Guiding Hand

The guiding hand will help you instil trust and guide or move a person with dementia.

  • Shake the person’s hand.
  • Gently slide your fingers upwards around their thumb.
  • Move to their right side and place your spare arm around their back.
  • You can then move and guide the person in a calm and gentle manner.
  • The guiding hand technique can also be used to assist a person into a vehicle.

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Possible Intruder in House

  • Follow general advice.
  • If the person has phoned for assistance be mindful that they may have forgotten that they rang for help.
  • Introduce yourself and explain why you are there, say you are there to help.
  • If the person still believes someone is in the home, emergency service personnel follow relevant procedure.
  • If no-one is there but the person still believes they are, it could be because of one of the following:
  1. They have confused the coat stand with coats on it for a person: Put the coats out of sight.
  2. They have heard a noise such as a branch brushing against the window: Remove branch if possible.
  3. They have seen their reflection in a mirror or window and don’t recognise themselves: Cover the mirror and close the curtains.
  4. They don’t recognise their spouse or relatives:
    • Don’t refer to the spouse or relative as “this your husband or brother.” Just say this is Brian. Avoid using the relationship title as this could increase the level of distress.
    • If person continues to be anxious ask the spouse or relative to go in to another room.
    • Stay with the person with dementia.
    • Speak slowly and calmly to reduce the tension.
    • Once calm ask the spouse/relative to come back in and use their first name only. Assess the mood of the person with dementia. If they become agitated again, the separation time needs to be extended.
  5. They have had a hallucination:
    • As they have phoned for assistance they were clearly scared.
    • Stop, Look & Listen. Are they still scared? Can they still see what frightened them?
    • Don’t say “there is nothing there” this will add to their discomfort. Say “You are very scared, let me help you”
    • Use the guiding hand technique to turn them away from their vision and to look at you.
    • Lead them into another room and suggest a cup of tea.
    • Hallucinations can be caused by an infection. In your opinion do you think they need medical attention?

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Missing from Home

  • When carrying out a search make all people assisting aware:

– That shouting the person’s name can make them feel threatened which could prevent them from making themselves known.

– When feeling threatened a person with dementia experiences tunnel vision and will therefore follow a path directly ahead of them. This can lead them into unexpected places such as sheds, alleyways, wooded areas, dense shrubbery or a ditch.

  • Once person is found follow general advice, as the right approach is critical in calming the person.
  • Adopt a friendly and interesting tone when calling their name. E.g. ‘Ruby come and see this.’Missing-From-HomeBackground

Do I Live Here?

It’s possible that a person may seek out an old address thinking they still live there. If this happens:

  • Follow general advice.
  • Once the person is calm find out if they have any identification.
  • Avoid transporting them in a police vehicle that has caging, as this is likely to cause distress and lead to potential injury._2edit-Do-I-Live-Here-Background

Medical Emergency in Person’s own Home

  • After gaining entry and finding the person follow emergency medical procedures.
  • If a family member is present and they have ‘Lasting Power of Attorney (Health)’ ask them to produce the documentation.
  • Be aware that if the person is conscious they may not be able to communicate verbally about their pain. They may demonstrate a behaviour such as screaming or rocking or even be unusually quiet which can be an indication that all is not well.
  • If they have suffered a serious injury such as a broken bone they are unlikely to realise/understand the extent of their injury and may try to move to get up.
  • Try to avoid transporting the patient to hospital if you feel they don’t require emergency treatment. Instead consider accessing support from the District Nursing team or other appropriate support agencies.
  • Use the general advice as much as you can._2edit-Medical-Emergency-in-Home-Background

Attending Accident & Emergency

  • Be aware that being in unfamiliar surroundings is likely to increase the person with dementia’s sense of confusion and agitation, which could lead to aggressive behaviour.
  • If accompanied by a relative/friend who they know and trust, ensure the relative/friend stays with them throughout their treatment.
  • Follow general advice.
  • If possible find a quiet area to place them and speed up the process so they are seen as quickly as possible.
  • As they may not be able to tell you about their pain, consider pain relief as early as possible, if this is appropriate._2edit-Accident-and-Emergency2

Fire Emergency

  • After gaining entry to the property if the person is in danger respond in the most appropriate way.
  • If the person is physically unharmed, be aware that they may be traumatised by their experience therefore use the general advice to help calm them and make them feel safe.
  • If waiting for emergency service personnel to arrive to take over their care try to choose somewhere to wait that will be relatively familiar to the person e.g. a neighbour’s house.

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Refusing Entry to Home

If a person locks themselves in their house and won’t allow anyone in:

  • Be aware that shouting the person’s name can frighten them and so adopt a calm tone.
  • Gain general information about the person from a family member/neighbour – name, interests, what they did for a job.
  • Call through the letterbox using a piece of the information to calm them down and entice them to unlock the door. E.g. If Fred loved dogs, say “Fred would you give me some advice about my dog at home, he’s being really naughty.”
  • When they open the door use the general advice._2edit-Refusing-EntryBackground

Relative Believed Missing

A person with dementia may believe that a relative is missing but they may have moved away or died:

  • The individual is likely to be feeling very emotional.
  • Use general advice to calm them.
  • If the individual makes reference to a relative/spouse who is dead do not remind them that they have died. As they do not remember this, they are likely to become much more anxious and upset if given this information – it will be like they have learnt they have died for the first time. Instead encourage conversation about the relative using the words “Tell me about……..”
  • When the person appears settled Emergency Personnel can find an appropriate time to leave.
  • There may be a need to contact the family or social services._edit2-Missing-Relative-Background

Committed an Offence

  • Be aware that the person is likely to be very agitated and anxious.
  • It is possible that they will be in complete denial that they have done anything wrong. A shoplifter, for example, may believe that they have bought the goods.
  • These emotions could lead to aggressive behaviour.
  • Follow general advice._2edit-Commited-an-Offence-background