Author: aarondawson97

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When a person has dementia different parts of their brain can be affected which can lead to a range of unusual behaviours. Over time their ability to reason will diminish, as will their levels of understanding. Therefore when responding to an individual with the disease you need to take this into account. Be aware that in an emergency situation the person is likely to be highly anxious, disorientated and confused. It doesn’t take much to make a situation worse and lead to the individual becoming even more scared, frightened and even aggressive. That’s why it’s important to try and understand how the person is feeling at this time. Our approach in this Website concentrates on understanding the feelings of the person with dementia during the crisis and suggests ways to ease the situation. Do be aware however, that everyone is unique and also the way dementia affects each individual is different. Therefore our advice is generalised.

Get it right and you can calm the situation and make the person feel more secure and at ease.

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Disclaimer

The material and information contained in this Website is provided without any guarantees, conditions or warranties as to its accuracy. It is provided as an information resource only, and it is not to be relied on for any legal, diagnostic or treatment purposes.

This Website was created by Dignity in Dementia – for more information visit: www.dignityindementia.org

If you are wanting to download a PDF version of the website click here.

To download the app for Android devices click the image below.

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General Advice

In an emergency situation an individual living with dementia is likely to be anxious and disorientated.

  • Stop, look and listen and assess the situation.
  • Approach slowly from the front, leaving a 1 metre space between yourself and the person.
  • Be mindful that as dementia progresses vision can become significantly impaired so you need to get into their visual field. For those without hearing loss, hearing can be accentuated so shouting and loud noises can be frightening.
  • Get to their level to make eye contact.
  • Say hello and use their name if known.
  • Introduce yourself in a warm and friendly manner. Use a calm tone.
  • People with dementia understand visual cues rather than words. Therefore use visual cues to help them understand.

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Communication Difficulties

As dementia progresses the individual’s ability to communicate deteriorates. In the earlier stages words may get muddled but the main meaning will be clear. Later on it becomes more difficult to understand the message but understanding the emotion behind the message can help.

  • Anger/aggression – they feel threatened or may be in pain.
  • Sad/crying – they may feel insecure and frightened or may be in pain.
  • Scared – they feel frightened and may try to get away from something.
  • Anxious – they feel disorientated and confused.
  • Sexual gestures – they are looking for intimacy e.g. a cuddle._2edit-Communication-Icon-background2

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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