The practical impact of dementia

Having dementia makes it difficult for people to do many practical things. Here we explain some of these and what you can do to help.

Dementia will affect a person's day-to-day life and they may need to adapt how they do things. When supporting the person, there are approaches carers can take that can reduce the impact of these practical difficulties and help the person maintain a sense of normality for as long as possible. This will help the person to feel independent and maintain their self-esteem.

Communicating

People with dementia often experience difficulties communicating - for example, problems with finding the right word or following a conversation. Other factors that may affect communication include pain, other conditions, side effects of medication, and sensory impairments.

Difficulties with communication may cause a person with dementia to lose confidence or withdraw from social situations. Families, friends and carers may find that these difficulties are frustrating and can increase stress.

Communicating with a person with dementia: tips for carers

  • If the person finds verbal communication difficult, speak slightly more slowly and use simple words and sentences. Be more aware of the tone you adopt.
  • A person with dementia may use their behaviour and body language to communicate, such as gestures, eye contact and facial expressions. Carers' non-verbal communication is also important, and the person with dementia can notice or pick up on expressions and gestures.
  • Try to maintain eye contact. This will help the person focus on you.
  • Try to avoid sudden movements and tense facial expressions, as these may cause upset or distress.
  • Try not to stand too close or stand over someone when communicating - it may make them feel intimidated.
  • Make sure the person is included in conversations. Try not to speak on their behalf, complete sentences for them or allow others to exclude them.
  • Listen to the person. Give them plenty of time, remove distractions like background noise and try to work out the meaning they are trying to convey. The message may be about feelings, not just facts.
  • Avoid asking too many direct questions. Consider giving the person options or asking questions with a yes or no answer.
Read more about communicating

Find out more about communicating with a person with dementia, including advice, tips and suggestions.

Read more

Losing independence 

A person with dementia may gradually lose their independence and become more reliant on the care and support of others around them. This can be a hard change to make and can be distressing for everyone involved.

It is important that, where possible, families, friends and carers support the person to do things for themselves rather than 'taking over'. This increases the person's wellbeing and helps maintain their dignity, confidence and self-esteem, rather than making them feel helpless or worthless.

The person's attempts to keep their independence may cause conflict between them and others providing care and support. The person may resist help because they don't want to accept that things have become more difficult for them or don't want to ask for help.

Carers and others should avoid assuming that the person isn't able to understand what is happening or contribute to a situation. It is important for the person to be involved as much as possible. This can mean enabling the person with dementia, within reason, to do things their way.

However, carers will need to balance the independence of the person with dementia against any safety concerns and the desire to support the person to stay safe and well.

Supporting the person with dementia to remain independent: tips for carers

  • Do things together - try to do things with the person rather than for them when offering assistance.
  • Focus on things the person can do, rather than those they can't.
  • Offer help in a supportive way.
  • Try to be patient, allowing plenty of time for tasks and offering reassurance, praise and encouragement.
  • Break down tasks into smaller, more manageable steps.
  • Try to adapt tasks to take account of particular difficulties. If the person is happy, keep doing the things they enjoy - just differently. Focus more on the process rather than the completion of a task.

Decision-making

A person's ability to make decisions for themselves is called 'mental capacity' (often just 'capacity'). It means being able to weigh up different options, decide on one and communicate the decision. A person with dementia may eventually lose capacity to make certain decisions (eg choices about finances), but it should always be assumed that a person has capacity unless it can be shown otherwise.

People with dementia should be supported to make decisions for themselves for as long as they can. If someone else needs to make decisions for the person with dementia, these decisions need to be made in the person's best interests, taking the least restrictive option and based on the person's previously expressed wishes. For more information see our page: Mental Capacity Act 2005.

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