A woman with a face mask and a woman without one

Should a person with dementia wear a face mask for coronavirus?

Due to coronavirus, many of us now wear face masks or coverings while out shopping or on public transport. Some people with dementia may not like wearing a face covering, or understand why they should wear one. Read our advice on how to help and who may be exempt from wearing a mask.

This article was first published on 7 July 2020 and most recently updated on 14 September 2020.

During the coronavirus pandemic we’ve seen health and social care staff wearing face masks as part of their protective personal equipment (PPE). Face coverings, worn by members of the wider public, are different. They come in many different styles and may be home-made.

Here’s what you need to know about face coverings and how to support a person with dementia who might struggle with them.

Why should I wear a face mask or face covering?

Wearing a face covering helps stop you spreading coronavirus to other people. If you wear a face covering you may also be a bit less likely to catch coronavirus from someone else. 

You must still keep your distance, and follow good hygiene. You must self-isolate and get tested if you become ill with coronavirus. Older people and those with dementia are at higher risk of severe illness if they catch coronavirus, so should be extra careful to follow guidance on staying safe. 

A face covering is particularly important in enclosed spaces, such as while out shopping or on public transport, and if you’re around strangers.

Even with distancing measures in place, people will often get closer in shops or on public transport. Without fresh air the virus is more concentrated in enclosed spaces. A face covering can help reduce some of this risk.

A person with dementia might consider wearing a face covering even just walking outdoors in the high street – it could make them feel safer. But you don’t have to wear a face covering in your own home, unless you’re unwell with the virus and self-isolating.

Where can I get a face mask, or how do I make a face covering?

The government has issued guidance on how to make and wear a cloth face covering

You can use a scarf or bandana, or make your own covering from an old T-shirt or piece of cotton. It should be comfortable and cover your nose and mouth. You may already wear a face covering such as niqab, and don’t need to make or buy one. 

You can also buy a basic face mask online or from a pharmacy or supermarket. 

Don’t buy special medical-grade face masks. Supply of these is needed for frontline care workers.

What does the UK law say on wearing a face covering?

It is now compulsory in England for anyone aged 11 or over to wear a face covering on public transport, in NHS facilities as a visitor or outpatient, and inside shops, museums, galleries, cinemas and places of worship.

Face coverings are required in Northern Ireland for those aged 13 and over on public transport and inside shops. In Wales, a face covering is required for anyone aged 11 or over on public transport, and in shops and indoor public places. 

These rules do not apply to a person with dementia if they have a ‘reasonable excuse’ not to wear a face covering. A reasonable excuse could be:

  • They cannot physically put on or wear a face covering.
  • Wearing the face covering would cause them severe distress.
  • Someone with them needs to read their lips to communicate.
  • They need to remove the face covering temporarily to eat, drink or take medication. 

If someone such as a ticket inspector or shop assistant challenges the person for not covering their face, explain that they have dementia and can’t.

Showing one of our helpcards, or a hidden disabilities sunflower lanyard (available at participating supermarkets) or exemption card is also a good idea. Or, if you live in London or the south east, you can order an exemption badge from Transport for London.

You can also print your own exemption card at home or download one to your smartphone from the government’s guidance page.

Need help explaining why a face mask can't be worn?

Carrying our helpcards may help you when out in the community. You can also wear a sunflower lanyard and face covering exempt card, both available from Hidden Disabilities. 

Order our helpcards Face covering exempt card

What if a person with dementia won’t wear a face covering?

It’s safer for everyone if we all follow the guidance on face coverings. If the person finds wearing a face covering difficult, try to understand why. 

Be patient and offer encouragement – if you show frustration or irritation, the person will pick up on this.

  • Do they simply forget why it’s needed? Consider a sign up by the door for when you go out. You may need to gently remind the person we’re still in a pandemic.
  • Does the mask fit comfortably? Try different styles or looser fastenings if it's too tight
  • Are they unhappy with the feel of the fabric? Try some different materials, maybe one made from a familiar garment (check with them first before cutting the fabric).
  • Do they pull the cover down? Try some distraction or positive reinforcement – how wearing a face covering helps to stop the spread of coronavirus and keep people well.
  • Are they anxious it will stop them breathing? Offer reassurance and show them that it won’t.
  • Is there a past experience that might make them fearful about wearing a mask (perhaps as a young child in the war)? Talk to them about it and try to find ways to reassure them.

If these still don’t work, and wearing the mask would cause the person distress, then you are within the law to give this as a reasonable excuse for the person not to cover their face.

How can I communicate if I have my face covered?

Whether the person themselves is wearing a face cover or not, you may still be wearing yours at times. This may be unsettling for the person because they cannot read your facial expressions. Or perhaps they can’t hear your voice as clearly.

