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.
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.