Simple strategies can make all the difference when you are supporting someone with everyday tasks. Dementia can cause damage to the frontal lobe which results in changes to lots of important skills. The frontal lobe plays a key role in what is known as ‘executive function’. This is a term that describes skills such as:

• weighing up information and making decisions
• organising and planning time
• thinking flexibly and dealing with the unexpected
• problem solving
• managing risk and acting safely
• controlling impulses
• giving us our ‘get up and go’

Behavioural changes caused by dementia can very from person to person, but here are some common challenges that you might experience as a carer and suggestions on ways to manage these scenarios.

Give verbal and visual prompts to help start a task.

For example, if a meal is left in front of a person with dementia they may not be able to get started, and may need a verbal or physical or visual cue. Just because they aren’t eating eat, doesn’t mean they’re not hungry. It may just mean they are unable to get started.

If someone has difficulty with stopping doing something, they may need a verbal or tactile cue. 

The difficulty with ceasing an activity is known by health care professionals as perseveration. It can occur in speech as well.

For example, if someone is searching through cupboards for an item, they may forget what they are looking for and become focused on the emptying of cupboards and be unable to stop. Or they may continue to keep brushing their teeth for far longer than usual. If this happens the person with dementia may need a verbal cue to stop so you might say “It looks as though you have finished brushing your teeth, why don’t you put the toothbrush down.”

If this doesn’t work you may need to give a gentle touch on the arm or hand.

Break it down. It really helps to divide tasks down into single steps.

Most simple tasks have multiple steps – an example would be brushing teeth. It is important that you prompt the person one step at a time:

• Let’s go to the bathroom
• Turn on the tap
• Pick up your toothbrush (and so on)

Break the task down.

Use paper and pen or a whiteboard to write down the decision that needs to be made. 

Help the person think of pros and write these on one side and write cons on the other side. 

Giving structure to tasks like this can make it more accessible and ensure the person with dementia is still involved in decision making.

Give short and simple pieces of information.

For example, if you are explaining where you are going, focus on the key points and don’t include lots of detail. 

Try to keep eye contact with the person as they will be aware of your facial expression.

People with dementia are often highly reliant on your visual cues and facial expression to make sense of what you are saying.

Ask the person with dementia for their help with a task rather than doing it all for – or to – them.

For example, ask them to hold the fork with you rather than feed them.

A useful way to think about this, is that we should not feed a person with dementia, but support them to eat and drink – it’s a subtle but important shift of focus. 

If you are cooking, can they chop vegetables, lay the table, fold the towels, fill the glasses of water etc? Think about doing ‘with’ not ‘to’.