Helpful Techniques

Explain as you go what it is you're going to do and why, as a matter of course - for example, if you're helping them put on coat explain you need them to straighten their arm so you can get the coat sleeve on, rather than silently manhandling their arm into the sleeve. In this example, repeat the explanation for the second sleeve.

They may find it easier (and less embarrassing) to understand what to do if they can copy you. For example, if you eat with them then they can see you pick up the knife and fork and see what to do, or you may be able to remind them how to brush their teeth by miming the brushing action.

Do things as 'we', since this can avoid putting them in a quandary as to what to do or decide – for example, say "Shall we have a cup of tea?" or if you feel you need to direct them say “Let's try this one, it looks nice”.

Take opportunities to 'signpost' the time and the current activity throughout the day - for example saying "It's eleven o'clock so here's your elevenses, then you can just listen to the music". You might add "I'll let you know when it's lunchtime in an hour or two, but we'll listen to the music first" - if you find that helps them feel more at ease with the day, rather than sets them thinking they have to worry about when lunch is. They may simply want to know that there's nothing in particular they have to be doing or that they have to remember to do some time later.

Avoid complex directions that give more steps or more information at once than they can cope with - for example avoid saying "We need to put on your coat and your shoes and warm hat so we can get into the car and go to the park". Their head may be left reeling with a sequence of things they think they need to remember to do but can't remember. In this example, start with the nice news about going to the park, then after a short pause explain you're helping them put on their coat, and once that's done move on to the shoes, and so on.

Try to phrase things so they can't be misunderstood if only partially heard or taken in - for example, if they're manoeuvering a walking aid round to sit in a chair say "Keep going a bit further" rather than "Don't sit down yet" which might be misheard as "Sit down".

Avoid asking questions that are beyond their memory capabilities and leave them feeling unsettled - for example, rather than enquiring what they had for lunch you could 'ask' a more general "I hope you had a nice lunch(?)", since that stills shows your interest but only requires an easy answer if one at all. Of course if that question makes them struggle to remember whether they've had lunch at all then you could try some other topic instead.

Don't draw to their attention that they're mistaken over something significant, as that can be deeply unsettling to them. For example, if they say they need to go back to work that afternoon otherwise they'll have their pay docked then don't tell them they're retired, try saying something like they'd better have a good lunch first; or if they think they need to go straight away then you could try saying it's a holiday today.

Try to maintain their capabilities while they can safely do so, and don't take over unnecessarily. For example, walking (with some form of aid such as a rollator if necessary, and over short distances if necessary) is good exercise and helps delay muscles weakening to the point they can't walk or stand up from a chair. Similarly, if they can use the remote control for the television then encourage them to do so, rather than taking over for speed or with the thought that it's helpful to do everything for them. Obviously if they aren't able to do it then help, and you may find they can do it on some days and not on others. Try to prompt them, rather than going straight to doing it for them, where you find that works.

Try to maintain their activities and hobbies where possible, adapting them if required - for example, someone may no longer enjoy painting because they feel they can't produce good results, but they may enjoy using stencils, a Spirograph, or 'scratch art'. Also consider new activities - see our section on entertainment.

Allow independence and offer choices where possible, but if they can't decide then gently help make the decision rather than leaving them to struggle with it - for example offer a choice between listening to the radio or watching the television, or between a couple of options of what to wear, or which microwave meal to be cooked. If they can't decide you can always say "This one looks nice" and go for that.

Chat frequently, even if just for short periods - it's reassuring to someone with dementia to have the underlying impression that they're in contact with you periodically, even if they can't remember when or how. Be careful if this makes them feel they have to stay beside the telephone all day because they don't know when to expect a call. We have advice on unaided video calls, & phones. If they're unable to speak, or find it difficult to make conversation, then speak as if to yourself so they can join in but don't have to - and it may still feel to them like a conversation they're taking part in. Similarly, if you're going past while busy around the house (or past someone else in a care home), a pause with a little wave and smile can do a lot of good.

Holding one or both hands can be very comforting - this can just be gently overlapping the fingers, rather than a handshake hold. Some recommend gently massaging the hand as a soothing technique.

Some people with dementia may grip around one or two of your fingers and squeeze very tightly - for the sake of your fingers avoid that recurring by positioning your hand on top of theirs (i.e. on the back of their fingers) rather than inside their hand.

Put on a smile and a happy face and reassuring manner, even when things don't make you feel like that - this affects their feelings positively through emotional mirroring (and that in turn will help you too).

Have some activities and entertainments that are engaging and purposeful, rather than all entertainments being passive where they just watch something. See our section on entertainment.

Make sure their environment (both the home and their daily life) makes them feel safe, settled and supported, including with 'signposting' for place, time of day, and contact with others. See our section on the home environment.

Particularly if their behaviour seems distressed or peculiar, use our section on interpreting behaviour to consider the many potential causes and try to identify a way of improving things. It's also worth considering these potential factors proactively even if there aren't obvious issues, as you may still find improvements that can be made.

If they're reacting against doing something that could be postponed, for example they don't want to have their hair washed and you can't find why, then try doing it at another time.

If they're insisting on doing something you think is peculiar, before rushing to impose your norms consider whether it really matters - for example if they eat dessert before the main course it isn't going to harm, so long as they have enough room for the nutritional main course too (and if not then perhaps reduce the size of the dessert portion next time). After all, it may be the norm for us to eat dessert at the end of the meal now, but a few hundred years ago Henry VIII had banquets with sweet and savoury dishes served and eaten together.

Try to avoid saying an outright no to what they want to do, which would be frustrating for anybody - if it's something they can't be allowed to do then try to redirect their goal to something else instead. This could take the form of distracting them with another thing they'd like to do, perhaps framing the transition between goals as 'we need to wait before we're able to do that' or 'we need to do this other thing first'.

If they're hard of hearing, then apart from making sure the cause is checked out (see hearing test), make sure they can see your lips, and if you have a high pitched voice then try speaking in a slightly deeper (but normal) voice if you can.