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Skip to 0 minutes and 7 secondsWe take for granted our ability to go out and about as we wish and take part in the activities we enjoy. But as dementia progresses, this can become more challenging. Issues may be the result of a person's reduced memory of places, their ability to recognise everyday objects, and impaired decision-making ability. Carers and people living with dementia may minimise feelings of anxiety and confusion by limiting where they go and who they spend time with. But this can contribute to social isolation. Contending with the outside world can lead to information overload, anxiety, and confusion for people living with dementia, and can contribute to the stress faced by carers.

Skip to 0 minutes and 54 secondsUneven pavements, crowds of fast-moving people, heavy traffic, poor sign-posting, and a lack of outdoor seating and toilet facilities all present challenges. Technologies that should help, like the crossing signals, can easily add to confusion and anxiety. If the person has other health conditions, such as difficulty walking, worsening eyesight, or impaired hearing, these challenges will be greater. The coffee shop where we meet our friends may bring changes in lighting, queues, noisy equipment, and a number of trip hazards. We have decisions to make. But with noise and uncertain procedures to follow, this can be overwhelming. We take for granted our ability to recognise friends. Hello, how can we help you today? May I have a toastie, please?

Skip to 1 minute and 51 secondsTo make quick decisions about what we want, choosing from written menus, for example. We expect to know how to interact with staff. All right, that's 6 pound 90, please. Thank you very much. And to be able to pay with cash or card machines. We are faced with observing social etiquettes throughout, when queuing, ordering, and finding a seat. A person's behaviour may not reflect what is expected of them in some places or circumstances, so many carers describe feeling anxious about the reactions of other people, since dementia is not a very visible condition. All too easily, we create disabling environments for people with dementia.

Skip to 2 minutes and 36 secondsThe challenge of a dementia-friendly society is to re-imagine public and private spaces so that they enable people with dementia to continue to live and interact outside the home within their community for as long as possible.

Where we communicate matters

Where we communicate can make a big difference - it can support our interactions, by helping to reinforce and convey meaning, or it can distract or confuse.

We may improve our communication by:

  • maximising familiarity - familiarity with a place can reduce anxiety for people living with dementia. So at home, leaving things (décor, furniture) as they are can give cues to purpose/expectations and help reduce anxiety.

  • having adequate space for interaction - you should be able to comfortably face the person you are speaking to and have adequate and appropriate lighting.

  • reducing distraction - turn off radios/TVs or go to a quieter space if possible.

  • matching content of conversation with location - for example, asking someone about lunch while they are sitting in a surgery may cause confusion - because the cues around them do not support this conversation topic. Starting the same conversation about lunch in the kitchen, at the dining table or in a supermarket will supplement verbal information with supporting clues.

Think about the last conversation you had. Did the setting reinforce what you were talking about or cause distraction?

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This video is from the free online course:

Dementia Care: Staying Connected and Living Well

Newcastle University

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