Dementia in home care — communication and security
When memory fails, your approach becomes the citizen's anchor
Dementia is a common term for a range of diseases that gradually weaken brain functions – memory, orientation, language and behaviour. For you as a social and healthcare assistant, this means that the same citizen can react very differently from day to day, and the way you communicate and create security often means more than the actual task you came to do.
§Dementia-friendly communication
The National Knowledge Centre for Dementia points out that communication with a person with dementia requires special attention because difficulties with understanding and expressing themselves often increase. It is not about speaking louder or slower as to a child, but about meeting the person where they are – calmly, clearly and with plenty of time.
- 01Speak with short, simple sentences – one message at a time.
- 02Seek eye contact and feel free to sit down at the citizen's height.
- 03Avoid correcting or discussing facts—instead go along with the resident's experience.
- 04Allow time for response and don't fill the silence too quickly.
- 05Use calm body language – restlessness and stress are contagious.
§The conversation wheel and ABC Dementia
The National Knowledge Centre for Dementia has developed tools you can use or be introduced to at your workplace. The conversation wheel helps professionals create a framework for meaningful conversation about the person's life, values, interests and wishes, often supported by picture cards. ABC Dementia is a free e-learning course for professionals working with care and support for people with dementia in, among other places, home care, nursing homes and activity centers – a good place to start if your workplace has not yet introduced it to you.
§Life story as a tool
When the present is hard to hold fast, the past can be a firm anchor. Knowing the citizen's life story—work life, family, interests, habits—enables you to create recognition and security in conversation and in daily tasks. A short chat about the childhood home or the old job can calm a restless citizen far better than an explanation about what time it is today.
§When behaviour is difficult to understand
Restlessness, anger or resistance to help is rarely 'difficult behaviour' – it is often the body's or mind's way of expressing a discomfort that the resident can no longer put into words: pain, hunger, boredom, too much noise or fear of the unknown. Your task is to search for the underlying need rather than to 'correct' the behaviour.
| Situation | Possible approach |
|---|---|
| The citizen refuses to bathe | Create predictability give time try again later instead of pressing now |
| The citizen is anxious in the evening | Check for pain, hunger, or need for toilet before assuming it's 'just' restlessness |
| The citizen asks the same question again | Answer calmly every time – repetition is part of the disease, not an attempt to annoy |
If your workplace has a dementia consultant or dementia key person, they are a natural sparring partner when you are in a situation you cannot find a good way through yourself. The dementia field is one of the areas in the trade where further training provides great professional and human value.
“You cannot change the disease, but you can change the encounter – and that is often enough to create safety.”