How to Preserve Identity in Dementia Care

Identity is the unique combination of memories, values, personality, preferences, and experiences that make each person who they are. When someone lives with dementia, changes in memory, language, and day-to-day abilities threaten this sense of self. Preserving identity is fundamental in dementia care. It maintains the person’s dignity and helps them feel valued and understood, even as their condition changes.

Losing touch with personal history can feel confusing and frightening for the person. This is why maintaining identity isn’t only about memory—it’s about recognising the person behind the diagnosis, making them feel safe, and reinforcing who they are at every opportunity.

Why Preserving Identity Matters

Care focused on the individual, not just their condition, results in better health and wellbeing. People who feel recognised are less likely to become withdrawn or anxious. They often engage more fully in activities and are more open to support.

Preserving identity:

• Supports self-esteem and confidence
• Encourages positive relationships with carers and family
• Maintains connections to meaningful activities and interests
• Helps reduce confusion, distress, or aggression

Showing the individual that they matter, and that their history counts, can bring both comfort and joy.

The Role of Life Story Work

Gathering a person’s life story is a practical way to preserve identity. Life story work involves creating a record of the person’s past—families, jobs, homes, holidays, favourite foods, hobbies, achievements, and more.

Ways of gathering and using life stories include:

• Photo albums with notes about events and people
• Scrapbooks containing mementoes, letters, and reminders
• Digital timelines with videos or audio recordings
• Memory boxes holding significant objects

This information helps carers understand daily habits, likes, and dislikes, which makes care more meaningful and personal.

Involving the Person and Their Family

The individual with dementia, where possible, should help create their life story. Talking about happy memories and favourite things can spark recognition even in the later stages.

Family and friends are crucial. They fill in the gaps when memories fade and provide context for carers. They often remember anecdotes, sayings, or routines that are particular to the person. Local communities, faith groups, or old workplaces may offer further useful details.

Valuing the Person’s Preferences

People with dementia often have strong preferences based on their background, faith, or interests. Even when verbal skills decline, these preferences may still be shown through choices or behaviour.

Ways to respect preferences:

• Ask about daily routines and try to keep them consistent
• Use familiar items in personal care or dressing
• Offer favourite foods and drinks
• Play music they enjoy; sing together if appropriate

Seemingly small routines—like having tea in a certain mug or saying a prayer before bed—can anchor the person’s sense of self.

Environment and Belongings

The surrounding environment has a marked impact on identity. Familiar spaces filled with personal belongings can anchor a person in their own story.

Key environmental features for identity:

• Family photos placed at eye level
• Favourite armchairs, blankets, or ornaments
• Labels or signs using the person’s own words
• Displayed awards, certificates, or creative work
• Use of scents or music from the person’s past

Care homes and services benefit from allowing personalisation of bedrooms and communal spaces.

Effective Communication

Positive and respectful communication upholds identity. Good practice includes:

• Using the person’s chosen name or nickname
• Reminiscing about important events or milestones
• Recognising long-standing speech patterns or catchphrases
• Group activities that encourage storytelling

If communication is difficult, sensory cues (music, smells, pictures) can trigger recognition and connection.

Even if the person cannot reply, speaking to them as you would to anyone—rather than talking over or about them—reminds everyone that they remain a person first.

Activities That Reflect Personhood

Tailored activities preserve identity by connecting people with their past roles and interests. Examples include:

• Gardening for someone who loved outdoor work
• Baking family recipes
• Crafting hobbies continued from younger years
• Sports or games the individual enjoyed

Adapting these activities as dementia progresses ensures that the person’s abilities are supported and their sense of self continues.

Regular Routines

Routines provide comfort and help someone feel themselves. Where possible, structure each day around habits the person valued before dementia, such as times for meals, walks, or religious practices.

Having a familiar rhythm:

• Reduces anxiety by offering predictability
• Makes activities easier to follow
• Reinforces roles and a sense of control

Change can be challenging, so keeping routines similar to those before dementia started is helpful.

Involving the Person in Care

Wherever possible, include the person in their own care decisions. This includes small things like choosing clothes or meals. Participation in self-care, however simple, upholds self-worth and recognises the person’s individuality.

When tasks need to be adjusted, explain every step and seek their involvement, even if only by watching or giving encouragement.

Language and Respect

The language used with and about people with dementia shapes their experience. Always:

• Refer to the person, not the ‘patient’ or ‘case’
• Avoid talking about the person as if they are not present
• Use language that is respectful and age-appropriate
• Recognise their achievements and value them

Never treat the person as a child. Respect their adult status, history, and rights.

Challenges in Preserving Identity

Difficulties arise when:

• Information about the person is missing or limited
• Multiple carers do not share knowledge about individual preferences
• Staff turnover is high
• The environment is institutional or impersonal
• Communication differences or language barriers exist

Overcoming these challenges requires teamwork and good communication between everyone involved in care.

Cultural Identity

Culture shapes food choices, ways of expressing feelings, beliefs, dress, and rituals. It is a key part of identity and needs respect and support.

Honouring culture can involve:

• Traditional foods and recipes
• Observing important festivals or faith practices
• Speaking a preferred language if possible
• Providing culturally appropriate reading or media material

Carers should ask about, record, and celebrate cultural traditions to support the person’s feeling of belonging.

The Role of Care Workers

Carers and professionals support identity every day through their words and actions. Good practice includes:

• Learning about the person’s background
• Attending training that highlights person-centred values
• Reflecting on how their approach either supports or undermines identity
• Advocating for consistent, joined-up care if other professionals are involved

This work is ongoing, as people’s needs and circumstances change.

Personhood in the Later Stages

In advanced dementia, verbal communication and memory may reduce even further. The importance of identity remains. Carers focus on non-verbal cues, sensory experiences, and maintaining comfort. Meaningful touch, favourite music, and presence from loved ones often have a strong effect, confirming the person’s continued worth.

Final Thoughts

Identity is not only about remembering the past, but about feeling connected to the present. In dementia care, cherishing the full person—past and present—ensures dignity, respect, and emotional wellbeing. Every song remembered, photo recognised, or routine repeated tells the person: You matter. You are still you.