Dementia - coping with placement

When a person with dementia moves into residential care, the role of families and carers does not usually come to an end. Many people choose to stay involved with practical caring tasks, such as helping at mealtimes. Others become involved in the social activities of the facility. The level of involvement varies from one person to another.

Visiting is important to both resident and carer#

Visiting is usually very important to both the resident and their family and carers. It is often the main way that families and carers stay connected with the people they have cared for, even though they may no longer provide day-to-day care. The person with dementia may enjoy seeing other members of the family or old friends.

Encourage grandchildren to visit#

If the children are young, prepare a visiting bag that contains treats and activities to keep them entertained. If the facility allows it, you might also bring in a pet.

Making visits more enjoyable#

Visiting can sometimes be difficult, especially as the abilities of the person with dementia decline. Try to find ways to make each visit as pleasurable as possible.

Bring newspapers and magazines to look at together#

Read mail together#

You might also play games that have been enjoyed in the past, listen to music or a recorded story, or watch a well-loved film.

Look at photo albums together#

Help decorate and tidy the room#

Help with personal grooming – washing or brushing hair, or painting nails.

Assist with writing to friends and relatives#

Bring others to visit#

The person with dementia may enjoy an outing#

Outings may include:

• a stroll or wheel around the facility garden
• a short drive in the car, perhaps stopping for afternoon tea
• a visit to another person in the facility

Visiting in the later stages#

As the disease progresses, find activities that draw in as many of the senses as possible – sight, taste, smell and touch.

• Touch – a gentle kiss or holding hands can be reassuring. Massaging the legs, hands and feet with scented creams or oils may be enjoyable for some people.
• Sensory – the scent of perfumes and flowers can be enjoyed.
• Facial expressions – a smile, a comforting gaze or a look of affection can often provide reassurance to a person with dementia.
• Music – listening together to familiar songs can be soothing.
• Walking – a stroll around the grounds, even in a wheelchair, may be enjoyable for both the resident and the visitor.

Parting#

There is no correct number of times to visit or amount of time to stay.

The important thing is to make each visit as rewarding as possible#

Leaving after a visit can be a difficult time for both the person with dementia and their visitors. Things you can try to make parting less stressful include:

• take an activity to do with the person; once it is finished, it is time to go
• ask the staff to divert the resident, or time your leaving for when a meal is about to be served, so there will be something else for the person to do
• let the person know at the beginning of the visit how long you can stay and why you have to leave – for instance, ‘I can stay for an hour, but then I have to go shopping’

Keep farewells brief and leave straight away#

Lingering, apologising or staying a little longer can make future farewells harder.

Wanting to go home#

A common phrase heard from people with dementia in residential care is ‘I want to go home’. This can be especially upsetting for families and carers. Wanting to go home may be caused by feelings of insecurity, depression or fear. ‘Home’ may be a term used to describe memories of a time or place that felt comfortable and secure – perhaps memories of childhood, or of a home or friends who no longer exist.

Some things you can try:

• try to understand and acknowledge the feelings behind the wish to go home

Reassure the person that they will be safe#

Touching and holding can be reassuring#

You can also reminisce by looking at photographs or by talking about childhood and family, and try to redirect the person with food or another activity, such as a walk. Don’t disagree with the person or try to reason with them about wanting to go home.

Support groups#

Support groups bring together carers, relatives and friends of people with dementia under the guidance of a group facilitator, usually a health care professional or someone with first-hand experience of caring for a family member. Families and carers may be looking after a person at home or visiting them in residential care.

Many people find enormous comfort and practical help from attending these meetings with others who know what it is like to care for a person with dementia. Many facilities also run relatives’ groups, because they recognise the difficulties many families experience once the move into care has happened.

Key points#

• Visiting is usually very important to both the resident and their family and carers
• The important thing is to make each visit as rewarding as possible
• A common phrase heard from people with dementia in residential care is ‘I want to go home’
• Wanting to go home may be caused by feelings of insecurity, depression or fear

Where to get help#