one-on-one time with your loved one with dementia. It is usually helpful to inform them how best to communicate with your loved one. For example, if your loved one is hearing impaired, inform others to speak with a low tone voice, or use a pocket talker, instead of shouting.

5. Prepare some reminiscence materials

Get your relatives involved by putting together a scrapbook with old photos and mementos from the past. You may also choose to listen to some festive music, especially ones that your loved one and the rest of your family like to play aloud during celebrations. This will serve as a conversation starter between your relatives and your loved ones with dementia.

6. Enjoy the festivities too!

Get a relative to help out with your caregiving duties so that you will have some time off for yourself to enjoy the festivities and celebrations too. In instances of stress and exhaustion, remember to partake in some self-care practices such as mindful breathing.

While these tips are generally helpful, it is important to recognise that each person living with dementia and their family is different. This means that some families may prioritise certain tips over others to better cater to the specific needs and preferences of their loved one living with dementia.

Here is an example of how a caregiver in Singapore has made festive celebrations more dementia-inclusive for her loved one living with dementia:

Mr Teng & Jacqueline's story

Jacqueline is the primary caregiver to her father, Mr Teng, who was diagnosed with Alzheimer’s disease in 2021. A retiree in the mild stage of his dementia, Mr Teng lives rather independently and spends his time reading the papers, going on long walks, and attending weekly activity programmes organised by the Meeting Centre near his home. However, like many others with mild dementia, he has trouble initiating activities, handling his finances, and remembering people’s names and faces.

When planning their Chinese New Year celebration, Jacqueline takes into consideration Mr Teng’s daily routine, strengths as well as weaknesses to eliminate any stress or anxiety leading up to and during the festivities.

Preparing for the festivities

Jacqueline makes sure to involve Mr Teng in activities like carrying some of the bags when they go grocery shopping, spring cleaning and choosing Chinese New Year snacks. When it comes to cleaning, she puts him in charge of wiping the surfaces with wet wipes. She also works with him to declutter the home by asking him if he would like to get rid of certain things he has not used in a while and respects his decision if he says he wants to keep them.

Nearing Chinese New Year, she also brings Mr Teng to Chinatown to soak in the atmosphere and engages him in conversation about what Chinatown used to be like back in the day.

Planning the day

When planning out the two-day public holiday, Jacqueline tends to schedule house visits (of not more than 3 houses) on the first day and a full day of rest on the second day. As Mr Teng likes to take 2-hour long walks every day, she is confident that he has the stamina to move around from one house to the other with no problem.

At these houses, she makes sure to involve Mr Teng in the tradition of giving out ang bao. When it comes to food, Jacqueline tends to leave him to it as he is rather health conscious himself and will not stop him from indulging on a few pieces of duck when he wants to. However, she does remind him to have his meals at his regular mealtimes if he has forgotten to do so.

Getting the relatives involved

Jacqueline also regularly updates their relatives about Mr Teng’s condition, which means that other family members are knowledgeable of his needs and will keep a look out for him on behalf of Jacqueline. For instance, they will check-in with him every now and then, are understanding when he repeats himself in conversations and do not get offended when he is unable to remember who they are.

Sharing the caregiving responsibilities with her family members, though temporarily, allows Jacqueline to relax and enjoy the festivities for herself as well. Additionally, both Mr Teng and herself are able to rest and recuperate from a long day of house visiting on the second day.

This careful and intentional planning for their Chinese New Year celebration has also proven to be meaningful for Mr Teng. He had informed Jacqueline at the end of the day that he feels so lucky that his family still remembers him, invites him over for celebrations and are extremely warm and caring towards him.

Mr Teng and Jacqueline’s story truly illustrates that is not only important, but extremely worthwhile, to make festivities more dementia-inclusive for your loved one living with dementia.

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1. Sharing Caregiving Responsibilities: Gathering the Family
2. Tips for Communicating with Persons Living with Dementia
3. Designing a Daily Routine

The post Making Festive Celebrations Dementia-Friendly appeared first on DementiaHub.SG.

]]> K.I.N.D. Gesture and C.A.R.E. Approach https://www.dementiahub.sg/living-well-with-dementia/kind-gesture-and-care-approach/ Mon, 17 Oct 2022 19:12:35 +0000 https://www.dementiahub.sg/?post_type=dementia&p=12047 There are many scenarios where persons living with dementia may face difficulties and require assistance. The K.I.N.D Gesture and C.A.R.E Approach can help us to remember what to do and be more confident when interacting and assisting persons living with dementia, especially in situations where they may appear to be lost.

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There are many scenarios where persons living with dementia may face difficulties and require assistance.

The K.I.N.D Gesture and C.A.R.E Approach can help us to remember what to do and be more confident when interacting and assisting persons living with dementia, especially in situations where they may appear to be lost. 

The K.I.N.D Gesture

When you come across someone who is alone and appears anxious, be K.I.N.D

K

Keep a lookout for people who show the ABCD signs of dementia. They may also appear unkempt, and/or ask for food or money. The ABCD signs of dementia are:

  • Activities of daily living: Difficulty performing daily activities or tasks such as cooking or dressing.
  • Behaviour: May be socially withdrawn, more easily upset and frustrated.
  • Cognition: Difficulty remembering things, problems with language and performing calculations.
  • Disorientation: The person may lose his/her way in less familiar places, have poor orientation of day, date, and/or time.