Try these tips to help you communicate when your face is covered:

  • Follow our general rules for good communication – use short, simple phrases and hand gestures.
  • Be mindful that a face covering makes things different – you may need to adapt how you communicate.
  • Think carefully about your tone – be clear, calm and friendly. Speak a bit louder from behind the cover.
  • Smile – your eyes communicate genuine warmth even if you smile is hidden.
  • Think about non-verbal clues – your body language (calm, open, friendly) should match your words. Gently mirror the person’s gestures if that helps connect you.
  • Above all, be empathic. Try to understand how the person is feeling – ask them if possible – and support them as patiently as you can.

More coronavirus advice and support

If you need help living with or supporting somebody with dementia during the pandemic, we're here for you. See our latest coronavirus advice and read how we can support you.

Coronavirus advice How we can help

52 comments

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Anyone who is distressed by wearing mask doesn't have to. My mum has dementia and is hard of hearing so we both won't be wearing them! Staff won't challenge anyone so don't worry. If customers get funny a poke in the eye usually helps,!

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Why don't you get a letter of your doctor, to carry round with you to show to anybody who might ask why you are not wearing a mask. The recepenist could print one off without having to see the doctor.

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We did try this but the receptionist wasn't very helpful.
So my partner now wears a Exempt card on a lanyard.

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Would seem the obvious answer however as my doctors and many others are not participating in exemption letters then it's not possible

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Hi Ann Davis, if you google face mask exemption card it will take you to the site and you can either print that off or add it to your phone (if your phone is one that takes photos). These are acceptable on all transport and in shops. Hope that helps x

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My mum has alzheimer's, she has had a fall and has a water infection, she is now in hospital, and we can't see her . I can talk to her by phone, but I'm concerned if she hears my voice she will kick off and upset her. Its killing me not seeing her, do you think speaking to her by phone is a good idea or not?

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Does your mum have a photo of you all together whilst in hospital
It may help keep her calm.

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Many wards will not permit this due to keeping every where clear for cleaning

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A lot of hospitals help people Skype or zoom using iPads, maybe you could ask if the hospital your mum is in has this facility. Your mum may not understand the technology, but she may find seeing your face reassuring. My sister in law has used this technique to talk to her brother who has a severe head injury after a fall. Not the same situation I know

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Arrange to have a nurse with her when you phone so that she has some support, afterva few calls she might even phone you.

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Hi I am career for my husband who has Alzheimer’s,it would help if I could get hold of a lanyard just having difficulties getting one our supermarkets don’t have any where I live ,if he will not wear it I will as I am always saying sorry he has Alzheimer’s which I hate it’s not his fault.

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I have boight sunflower lanyards off the Internet but last week forgot to put it on him. Our lovely Sainsbury's local had a drawer full and gave me one. ASK AT SAINSBURY'S

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It would be helpful to be able to obtain the sunflower lanyard but have been unable to get one for my husband who has,alzheimers

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Barbara do you have a Careers Centre or a Sainsburys Supermarket near to where you live, they have them as I got one for my mum there from Careers centre (free of charge) also free at sainsbury's too x

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I would like to know what a family can do if the care home a loved one is in does not open up after July 31st?

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My father has Alzheimers and is in a care home 2 hours away. They have a dedicated smart phone I can use to facetime or whatsapp him. He doesn't understand what the phone is, but I can see him, that he is smiling, healthy or otherwise. As normal conversation is beyond him, I sing him songs he knows, which he enjoys. The staff know I am still keen to communicate, and I find it very reassuring.

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This would have been useful some time back but now our relative aged nearly 90 is in a care home and we saw her for the first time in months last Friday week and she wanted to hug us!! We were in masks.

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have you considered mentioning the use of clear visors. This way the face of all parties can be seen and those with hearing problems can still see the other person's mouth to lip read.

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Unfortunately the dementia care home my deaf mother resides is refusing visors only and is insisting on face mask alongside the visor.

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My problem is my husband has dementia and my son got bowel liver cancer and having treatment we are in lockdown and have been since February. My husband annoyed because won’t let him out as he also diabetic and has fits. I haven’t had no family members pass through my door and nobody gone out apart from my son going for treatment on his own. What’s the answer I’m 76 and don’t know which way to turn

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Hi Eileen,

Thanks for your comment, I'm really sorry to hear about your husband and son's conditions. This sounds like a very difficult time for you all.

Have you received advice from a medical professional or the Government to stay at home? This must be extremely hard over such a long period of time, and we have some advice on our website here you may find helpful if you need to stay at home: https://www.alzheimers.org.uk/get-support/coronavirus/supporting-person…

Some people who were shielding are now able to go out more often. It's difficult to give advice without knowing the full extent of your situation, but if you call our Dementia Connect support line a trained dementia adviser will be able to give ideas, advice and support. Please call on 0333 150 3456, and read more information about the support line here: https://www.alzheimers.org.uk/get-support/national-dementia-helpline

Hope this helps, Eileen.

