Living with dementia is challenging enough without being constantly told ‘No’ and reminded that things that you could do before are now more difficult to manage. Working with healthcare staff who care for people with dementia I do observe a high level of negative responses or interactions where the staff prevent the person from doing something or step in and do it for them to ensure it is done ‘quickly’ or ‘properly’. In the majority of cases the intervention is well-meaning based on an impulse to help the person. However, the intervention may in fact have the opposite effect and result in the person feeling frustrated and diminished.
Being constantly told ‘No’ is a very negative experience which can result in frustration and anxiety or anger and resentment. When I speak with staff they tell me they are worried that there may be an accident and in effect they are doing this for health and safety reasons. Yet I have witnessed a person with dementia being told repeatedly not to stand up as they might fall with the result that as soon as the staff are not watching they try to stand. The negative responses resulted in a higher risk of a fall which was the exact opposite to what the staff wanted to achieve. Meeting the need to stand and move with a positive response would have a much lower risk and would support the person both physically and psychologically.
It is really important to encourage people with dementia to do as much for themselves as possible in order to retain abilities for as long as possible. Our job is to support the person to maintain their abilities and help them with the things they are struggling with. We need to stop focusing on what cannot be done and focus on what can be done. The person living with dementia is experiencing changes in their abilities and needs encouragement and support to maintain their sense of wellbeing and self-esteem. So let us try to replace ‘No’ with a positive response that will look at ways to support the person to live their life the way they want to.
Published by Laura Pratt MSc. on 3rd March 2023.