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Creating an Enjoyable Environment

The following are some ideas that may help you create a more enjoyable and peaceful environment for both you and the person living with dementia. These are based on proven strategies, however, some or may not work for everybody in their environment and circumstances, it is possible that they my work one day but not the next. Even if they are not effective keep them in mind as the person you are caring for will change and you may find more success on another occasion.

It is hoped that the list will provide you with a head start in creating a better environment and possibly help you find your own strategies that provide you and the person living with dementia a positive environment to live in.

Communicate with respect and clarity

It is of the utmost importance it to treat the person with respect, far too often people talk to someone with dementia as if they were a child. Not only with the tone of their voice but also in the words they say. It is true that some with dementia may exhibit childlike behavior from time to time, but you need to remember the person you are with has may years on adult experience unlike a child. The onset of dementia can cause difficulty in absorbing information quickly, so it is important that if you are having a conversation, you make one point at a time therefore giving the person a chance to absorb what you have said. If the person appears to be perplexed or confused with what you are saying, try expressing it in a different way or carefully find out what you said caused their concern. A long conversation can become tiring so moments of silence can be expected and welcomed. If the person usually wears glasses or uses hearing aids make sure, they are in use before you start visual or audible interaction. If the person tries to explain something take time to understand what they are saying, do not simply acknowledge to move on. If the person has taken the time to say something show respect by absorbing what they say.

Further information

Youtube: Cedars-Sinai Hospital – Communication in Patients with Dementia
Youtube: Riverside Health – Communication Engaging with Compassion Skills
Dementia Australia – Talking to someone with dementia
Alzheimer’s Society (UK) – Non-verbal communication and dementia
Dementia Australia – Dementia Language Guidelines

Reminisce

Taking time to familiarise yourself with the likes and dislikes of the person you are engaging with can help you stimulate conversation and build repour with the other person. If available using items such as photos, mementos, trophies or artworks can help the person be in a space they feel comfortable with. It can help to talk about the significant events in their past. Allow the person to lead the conversation once they become comfortable. If they do not recall the facts as you remember, it does not matter. As the dementia progresses the neural connections that connect all the facts may be lost so the stories they tell may be a combination of many experiences and knowledge. It is important to understand they are not getting confused, in their brain how they recall is as real as you recall it. If you correct them, it will only cause confusion and loss of trust and could result in agitation which would be counterproductive.

These conversations can still be enjoyable for both you and the person you are with, you may even learn something you did know.

More information

ABC NEWS (Saturday 20 Jul 2024) – How reminiscing can improve the physical and mental health of older people
Dr Helena Popovic – What is Reminiscence Therapy?

Approach with a happy face

Regardless of the stage of dementia, the person living with dementia will be sensitive to your mood and how you approach them. Understanding the emotions of those around us is one of the earliest things we learn, such as a smiling face can result in a happy response from a baby, an angry face or loud aggressive speech can result in an unhappy response from the baby. So as a baby we learn body language and respond accordingly. This therefore is one of the most mature aspects of our brain development and tends to be retained the longest as the dementia progresses. A person with dementia can find the events of their environment overwhelming at times, a person approaching them with a smiling face and happy demeanor will likely be seen as a positive experience by someone living with dementia. you are more likely to have an enjoyable experience when the person you are with is in a clam happy environment. If you or another person gets angry with the person living with dementia it is likely to result in agitation and possibly physical reactional against the angry person. The may not understand why you are angry or the circumstances that lead to it so may feel you are being aggressive to them and will naturally try to defend themselves in the best way they know.

A simple phrase to remember is “a happy house is a peaceful house”. being able to have a peaceful environment may also provide an opportunity to allow any stress you are experiencing to dissipate.

More information

Avila Institute of Gerontology (USA) – Using Body Language to Communicate with Loved Ones with Dementia

Music

Music can have a phenomenal effect on the behavior and wellbeing of someone living with dementia. As is the case with anyone, the rhythm of music stimulates the brain such that it can invoke feelings of happiness and intense emotion and stimulate movement. There are numerous stories of people living with dementia whose relatives had thought they “are no longer aware of anything around them”, suddenly come to life when they hear music that has some special connection to them. It could be the beat, or it stimulates an emotional response or even triggers a moment of happiness from their past. These experiences can result in people making movements that had not made for some time, sing, smile or cry. All responses should be welcomed as they are experiencing something special.

More information

Alzheimer’s Queensland – Music therapy for dementia – Alzheimer’s Queensland
ABC Listen – How music therapy is helping people with young onset dementia
Youtube: TEDx Ohio State University – Transforming Dementia Care Through Music, Kaylie Glenn

Art

viewing and participating in the creation of art
meaning in life
stress reduction
contributes to overcoming isolation
helps with enjoying the moment

More information

Dementia Australia – Engagement in creative arts offers significant benefits to people living with dementia
University of South Australia – Dual-action arts and wellbeing program transforms dementia care
Youtube: Dementia Australia – Dr Nathan D’Cunha | Arts-based therapy for dementia
Youtube: University of Sydney – Art and Dementia
Youtube: PBS News Hour – How art can help people with Alzheimer’s enjoy the moment

Give the person time

It is important when interacting with someone living with dementia that you give them time to comprehend and engage. In a world where many are rushing round short of time this can seem to be too difficult. When in this situation there is definitely a case of “haste make waste”. If you try and rush someone with dementia it is likely you may create a situation where they get anxious, confused, frustrated and/or become stubbornly less cooperative. It is therefore better to slow down, approach everything with a calm demeanor and tone of voice. Other than an immediate safety issue, there are few moments in life where not reacting quickly and being a bit late will be the end of the world. But if you are calm and take the time, not only will the person living with dementia be happy you will experience less stress.

