One of the key indicators of dementia is how it affects an individual’s memory. Their short-term memory becomes increasingly less effective whilst, at least for some time, their long-term memory can function very well.
So how do we know what the best care is for a person living with dementia is?
To learn more about helping to support people living with dementia you can visit our ‘Dementia’ section of our website here
In this article we share some of the most popular and innovative models of dementia care.
What you will notice is that there is a common theme which runs through each model. What some may see as ‘Challenging behaviour’ is seen as a means to understand what the feelings and the needs are of the person living with dementia, behind their behaviour, to get to know and understand the individual better to engage with them in different ways for improved wellbeing and sense of self.
Alternate Realities
For people living with advanced dementia, their long-term memory takes over for much of the time. Having cared for my own Mum, who lived at home with Vascular Dementia, sometimes she would mistake me for her Mother and would start speaking to me as if I was her.
Up until fairly recently, many of those working in dementia care and elderly care would have advised me to correct Mum; to inform her about the present-day reality.
However, this may not always be effective, particularly for someone living with late-onset dementia. Their short-term memory may not be strong enough for them to retain the ‘facts’ and they are likely to repeat the mistake. Worse still, they may well become distressed, embarrassed and upset as they feel “told offâ€.
There are now a number of organisations who promote emotion led dementia care which places the importance of an individual’s feelings over facts.
Person Centred Care
Meeting the emotional needs of people living with dementia can be challenging. When you’re caring for someone who’s living with dementia, they can often have trouble expressing themselves, which may lead to frustration as a result.
During the 6 years I helped to care for my Mum for over 6 years, I learnt that that all of her behaviour was a means of communication. And that how I responded in any situation should be personal to her – this is often called person-centred approach, or personally tailored care.
Communication could be challenging between Mum, myself and her other carers, for example, she would often ask me ‘where’s your Father? (who was no longer alive) and it was hard to know how best to respond without upsetting her when she was living with a different sense of reality.
If we told her the blatant truth, this could have caused her significant and repeated distress. Distracting her could also have left her more confused and frustrated. In this difficult situation I learned that it helped to focus on the emotions she was expressing rather than facts, and acknowledge how she might be feeling, for example, “I can see you’re upset Mum’ and I’d sit with her for a while and prompt conversation about Dad until she felt calmer.
By showing that I recognised Mum’s emotions and exploring why she was asking for her husband, I helped her to feel supported and secure, allowing space and time to explore what you might be able to do to reassure and help. The better you know the person, the less complex this is to deal with.
In any circumstance, to begin to understand what that person might be saying, first try to consider the context of the question being asked. Look beyond what the person is saying to find the meaning behind the words and try to the identify the need they may be expressing.
Being With Them In The Moment
According to one organisation, Meaningful Care Matters, “We all live in the moment. For everyone, with or without a dementia, all we have is now. Showing people living with a dementia that we know their feelings matter most can transform lives. All of us live in our own reality. Joining someone in their reality, entering their bubble, is the only way to reach people.â€
Emotion Led Care
Meaningful Care Matters, a business established in 2019, believe that ‘engaging in moments, experiences and activities that resonate with who we are and meet our needs for love, attachment, belonging, occupation and comfort makes life meaningful’
They focus on developing resilient relationship centred cultures of care shaped by the people living and working in them. ‘Our relationship with the people, places and things which have shaped our life journey hep to make us who we are and sustain our sense of personhood. Nurturing person centred relationships is key to sustaining individual well-being and developing an emotionally resilient culture of care.
I have the pleasure of working with two care homes who live and breathe this model of dementia care, where everyone who lives and works in the home are one big family, with no barriers. They eat together, they play and laugh together and their family members are happier and more engaged with improves health and wellbeing outcomes.
I have even been known to join in a song and a dance whilst visiting!
You can read more about these fantastic ‘outstanding’ rated homes here:
The SPECAL Methodology
The leading feelings-focused methodology for dementia care is SPECAL (Specialised Early Care for Alzheimer’s).
SPECAL believes that individuals living with dementia frequently draw on old factual memories in order to make sense of the present. They need to do this to compensate for their lack of recent factual memories caused by short-term memory loss.
The organisation’s website states: “Forcing a person with dementia to abandon their own chosen strategy in favour of a reality they do not understand is, in our view, completely unacceptable.â€
SPECAL promotes a range of techniques in order to help relatives and carers understand how an individual living with dementia processes memories and realities. The organisation also trains carers from good quality home care companies, to enable individuals who are living with dementia to experience the benefits of the SPECAL methodology directly.
According to SPECAL, their methodology enables people receiving dementia care to regain a sense of joy and dignity in their lives: two feelings that must, surely, be more important than facts.
The Montesorri Method
Montessori for Dementia and Ageing is an innovative approach to aged care. It empowers people living with dementia by creating an environment that allows them to live as independently as possible. The goal of the Montessori program is to support older adults and people living with dementia by creating a prepared environment, filled with cues and memory supports, that enables individuals to care for themselves, others, and their community.
They strive to develop communities that treat individuals with respect and dignity and honour their choices so that they may live as independently as possible.
In summary, these different models of care are designed around meeting a person where they are, rather than where you want them/think they should be.
Always remember this:
Beneath every behaviour is a feeling, and beneath every feeling is a need. And when we meet that need rather than focus on the behaviour, we begin to deal with the cause not the symptom.’
We also have a free guide designed to help people living with dementia to eat better which you can download here:
http://hcsuk.co.uk/dignified-dining
Look out for our new Living Well with Dementia free guide coming soon! You can register to receive your free copy here!
"Download your own copy of our Dignified Dining Solution Guide below or visit our website at www.hcsuk.co.uk.
