Due to coronavirus, many of us now wear face masks or coverings while out. 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 8 December 2021.
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.
A face covering is particularly important in enclosed spaces, such as while out shopping or on public transport, and if you’re around strangers.
People are often closer together in shops or on public transport. Without fresh air the virus can spread more easily in enclosed spaces. A face covering can help reduce some of this risk.
Some people, including those with dementia choose to wear a face covering even just walking outdoors in the high street – it can make them feel safer.
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?
Guidance on face coverings is subject to change, and is different depending on where you live and what public place you are visiting. See the latest government guidance on face coverings, which includes when to wear one, exemptions, and how to make your own.
When may somebody be exempt from wearing a face mask or covering?
The rules on face coverings do not apply to a person with dementia if they have a ‘reasonable excuse’ not to wear one. 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), Please give me space lanyard 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.