If the person is taking a long time trying to do a task, do not immediately jump in and take over, remember you would like someone doing that to you. If despite trying hard it appears the person is struggling, learn the best way to offer help without it appearing to be a vote of no confidence in them. This will be a very individual solution as we are all different and will require you to get to know the person and their feelings on the day. It is possible they are feeling a lack of confidence and frustration knowing that they should be able to complete the task on their own, this situation requires respectful assistance. If they do accept assistance try and encourage them to help you complete the task, make it a partnership and a shared enjoyable task, this can help in boosting their self-esteem.

It is common that someone living with dementia will stop doing an activity that they love. This can occur if the person cannot find their own way to start the activity and have a lack of motivation. You will often hear them say that they are no longer interested or find other excuses as to why they cannot do the loved activity. This may also include an excuse that may makes you the centre of the reason for not doing it. This can take some skillful conversation and maybe consultation with a counselor to find a way of helping them re-engage in activities.

More information

Hammond Care – Loss of motivation in dementia: A guide for aged care workers

Crowded environments

position yourself when walking through crowds to protect the person you care for
noise and over stimulation
Hidden Disabilities Sunflower

More information

Hidden Disabilities Sunflower – A symbol for non-visible disabilities, also known as hidden disabilities or invisible disabilities.
Invisible Disabilities Australia – Invisible disabilities website

Do not engage in an argument

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Encourage and support

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Redirect

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Engage with support networks

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More information

This website – How to get help and engage with support networks

Take the time to educate yourself

The more you know about dementia and its effect on the person living with it the better prepared you will be for the circumstances you find yourself in now and the future. There are many organisagtions that provide both free and costed courses for you to attend both in person and online. Some allow you to progress in your own time giving you the opportunity to fit it around caring, work or other obligations. It is also a important to familiarise yourself with government service and legal needs to ensure you are able to c the services you need, when you need them.

Both formal and informal training has been featured on this website with the hope there will be a path for all to find new knowledge.

The link below will open the education page on this website where we have identified formal training we believe is credible and worthwhile taking the time to complete.

More information

This website – A growing list of information sources for furthering dementia care knowledge

Be alert to any changes in demeanor

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Give the person space

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Accidents can happen

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Babies, children and pets

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Dementia friendly Communities

There is a movement in many countries to create environments that are sensitive to the needs of those diagnosed with dementia and in turn making it easier for their carers to take them out into the community with safety and have an enjoyable experience. Dementia Australia has a very active program and is continuously engaging organisations to become more Dementia friendly.

Other regions that are known to have similar programs are the United Kingdom, United States of America, Canada, New Zealand and Europe. If you intend to travel overseas do some research before you leave, it is possible you will be able to find friendly environments in the countries you intend to travel.

More information

Dementia Australia – Dementia-Friendly Communities
Hidden Disabilities Sunflower – A symbol for non-visible disabilities, also known as hidden disabilities or invisible disabilities.
Invisible Disabilities Australia –Invisible disabilities website
Alzheimer’s Society (UK) – Dementia Friends
Dementia Friendly America – Living, engaging and thriving in dementia-friendly communities
Alzheimer’s Society (Canada) – Dementia-Friendly Canada
Alzheimer’s New Zealand – Dementia Friendly Communities
Alzheimer’s Europe – Dementia in Europe Yearbook 2015: Is Europe becoming more dementia friendly?

When needed calmly withdraw to safety

Despite trying hard to create a peaceful environment, you may one day find yourself in a situation where the person you are caring for becomes very agitated. If you are concerned for your safety, it is primary importance that you calmly move to a position of safety and if possible, have a mobile phone with you, but do not put yourself at risk trying to retrieve your phone. Make sure you have a clear route to an exit so you can leave the area if needed, preferably calmly position yourself between the exit and the other person. If you are unsure how to de-escalate, you can call the Dementia Australia 24/7 helpline. As a pre-emptive measure it may be a good idea to add this number to your phone contacts.

In violent situations you should completely retreat from the area, call 000 and let them know the person has dementia.

If you feel you are able to, calmly try and find out what the is the cause of the agitation. It is important that you acknowledge anything the person says, re-assure and build trust such that they accept that you are there to help. Do not give the impression that they are mistaken or imagining things and do not tell the person to calm down, you may make things worse. The emotions they are experiencing are real and need to be addressed to their satisfaction to have a chance of de-escalation. This sometimes can be achieved by allowing them to speak and you listening. A calm de-escalation is the best outcome for both of you; the person you are caring for may sometimes apologise for the disturbance and thank you for caring enough to listen. You can then help resolve the cause of the agitation in a respectful way.

More information

Dementia Australia – Agitation and aggression
Youtube: Teepa Snow’s Positive Approach to Care – Time with Teepa: How Can We De-escalate Someone That is Agitated?
Alzheimers Association (USA) – Aggression and Anger
Australian and New Zealand Committee on Resuscitation – Guideline: First Aid Management of The Agitated Person