Understanding and supporting a person with dementia

4. Psychological and emotional impact of dementia

The impact that dementia has on a person is not limited to the practical effects of the condition. The person still experiences feelings, thoughts and responses just as a person without dementia does. However, living with dementia will affect these. It is important to recognise and respond to the person's emotional needs and responses.

Reactions to diagnosis

A diagnosis of dementia can have a huge impact on a person's life. Someone recently diagnosed with dementia is likely to experience a range of emotions. These may include grief, loss, anger, shock, fear, disbelief and even relief.

Some people may struggle to deal with these emotions and they may move between emotions as they adjust. They may feel afraid about the future, scared about moments of confusion and forgetfulness, and upset about the impact dementia has on those around them.

The confirmation of a diagnosis may trigger depression and anxiety in some people. There are a number of talking therapies and - if needed - drug treatments available for depression and anxiety. Lifestyle changes can help too. For more information see our page: Depression and anxiety.

Those around the person will also have their own emotional reactions to cope with. It is important that both the person with dementia and the people around them feel able to, and are encouraged to, express their feelings.

Some people experience positive reactions when they receive a diagnosis of dementia. They may be relieved to know what is wrong or be glad to be able to plan ahead. Some may use the experience to re-evaluate their situation and focus on the activities and relationships that make them happy.

Supporting the person's emotional responses: tips for carers

  • Try to understand how the person with dementia feels.
  • Do not dismiss a person's worries - listen and show them that you are there for them.
  • Try to enjoy the moment and try not to spend too much time thinking about what the future may or may not hold.
  • A sense of humour may help, if the time feels right.

Emotions and feelings

People with dementia often experience changes in their emotional responses. They may have less control over their feelings and how they express them. For example, someone may be irritable, or prone to rapid mood changes or overreacting to things. They may also appear unusually uninterested in things or distant.

These changes are often difficult for carers to deal with. It can help if carers remember that they are partly caused by damage to the person's brain. Someone may react more emotionally to a situation than might be expected (eg by becoming tearful or agitated) because some of their factual memories or ability to think clearly about the situation have declined. It is important to look beyond the words or behaviours you can see to the feelings that the person might be trying to express. Strong emotions may also be caused by unmet needs. Carers should try to work out what these needs are and meet them where possible.

Confidence and self-esteem

Dementia may cause people to feel insecure and lose confidence in themselves and their abilities. They may feel they are no longer in control and may not trust their own judgment. They may also experience the effects of stigma and social 'demotion' - not being treated the same way by people - as a result of their diagnosis. All of this can have a negative impact on the person's self-esteem.

Dementia may also have an indirect effect on someone's self-esteem by affecting other areas of a person's life. Health issues, financial circumstances, employment status and, importantly, relationships with those around them may suffer.

Some people, however, form new relationships as a result of their diagnosis, through activities such as attending a class or a support group. High self-esteem allows some people to cope better with chronic health conditions.

Supporting the person with dementia to maintain self-esteem: tips for carers

  • Offer the person plenty of praise and encouragement - celebrate successes and focus on positives.
  • Avoid harsh criticism or belittling comments.
  • Ensure people have time to do the activities they enjoy and that give them purpose.
  • If a person makes a mistake, try to be as supportive as possible.
  • Help people to maintain existing social relationships and form new ones. This can be done by facilitating joint activities with friends and family, joining hobby groups and encouraging conversation.