Alzhimer's Society blog team

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How do you provide evidence to people that question why a person is not wearing a mask? My husband has vascular dementia and forgets things very essily

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Hi Hilary, thanks for your comment.

This is a developing area and we hope that shops will respect and promote the exemptions where possible.

You may find it helpful to order some of our free helpcards, which you can carry around and use if needed. More details of the helpcards can be found here: https://www.alzheimers.org.uk/get-support/publications-and-factsheets/h…

Some people also like to wear a sunflower lanyard, which indicates hidden disabilities including dementia. These are becoming more popular and well-recognised in shops, and we have some more information about the scheme here: https://www.alzheimers.org.uk/blog/hidden-disabilities-dementia-sunflow…

Hope this is helpful, Hilary. If you need any more information, support or advice, please call our Dementia Connect support line on 0333 150 3456. More details are available here: https://www.alzheimers.org.uk/get-support/national-dementia-helpline

Best wishes,

Alzheimer's Society blog team

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With regard to the Sunflower lanyard- I really believe that more should be done to make the general public aware of the meaning of it..I had never heard of if until we had to travel from Birmingham Airport last year and were given one...

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We had to travel through a tiny French Airport with my grandson who has Aspergers. They had decided to have a live group in there. The noise was deafening. I was stressed myself! As soon as they saw the sunflower lanyard we were all whisked through to our plane. The children even met the pilot. It was wonderful!

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If face coverings become mandatory for shops in England then I will be dealing with the emotional fallout of the person I care for being refused access - this is someone who ‘lives independently’ but fails to understand they have dementia so wouldn’t think to explain.

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We have exactly the same challenge with mother in law. Wasn’t a problem with transport as she doesn’t use it, but now it’s extended to shops too. This presents more of an issue, because she still insists on going to the local shop even if we have taken what she needs, and every time Coronavirus is mentioned it’s new to her, and doesn’t get it - actually mocks us wearing masks when we visit for checks. The reasonable excuse doesn’t cover dementia, and sure she will get challenged ! How on earth do we make sure she isn’t put in a difficult situation, or even verbally abused as seems to be some people’s response ?

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Hi Gareth, thanks for getting in touch.

Sorry to hear about these concerns with your mother-in-law. This is a developing area with the new guidance in shops, but we hope that exemptions will be promoted and accepted the same as they should be on public transport.

It may help to order some of our free helpcards, which can be carried around and used if needed: https://www.alzheimers.org.uk/get-support/publications-and-factsheets/h…

Some people also like to use sunflower lanyards to indicate a hidden disability, including dementia. These are becoming increasingly popular and well recognised in shops, and we have some more information on the scheme here: https://www.alzheimers.org.uk/blog/hidden-disabilities-dementia-sunflow…

Shops and public transport should be taking the exemptions for face masks into consideration, and we'll be paying close attention as this develops.

If you need any support, please call the Dementia Connect support line on 0333 150 3456. A trained dementia adviser will be able to learn more about your situation and give ideas, advice and support.

Hope this helps, Gareth.

Alzheimer's Society blog team

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Blog Team,
Thank you for the pointers.
A statement on your lanyard page, could be useful, but reminds us . “Someone with dementia might not remember they have the condition. “ ... and this is the case we encounter, where mum has physical capacity to shop independently, but no insight to her condition or Covid so would not present the card, or wear the lanyard most likely, but we can try I suppose.

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You can wear the lanyard for her that’s what I do for my mum who is exactly the same, doesn’t recognise her condition or COVID, social distancing in Sainsbury’s is a complete nightmare but the staff are lovely coz I’m wearing it.

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OK, which clown dreamt up trying to persuade someone with dementia to wear a face mask? The past 4 months has been hell without making life totally impossible for carers. I have been told to leave both a bank and a shop in recent weeks when attending to daily life with my wife who has early onset Alzheimers when we have entered premises with my wife wearing her sunflower lanyard. Are we now to be unceremoniously turfed off a train if she refuses to wear a mask part way through a trip? Sadiq Khan and Nicola Sturgeon need to get off their ivory towers and live in the real world.

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Hi David, thanks for your comment.

We're really sorry to hear that this time has been so difficult for you. That's also disappointing to hear about your experience in the bank and the shop, as businesses should be taking different circumstances into account.

Although wearing a mask is a good idea on public transport to keep yourselves and others safe, there are exemptions for people who would find this difficult. If it is not possible for your wife to wear a face covering on the train, then she will not need to wear one.

If you have any concerns about this or anything else, please do call our Dementia Connect support line on 0333 150 3456 for information, advice and support: https://www.alzheimers.org.uk/get-support/national-dementia-helpline

Hope this helps, David.

Alzheimer's Society blog team

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