Understanding and supporting a person with dementia

3. 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.