Dementia-friendly tips for health workers

The physical environments of hospitals and other healthcare settings can be distracting and confusing for people living with dementia which can cause distress. 

A few simple changes to physical spaces can help improve the experiences of people with dementia and enable them to maintain a sense of independence. 

Provide clear and simple signage 
Make sure any important signs are written using large letters (48 point) and a clear, san serif font (such as Helvetica or Arial), and place them at a height of 1.2 metres where they can easily be seen. Letters should appear against clear background without any unnecessary visual elements.  

Consider adding simple symbols to signs to indicate the functions of items or rooms. For example, a toilet symbol on the bathroom door. Removing any unnecessary signage from the space also will be helpful. 

Minimise noise and distractions 
People living with dementia can become confused or anxious around loud, competing noises and distractions including sound from the TV or radio, loud conversations, mirrors, reflective surfaces and bright lights. Minimising unhelpful stimuli will help people with dementia to remain focused and calm in the space. 

Collect visitor names 
Try encouraging all visitors to write their names on a sheet of paper. Looking at this list later on and remembering they have been visited by people who care about them can provide a sense of comfort. 

Provide an easily visible calendar 
Something as simple as placing a 24-hour clock or calendar by the bed or in another easily seen spot can help orient the person and enable greater independence. Ensure all clocks and calendars in the setting are accurate. 

Keep the bathroom in view 
Having a clear, unobstructed view from the bed to the bathroom will reassure the person by making sure they know exactly where the bathroom is when they need it. 

Make sure spaces are well-lit 
Good lighting is important to reduce shadows, reflect the correct time of day and help ensure the person doesn’t become disorientated – a minimum level of 300 lux is best. Where possible, make sure curtains are open so the person has access to natural light. Placing the bed next to a window can help restore sleep patterns. 

Make important items visible 
Keeping important items such as toothbrushes in a visible location rather than in a cupboard or drawer will help the person to access them easily and independently. A glass of water should also be kept in a prominent place as a visual cue to stay hydrated.

People living with dementia have unique requirements when it comes to communication. Dementia makes it harder for people to concentrate, and the extra distractions and stresses found inside some care settings can make communication more difficult. 

Poor communication can cause the person distress and may result in their specific needs not being met. 

Listed below are some helpful strategies for enabling effective communication. 

Minimise distractions and disruptions 
When communicating with a person living with dementia, removing as many distractions as possible will help them to focus. For instance, switch the radio or television off, or make sure there are no competing conversations in earshot. Avoid moving around while speaking, sit still and stay in their line of vision. 

Talk directly to the person 
Don’t assume people living with dementia can’t understand you. Don’t talk to their carer, family member or friend instead. This will make the person feel excluded and isolated, and could make them less open to communicating with you. 

Make a connection 
Let the person know they have your attention by making eye contact. Use their name in conversation so they can be confident you know who they are and that you are engaged with them. Body language such as leaning in and nodding encouragingly as they speak will help to show them you’re listening. 

Be patient, understanding, gentle and calm 
Try to be as patient and understanding as possible when speaking to a person with dementia. They might take a long time to find the right words or ideas, or they might lose track of the conversation. But don’t rush them – give them all the time they need and remain gentle and calm in your demeanour. Try responding to the emotion that is being communicated, for example, “you sound upset”, or “I can hear that makes you feel sad”. 

Speak clearly 
Make sure your words are spoken clearly and slowly and avoid using complicated language. It can help to use short sentences, communicating one idea at a time. Providing information in smaller chunks can help the person to process it more easily. Closed questions with yes or no answers and a focused context can be easier for the person to understand i.e. “Wasn’t it nice and sunny on our walk yesterday?”. 

Get to know the person 
Getting to know a person with dementia will reassure them that they are being listened to and will help to make them feel comfortable when communicating with you. Ask them what their preferred name is, about their normal routine and about their likes and dislikes. Find out what their favourite things to talk about are such as hobbies, their family, pets, or travels. 

Connect with the person’s carer separately 
It can be a good idea to connect and communicate important information to the person’s carer separately, in addition to the person with dementia. This will enable the person with dementia to clarify important medical information with someone they know and trust. You can also ask their carer for helpful information that might support positive communication with them.

When people living with dementia become disoriented, this can increase their stress levels.  

Below are a few ideas and suggestions to help keep the person oriented. 

Wear a name tag 
Wear a clear name tag with large letters (at least 48 point font, if possible) so the person can easily identify you and remind themselves of who you are. They may feel more relaxed if they don’t have to worry about remembering your name. 

