There are nearly a million people living with dementia in the UK. If you are close to one of them, maintaining a connection is vital. But how can you best care for and communicate with your loved-one?
Now experts from a new state-of-the-art “dementia-friendly” care home, are sharing their extensive research, gleaned from years of consultations with a wide range of specialists.
They stress that every person is different and that this will have a large bearing on which conversations and activities are most suitable – as will the degree to which the dementia has advanced.
Those contributing to the strategies being used at KYN Bickley, the care home in Bromley, south London include Michelin-starred chef, Tristan Welch, who has devised a menu that sneaks in all kinds of nutritious ingredients, limits ultra-processed foods and weaves in nostalgic treats.
Meanwhile, Honey Langcaster-James, a consultant psychologist who has appeared on the reality TV shows Love Island, Big Brother and Made in Chelsea, has worked on a list of ice-breaking questions to help those living with dementia connect with those around them.
The tips are intended as a guide which can be adapted, in part through trial and error, to see which ones work and which don’t.
How to talk
Meaningful conversations are essential for people with dementia, combating loneliness and forging connections. However, A KYN survey of 2,000 UK adults in May identified a “conversation chasm” between younger and older generations, that leaves many never really getting to know their nearest and dearest.
According to the findings, only a third of people know where their older loved-one grew up, or what school they went to, and just a quarter knew what their hobbies were when they were younger. The top reasons given for the chasm were not knowing where to start (26 per cent) and worrying about upsetting them (24 per cent).
Dr Langcaster-James has developed 21 questions with KYN, to encourage communication.
“Asking people about themselves, with a genuine curiosity and interest in them, can help fortify their sense of identity, help them feel more connected and less lonely, and boost their mood too. Asking them to recall and tell you about their happiest memories can be especially lovely for them, because they are transported back often to the happiest times in their lives,” says Dr Langcaster-James.
You can ask these questions in person or even in a letter, but the important thing is that you’ll be showing interest and giving them an opportunity to open up to you.
1. What have you learned over the course of your life that you can pass on to me – what do you think it would be good for me to know?
2. Tell me about some of your earliest memories.
3. Where were you born and raised, and what was it like there while you were growing up?
4. What was your childhood like overall and what is your fondest memory from when you were young?
5. What were your school days like and what did you most enjoy learning about at school?
6. What hobbies and interests did you have, and what did you most enjoying doing in your free time when you were younger?
7. What is the most surprising thing you think people don’t know about you?
8. What was your favourite music or artist when you were growing up and why?
9. What has been the most interesting job you’ve ever done?
10. Who have you loved during your life, how did you first meet them, and how did your love story unfold?
11. What is the most significant historical moment you lived through or witnessed and what did you think about it all?
12. What was your favourite decade overall and why?
13. Who were your role models and who influenced you in your life and why?
14. Where was the most interesting place you ever travelled to and what did you make of the place?
15. What was the most challenging obstacle you had to overcome in your life and what did you learn from that?
16. What is your proudest accomplishment in life and why?
17. Looking back, what advice would you give to your younger self?
18. What’s the best book you ever read and why?
19. What have been the biggest changes you’ve seen throughout your lifetime?
20. What’s the funniest thing that ever happened in your life and what makes you laugh?
21. What are your hopes for the future and how would you most like to be remembered?
Deepening the connection
Before every resident moves to KYN Bickley, they sit down with friends and relatives to write a book of their life called “My life, past, present and future”, containing photographs, concert tickets or other reminders of a happy past. This gives the person a greater sense of their identity and something to draw on in times of confusion, and can be added to as time goes on.
Making a book like this at home could be a valuable experience, and can be informed by the conversations started by the questions above. Chapter headings might include family life; childhood; significant places, relationships, memories or life events; interests; values and beliefs.
Meanwhile, musical memories often remain in the brain even as language and other memories disappear. This means those with dementia can retain the ability to dance and sing long after their ability to talk has diminished.
Spending time singing, banging tambourines and enjoying songs from younger days can help them bond with those around them – making them more socially engaged, with more eye contact, less distraction, less agitation and resulting in an elevated mood.
Activities
Getting outside into the garden or, better still, nature has tremendous benefits. It can improve wellbeing and help us feel less stressed. It also stimulates our senses, whether listening to birdsong, watching wildlife or feeling leaves. Plus, the exercise and social contact is healthy.
Encouraging activities such as cooking and baking, washing up and gardening is essential, as it feeds the basic human need to feel involved and busy and helps give meaning to life.
Creative expressions such as painting and writing are also key to a sense of identity and wellbeing.
Food and dining
While appetite tends to decrease with age, nutrient requirements actually increase, so it becomes even more important to eat nourishing meals, with plenty of high-quality protein, such as eggs, poultry, beans and pulses. You can add in extra ingredients to boost the nutritional value – serve soups with a swirl of Omega 3-rich oil, and vegetables with every savoury dish.
Steer clear of ultraprocessed foods, replacing those empty calories with nutrient-rich alternatives. Some people with dementia can have trouble remembering when they last ate and how much, and the disease can lead to sugar cravings, both of which can often lead to an over-reliance on snacks.
Food can be highly evocative and take people back to past memories, which can stimulate the appetite – essential for those living with dementia. Traditional favourites such as shepherd’s pie or fish and chips are a good idea in general – but obviously it’s all very personal and preferences will vary.
Shaking occurs in some people with dementia and can be aided with “anti-tremor” cutlery. And white plates, with a coloured border, can help people navigate around the food on their plate.
Surroundings
HOME
Some people find the blackness of blank TV screens distressing. When the TV isn’t on, you could cover it up with a tablecloth, or put up screen-saver style images of a peaceful setting.
If you have stairs, make sure there is at least one handrail. Put carpet or safety grip strips on stairs, or mark the edges of steps with brightly colored tape so they are more visible.
Insert safety plugs into unused electrical outlets and consider safety latches on cabinet doors.
Make sure all rooms and outdoor areas are well-lit and remove curtains and rugs with busy patterns that may confuse the person.
GARDEN
If you have a garden, spend time in it with your loved-one. Make sure there’s a comfortable place for them to sit and relax, and think about hanging a wind chime, which can be soothing. The sound of trickling water can be therapeutic, too.
Raised flower beds make it easier to do a spot of gardening or to take in the plants, while eye-catching plants are a great way to stimulate senses. You might want to opt for bright and bold flowers, like purple coneflower, pelargoniums, tulips, and alliums, while areas of softer planting, particularly blues and whites, will have a more calming effect.
i would like to thank the following KYN staff and consultants for their work in putting together the care tips that this article draws on: Caroline Naidoo, managing director; Emma Hewat, head of dementia; Sian Walker, marketing director; Dio Giotas, Admiral Nurse; Quincy McDonald, IT director; Jessica Shiel, head of life enrichment and wellbeing; Tristan Welch, executive head chef; Honey Langcaster-James, a consultant psychologist; Eva Humphries, nutritionist.
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