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Caring for someone with dementia requires patience, understanding, and a willingness to adapt. While dementia care is complex and highly individual, certain principles consistently prove effective. At Ashberry Care Homes, we've found that following three "golden rules" can transform interactions with people living with dementia, creating more positive experiences for everyone involved.
Golden Rule 1: Enter Their Reality
When caring for someone with dementia, one of the most powerful approaches is to step into their world rather than trying to bring them into ours. This means accepting their perception of reality, even when it differs from our own. This approach, sometimes called validation therapy, helps maintain trust and reduces unnecessary distress.
In practice, entering their reality means acknowledging the emotions behind what they're saying, rather than contradicting or correcting them. For instance, if your loved one believes they need to catch a train to visit their childhood home, arguing that their parents passed away years ago will likely cause confusion and distress. Instead, acknowledging their feelings and gently redirecting can be much more effective.
This approach requires us to let go of our instinct to correct inaccuracies and instead focus on emotional truth. What matters most is how the person feels in the moment, not whether their understanding aligns with factual reality.
Key aspects of entering their reality include:
- Validating feelings rather than correcting facts
- Using their language and references, even if they seem from the past
- Finding the emotional truth behind confused statements
- Avoiding phrases like "Don't you remember?" or "That's not right"
When we meet people with dementia in their reality, we create a space where they feel understood and accepted. This significantly reduces anxiety and builds trust, which forms the foundation for all other aspects of care.
Why This Approach Works
Entering their reality works because it addresses the emotional needs that often drive behaviour in people with dementia. When someone feels understood and validated, they experience less anxiety and frustration, which in turn reduces challenging behaviours.
Research shows that contradicting someone with dementia often triggers their "fight or flight" response, increasing agitation and distress. By contrast, validation approaches help maintain a sense of security and trust.
Golden Rule 2: Adapt the Environment, Not the Person
The second golden rule recognises that it's easier to change the environment than to expect someone with dementia to change their behaviour or abilities. As dementia progresses, a person's ability to adapt to their surroundings diminishes, making our role in creating supportive environments increasingly important.
This rule extends beyond physical spaces to include routines, communication styles, and expectations. Rather than becoming frustrated when someone can't remember instructions or complete tasks as they once did, we adapt our approach to match their current abilities.
In physical environments, this might mean:
- Reducing background noise and distractions
- Using clear signage with both words and pictures
- Ensuring good lighting to reduce confusion
- Creating contrast between objects (like coloured toilet seats)
- Removing trip hazards and securing dangerous items
In communication and interactions, adaptation includes:
- Simplifying instructions and breaking tasks into smaller steps
- Using visual cues alongside verbal ones
- Maintaining consistent routines
- Allowing more time for processing and responses
At Ashberry Care Homes, we've seen how thoughtfully adapted environments can significantly reduce anxiety and confusion while promoting independence. Something as simple as a familiar photograph on a bedroom door can help someone find their way, while consistent daily routines provide reassuring structure.
Creating Success Through Adaptation
When we adapt environments and expectations, we create opportunities for success rather than setting up situations where failure is likely. This approach helps maintain dignity and self-esteem, which are often threatened by the progression of dementia.
For example, rather than repeatedly correcting someone who struggles with utensils at mealtimes, offering finger foods allows them to eat independently. Instead of quizzing someone about recent events they can't recall, reminiscing about long-term memories they can access creates positive interactions.
Golden Rule 3: Focus on Feelings, Not Facts
The third golden rule recognises that in dementia care, emotional connections often remain intact even as cognitive abilities decline. By prioritising emotional wellbeing over factual accuracy, we maintain meaningful connections and improve quality of life.
People with dementia may not remember specific events, but they often retain emotional memory, the feelings associated with interactions. A person might forget your visit, but the positive feelings from a warm, loving interaction can persist long after the specific memory has faded.
This principle encourages us to:
- Prioritise creating positive emotional experiences
- Use non-verbal communication (smiles, touch, tone of voice)
- Engage through sensory experiences like music or familiar scents
- Value connection over correction
- Focus on strengths and remaining abilities rather than losses
At Ashberry Care Homes, we've witnessed how activities focused on emotional engagement like music therapy, sensory gardens, or reminiscence work can bring joy and connection even in advanced stages of dementia.
Building Meaningful Connections
When we focus on feelings rather than facts, we open up new possibilities for connection. Someone who struggles with recent events might still enjoy sharing stories from their youth or expressing themselves through art or music. By engaging with their emotional world, we create moments of genuine connection that enhance wellbeing.
Research consistently shows that emotional wellbeing has a significant impact on physical health and cognitive function in people with dementia. Positive emotional states can improve appetite, sleep quality, and even cognitive performance.
Putting the Golden Rules into Practice
Implementing these golden rules requires practice, patience, and sometimes a significant shift in our approach. It means letting go of our own need for accuracy and control, focusing instead on creating positive experiences and connections.
Some practical ways to apply these principles include:
- Responding to the emotion behind confused statements
- Using distraction rather than correction when someone is upset
- Creating simple, accessible activities that focus on process rather than outcome
- Maintaining a calm, reassuring presence
- Learning about their past to better understand their current reality
- Being flexible and willing to try different approaches
At Ashberry Care Homes, our staff receive specialised training in these approaches, learning to implement them in daily care. We've found that when these principles are consistently applied, not only do residents experience less distress, but relationships between carers and residents become more rewarding.
The Impact of Consistent Application
When these golden rules are applied consistently, the benefits extend beyond individual interactions to create a more positive overall experience. Residents experience:
- Reduced anxiety and agitation
- Improved appetite and sleep patterns
- Greater willingness to participate in activities
- More moments of joy and connection
- Better relationships with carers and family members
How Ashberry Care Homes Can Help
At Ashberry Care Homes, these three golden rules form the foundation of our approach to dementia care. Our specially trained staff understand how to create supportive environments, enter residents' realities, and focus on emotional connections.
We provide:
- Specialist dementia care in purpose-designed environments
- Staff trained in person-centred dementia care approaches
- Regular activities that promote wellbeing and connection
- Support for families in understanding and applying these principles
- Consistent application of the golden rules across all aspects of care
If you're supporting a loved one with dementia, or considering care options, we're here to help. Our experienced team can provide guidance, support, and specialist care built around these proven principles.
Every person's journey with dementia is unique, but these golden rules provide a framework for care that promotes dignity, connection, and wellbeing. Let us help you apply these principles to create more positive experiences for your loved one.
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