I

Interact with patience.

  • Ask one question at a time, for e.g., “Can I help?”. Be patient when waiting for a response.
  • Talk and communicate slowly.
  • Jog their memory by giving them the names of the nearby landmarks or the name of the current location.

N

Notice their needs and offer help.

  • Bring them to a place to sit and rest. You may also offer a drink or some food.
  • Ask for the next-of-kin’s whereabouts or contact number, or if they can recall their home telephone number.
  • Check if they have some form of identification or look for an identification sticker with next-of-kin’s details e.g. EZ-link Card.

The identification sticker may look like this:

D

Dial for help.

  • Call the next-of-kin.
  • Alert security if found lost in buildings.
  • Bring the person to the nearest Go-To Point that can provide assistance.
  • Please call the police at 999 as the last resort.
  • Continue to chat with them to provide reassurance until help arrives.

Prominent Person-Centred Dementia Care Approaches

It is important that you communicate with C.A.R.E to someone who may have dementia
Clear, Simple & Patient When Talking to A Person Living with Dementia
  • Use short and simple sentences
  • Maintain a calming and comforting tone
  • Speak clearly at a slower pace
Acknowledge His/ Her Concerns
  • Smile
  • Maintain eye contact
  • Put the person at ease
  • Be attentive when listening to him/her
  • Be prepared to spend more time with him/her

Respectful & Reassuring

  • Bring the person to a quieter location
  • Give him/her time to think and respond
  • Use a friendly and caring tone
  • Show him/her care, concern and encouragement

Engage to Provide Comfort & Build Trust

  • Be friendly
  • Create and maintain a comforting presence when talking to the person
  • Build a trusting relationship with him/her

⇒ Introduce yourself
⇒ Assure the person you are there to help him or her

  • Ask appropriate questions in their preferred language, to help him/her regain self-awareness

⇒ “Who did you come with?”
⇒ “Where are you going?”
⇒ “What would you like me to do?”
⇒ “How would you like me to help you?”
⇒ “Do you want us to give _____ a call”

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]]> Encouraging My Loved One to Accept Their Condition https://www.dementiahub.sg/living-well-with-dementia/encouraging-my-loved-one-to-accept-their-condition/ Mon, 17 Oct 2022 03:58:50 +0000 https://www.dementiahub.sg/?post_type=dementia&p=11533 It can be difficult to accept a dementia diagnosis, and understanding the reason behind the denial is important to coming up with strategies to help your loved one. Receiving a dementia diagnosis can be harrowing—it’s normal for the person who has been diagnosed to feel a range of negative emotions, from sadness to frustration, or even outright denial.

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It can be difficult to accept a dementia diagnosis, and understanding the reason behind the denial is important to coming up with strategies to help your loved one.
Receiving a dementia diagnosis can be harrowing—it’s normal for the person who has been diagnosed to feel a range of negative emotions, from sadness to frustration, or even outright denial.

Continued denial can pose problems when your loved one refuses to accept help in future, or continues activities like driving even when it has become unsafe for them to do so. The refusal to acknowledge that they are experiencing memory or cognitive difficulties could sometimes be due to fear, or a genuine inability to understand that there is a problem. It is important to identify the reason why your loved one is denying that they have dementia so that you know how to tackle the problem.

Anosognosia

In some cases, your loved one’s struggle to acknowledge their condition does not stem from an active effort to deny the signs, but rather is due to an inability to understand that there is an impairment. Known as anosognosia, changes in the brain mean that the individual truly believes that there is nothing wrong with them. This can be frustrating to deal with as a care professional, but it is important that you acknowledge that this is not your loved one’s or anyone’s fault, and accept it for what it is.

With anosognosia, no amount of evidence will convince your loved one to accept their diagnosis. Instead, you will need to come up with care strategies working around this. As long as it does not pose a safety issue, it is okay to let them keep helping out around the house or their day activity centre.

If you believe that your loved one has anosognosia, it is important that the psychologist working with your loved one is consulted to ensure he/she gets a proper diagnosis. Medical professionals working with your loved one will also be able to better advise on how to proceed in such situations.

Fear

Denial of a dementia diagnosis often stems from fear—there’s just something about accepting the condition that makes it seem more real.

Right after the person has received their diagnosis, give them some time and space to think about it, and how they want to approach the situation or proceed. Do give them some time to speak to their loved ones. However, if they continue to deny their diagnosis, do be patient and continue to support them.

One of the things you can do is to find out more about the dementia support groups or therapies run by Dementia Singapore or other organisations, and encourage your clients or caregivers to try attending them. If you and your loved one are attending these sessions with other caregivers and persons with dementia, they may be able to see how such persons are still capable of living meaningful lives and having fun. This can be helpful in assuaging fears they have and allow them to come to terms with their diagnosis.

It is also important to stay calm and supportive. Persons with dementia can live full and fulfilling lives with your support, especially at the early stages. Check out the stories of dementia advocates from Dementia Singapore’s Voices For Hope programme, and other inspiring persons with dementia like Kate Swaffer and George Chong, who are embodiments of the fact that life does not come to and end because of a dementia diagnosis; rather, it is a new adventure.

How Can I Encourage Someone to Seek Help for a Dementia Diagnosis?

Source: Dementia-Friendly Singapore

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The post Encouraging My Loved One to Accept Their Condition appeared first on DementiaHub.SG.

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