Introduce yourself each time 
Introduce yourself by name and occupation each time you enter the person’s room and explain the reason for your visit. Don’t assume they will remember who you are and how you are helping them. Continuing to remind them will help to prevent them becoming confused or uneasy. 

Put information in writing 
Putting important information that the person might need or want to know during their stay in writing will enable them to refer to it as needed. This can help put them at ease and maintain a sense of independence. This information might include how to contact the nurse, where to find the bathroom, and when to expect visits from staff and loved ones.  

Place familiar objects around the room 
Placing familiar objects such as family photos, cushions or blankets around the room can help make the person feel more comfortable and oriented. This can be particularly effective for longer stays, respite or when the person is making the transition into residential aged care.  

Use orienting names 
It can be helpful to insert ‘orienting names’ into conversations to remind the person who you are talking about. For example, “Your son, Jack” or “Doctor Williams, your doctor”.

It is important that people living with dementia are encouraged and enabled to live full and active lives whenever possible, and that they stay socially, physically and mentally engaged. 

While this can sometimes be challenging in care environments, members of staff should prioritise offering and enabling opportunities for residents to participate in meaningful activities. 

Below are some ideas and tips to help keep people living with dementia engaged. 

Enable everyday decision making 
Most people living with dementia will benefit from being enabled to do things by themselves or being involved in planning or problem solving. When organising an activity such as a walk outside, for instance, allow the person to be involved in the planning and let them decide where they would like to walk. 

Healthy mind activities 
Organise and encourage ‘healthy mind’ activities including crosswords, word searches, colouring books, reading materials, board games and any other activities that challenge or engage the mind. These kinds of activities will help the person with dementia to remain oriented in the present and to enjoy themselves. By keeping their mind active the person may also experience improved wellbeing and clearer thinking.  

A Better Visit is a free app from Dementia Australia that features a range of two player games designed to enhance communication and facilitate positive interactions between people with dementia and their visitors. 

Engaging activities 
Understanding each individual’s needs, strengths and abilities will help you plan suitably engaging activities. 

For example, encouraging the person to participate in group activities such as singing, gardening and games might mean they feel included as part of a community, which can contribute to a greater sense of wellbeing.  

In acute care settings, allowing the person to spend some time in the lounge area around other people can be greatly beneficial.  

Where the person is non-verbal, consider how else they might be communicating with you, as well as other activities through which they might be able to engage including drawing, painting or listening to recognisable music.  

Enable your team to create meaningful and purposeful engagement for people living with dementia by taking Dementia Australia’s course, Achieving purposeful engagement.  

Diet and exercise 
Eating healthily and staying physically active will keep the person’s energy levels high and enable them to think more clearly. They should be encouraged to do as much gentle exercise as they are capable of, including walking. Where possible and practical, they should be allowed to undertake physical tasks on their own to help them maintain a sense of independence. 

Ensuring access to healthy and nutritious meals is another important aspect of caring for a person with dementia. Using Dementia Australia’s virtual reality and avatar technology, A day in the life – Mealtime experience, you can explore the multifaceted influence of food and mealtimes on the person’s quality of life.  

Talk regularly 
Talk to the person living with dementia as much as you can, even if communication can sometimes feel difficult. It will help make them feel socially engaged, connected, included and less lonely. Having a conversation is an effective way for people living with dementia to stay in the present and can also help them feel more comfortable in their surroundings.  

You can practise your verbal communication skills with Dementia Australia’s Talk with Ted program, which allows you to have a virtual conversation with Ted - an Artificially Intelligent (AI) avatar with symptoms of dementia. 

For more communication tips, check out our Let’s Talk brochure, developed by people living with dementia.

For a health professional to be equipped to care most effectively for people living with dementia it’s vital they commit to education and training as well as creating a dementia-friendly culture within their organisation.  

Upskilling staff 
Dementia Australia’s Centre for Dementia Learning offers a suite of education programs designed for health professionals. We can even produce customised education solutions tailored to meet the specific needs of your organisation. Our education is delivered in a flexible and engaging way by highly-skilled facilitators using experiential technology to support deep understanding and empathy among participants. 

Creating a dementia-friendly culture within your organisation 
As the number of people living with dementia continues to grow, many Australian businesses and organisations are taking positive steps to become dementia-friendly.  

Dementia-friendly organisations are inclusive and friendly, recognising people living with dementia as equal members of the community.  

These organisations respond to the needs of their customers, clients, staff or volunteers living with dementia. To do this, they’re willing to make small changes that improve accessibility, inclusivity and connectedness. 

For more information about ways to upskill your staff, visit our Professional development and training page. To find out more about creating a dementia-friendly organisation visit our Dementia Friendly Communities page.