3.2 Describe a range of different techniques that can be used to meet the fluctuating abilities and needs of the individual with dementia

This guide will help you answer 3.2 Describe a range of different techniques that can be used to meet the fluctuating abilities and needs of the individual with dementia.

Dementia affects every individual differently. This means that their abilities and needs can change from day to day or even hour to hour. Workers in care settings must use a variety of techniques to support the individual while respecting their dignity and promoting independence.

This guide covers some practical approaches to care, offering guidance on how best to respond to these changes. Always follow your own organisations policies and procedures.

Person-Centred Care

Person-centred care focuses entirely on the individual. It considers their personal history, preferences, interests, and values. This approach helps tailor support to their unique personality and needs. Techniques include:

• Taking time to listen and learn about the individual’s life history. Speaking about past events or achievements can help build trust and calm the person.
• Paying attention to what makes them feel comforted or unsettled. For example, some people with dementia feel more supported with routines, while others may need more flexibility.
• Being flexible. On a “good day,” the person may feel able to complete tasks themselves. On other days, slightly more assistance may be needed.

Person-centred care ensures that support is respectful and responsive to the individual at that moment.

Using Clear and Simple Communication

Changes in communication abilities are common in dementia. Adjusting the way you interact can help reduce anxiety and improve understanding. Techniques to enhance communication include:

• Speaking slowly, clearly, and at a slightly lower pitch.
• Using short, simple sentences. Avoid asking multiple questions at the same time.
• Giving the person plenty of time to respond. Rushing them can increase frustration.
• Non-verbal communication, such as using gestures or pointing to objects, is helpful when words are not understood.
• Maintaining eye contact and using a calm tone of voice.

Rephrasing questions or requests instead of repeating them identically is often useful. This can help prevent the individual from feeling pressured.

Creating a Calm and Familiar Environment

The environment plays a critical role in supporting people with dementia. Changes in ability can often make unfamiliar places, noises, or events overwhelming. A calm, structured environment can help the person feel safe.

Ways to make the environment dementia-friendly include:

• Keeping the space free from clutter. Too many objects can confuse or overwhelm.
• Using clear signage with pictures or symbols to identify rooms or items. For instance, signs for the bathroom or bedroom make it easier to navigate daily spaces.
• Reducing background noise, such as loud televisions or radios, if it causes distress.
• Using soft, natural lighting instead of bright, artificial lights, as this is less likely to disorientate the person.
• Arranging objects in predictable places. For example, keeping the same cup by the kettle if the person enjoys making their own tea.

Consistency and familiarity in their surroundings can help the person maintain independence while feeling safer.

Promoting Independence with Assistance

Supporting independence is crucial for people with dementia, even if their abilities fluctuate. Providing help subtly, rather than doing tasks for them, encourages the individual to remain as active as possible.

Techniques to promote independence include:

• Breaking activities into small, manageable steps. For example, if they want to dress themselves, they may need help with fastenings but not selecting or putting on clothes.
• Providing prompts or cues as reminders. For example, showing a toothbrush if they cannot immediately remember to brush their teeth.
• Using adaptive equipment, such as plates with raised edges or cutlery with larger handles, for easier use. These tools help maintain dignity during tasks like eating.
• Encouraging them to choose between two or three options instead of making open-ended decisions. For instance, “Would you like tea or coffee?”

Sometimes, the person may have less energy or motivation. On those occasions, gently encouraging them to rest is also valid support.

Using Validation Therapy

Validation therapy focuses on accepting the feelings or beliefs of the person with dementia, even if their understanding of reality is different. This contrasts with the need to correct or convince the person. Acknowledging their reality can prevent distress and build trust.

Examples of validation therapy techniques include:

• Supporting conversations without arguing. For instance, if the person believes they are waiting for someone who has passed away, do not correct this directly. Instead, ask questions about the person they are waiting for and share memories if appropriate. This validation helps them feel valued.
• Recognising emotions even if their context seems inaccurate. For example, if the person is worried about “missing the bus to work,” acknowledge that worry by saying something like, “It sounds like you’re feeling anxious about being late.”
• Shifting the focus to gentle distractions if someone becomes too upset about their belief.

Validation therapy meets the person emotionally where they are in that moment.

Reminiscence Techniques

People living with dementia often retain long-term memories even if their short-term recall is impaired. Reminiscence activities engage these memories, helping stimulate conversation and connection.

Techniques for reminiscence include:

• Using photographs, music, or objects from their earlier life to spark memories. For example, playing a favourite song from their youth may prompt happy recollections.
• Storytelling about significant or joyful events they experienced. Asking open-ended questions might encourage more details about their memories.
• Creating a “life story” book with them, using images and stories that are meaningful to them. This book can also be revisited on difficult days.

Reminiscence activities create positive experiences while maintaining a link to their identity.

Adapting Activities to Fluctuating Abilities

People with dementia often benefit greatly from engaging in activities. However, their day-to-day ability to participate may change. Adapting activities ensures they remain enjoyable and meaningful.

Suggestions include:

• Introducing creative activities such as painting, knitting, or singing. These activities can provide relaxation while building confidence.
• Simplifying tasks as needed. For example, if someone enjoys baking but struggles to follow instructions, assist with preparation and let them focus on mixing ingredients.
• Encouraging physical activity, such as short walks or seated exercises on challenging days, to support mobility and mental wellbeing.
• Offering shorter activities if their concentration wanes.

Always tailor activities to the individual’s energy and capabilities at the time.

Using “Reality Orientation” When Appropriate

Reality orientation involves gently reminding people where they are, what day it is, or who they are speaking to. This may help individuals with dementia feel more secure if they become disorientated. However, this technique must be used with sensitivity, as forcefully correcting someone could lead to distress.

Techniques for reality orientation include:

• Using calendars or clocks to display clear dates and times in their environment.
• Referring to familiar routines, such as “We usually have lunch after this activity,” to provide a sense of structure.
• Prompting through gentle conversation if they seem unsure—for instance, saying, “I’m here with you today because we’re going to your appointment.”

Reality orientation works best alongside other supportive techniques like validation or calm reassurance.

Applying Distraction Techniques During Distress

Individuals with dementia may experience moments of agitation or distress. In these situations, distraction can provide relief by shifting their focus.

Distraction methods include:

• Offering a comforting object, such as a soft blanket or a familiar item, to hold.
• Suggesting a preferred activity, like looking through a photo album or listening to music.
• Reassuring physical touch, such as holding their hand, provided they are comfortable with this.
• Taking them to a quieter area if the current environment feels too stimulating.

The goal is to reduce anxiety without forcefully redirecting their attention.

Monitoring Physical Discomfort or Medical Needs

Fluctuating abilities in someone with dementia may stem from hunger, thirst, pain, fatigue, or other physical discomforts. Observing the individual for signs of these unmet needs is as important as addressing cognitive or emotional needs.

Suggestions include:

• Encouraging regular meals and hydration. Some individuals may forget to eat or drink.
• Watching for changes in posture, facial expressions, or behaviour that could indicate physical discomfort.
• Maintaining a routine for physical care, such as medication administration or addressing mobility needs.

Caring for physical health alongside emotional support ensures the person feels as comfortable as possible.

Final Thoughts

Supporting someone with dementia requires patience, adaptability, and a compassionate approach. Every person’s dementia journey differs, and individualising their care helps provide meaningful support.

Using these techniques collectively can help meet fluctuating needs while promoting dignity, comfort, and wellbeing.