Christopher Wagstaff

Christopher Wagstaff

Chris is a senior lecturer in mental health nursing. He worked for the NHS for 14 years before entering higher education and is part of the 'Risk, Aggression & Violence' research programme.

Location University of Birmingham


  • Dear all,
    Thank you for your participation and comments. It is you, the participants of the course, that make it work and offer invaluable advice and support to others.
    As with other years there has been controversy and disagreement but there has also been a lot of learning and mutuality.
    Alison, Nutmeg and I are signing off now and extend a heart warming...

  • I have to say Vicci that you have been both insightful and intelligent in your discussion points. Thank you for your input.

  • The importance of individualised care!

  • Always.

  • I know that some homes do use picture boards. I think that picture boards are a sensitive subject with some people finding them quite patronising. Whereas I am sure there are other people will find them useful.

  • You are welcome to use this for training purposes Melinda, just credit the source. Glad you find it useful.

  • The transcript and subtitles for this video have now been fixed.

  • It’s a shame that you have to take time away from other people to give the time needed to someone else. But as you say, the interventions worked.

  • Some skills are always transferable.

  • As you say Christine, patience and calmness are key.

  • Indeed, laughing helps everyone.

  • Bombarding people with dialogue is a mistake that is frequently made!

  • There are lots of simple & sensible ideas which positively impact upon the care being delivered and received. Thank you.

  • Being be relaxed, calm and comfortable makes a big difference. And there also needs to ne a match between your verbal and non-verbal communication.

  • You are probably right Ian!

  • You are right Alejandra those key human skills of common sense , communication gestures, eye contact , nice tone of voice (& taking time) can make all the difference.

  • 3. Work to identify triggers and try to prevent the inappropriate behaviour from starting:

    • Keep their hands occupied with a fidget activity or sensory activity.
    • Boredom can also cause sexual behaviour. Keep your older adult happily occupied with different types of engaging activities.
    • Keep a caregiving journal of the inappropriate behaviours to...

  • 2. Explain sexual behaviour to other people
    • Dependent on the setting let family, friends, and visitors know ahead of time that inappropriate behaviour or sexual remarks might happen and that it’s caused by changes to their brain from dementia.
    • Calmly ask other adults to excuse their behaviour or advise them to step back a bit.
    • In some instances it may...

  • 1. Manage inappropriate behaviour when it happens:

    • Stay calm and be patient.
    • Gently but firmly tell the person that the behaviour is inappropriate.
    • Match your body language to your words – frown and shake your head. People with dementia are better at reading nonverbal cues.
    • Maintain consistent, firm boundaries. Don’t accidentally encourage...

  • Thank you for the comments that have already been made. An important point to stress is that sexually inappropriate behaviour is most likely to be caused by changes in the brain due to the dementia; it is not something that is being done on purpose. Dementia affects parts of the brain that control a person’s ability to control their own responses.

    There is...

  • Surely if you can make your wife laugh/ happy then surely, at some level you are successfully communicating with her?

  • & by individual care and attention.

  • Difficult and complicated behaviour was in fact quite easy to explain. But as you say it needs understanding, observation and time.

  • I agree with your point Kelly, if several (unfamiliar) people are trying to persuade Peter to do something that he understand the purpose of it is only going to lead to frustration & anger.

  • Respecting individuality is incredibly important!

  • Patience, kindness, calm, eye/ face contact, retaining a sense of humanity and understanding, thinking about your positioning, hand gestures, familiarity with people and environment all help. But as said before in the course all people are different so therefore the style of communication will be different too.

  • Sometimes it is easy to understand the root cause of the anger and frustration.

  • @MaureenMarshall without wishing to detract from the other replies, I would agree Maureen. Almost all human behaviour verbal or otherwise has some communicative value. There is a message that people are trying to send.

  • I am truly sorry to hear about this sad state of affairs. As you say, you are united by the common cause that you all love your Mum.

  • And retaining our sense of humanity is a goal which all care givers must try to aspire to. @LeonieSeeds

  • I hope you are able to may amends with your siblings Barbara ........

  • Whilst it may be your experience that some homes offer inhumane care, many homes offer absolutely excellent care.

  • Hopefully this course will be of benefit to you Rossalyn.

  • It is interesting that you are encouraging your team to participate Deidre, I am aware that a construction firm are doing the same.

  • You are right Ian, it is fascinating reading people’s reflections and unique qualities of everyone’s experience.

  • Hi Valerie, would you like to say more about what you mean by a Dementia-friendly community?

  • Hi Faye, in terms of taking care of yourself are you talking about how to feel supported or trying to be proactive to stave off dementia?

  • & if you read elsewhere in this course other people have commented on the removal of wires. Paranoia about what is happening; misunderstanding the function of the wires and people with heightened sensory perception do sometimes 'hear' the sound of electricity.

  • @MichaelO This sounds both fasinating and very personal MIchael. Certainly lots of people with dementia have perceptual disturbances and I have known people experience exagerations in colour before. Sounds like you have watched this very closely and thought of inventive solutions.

  • @BeatrizUnda Hi Beatriz, there is nothing on a national but locally there are quite often support groups. My advice is to go to the Alzheimers Society website and see what information you can glean from there. Everything they post is evidence based.

  • @JeanGold is this a recent development or has it always been a feature of your husband's dementia?
    Are there any particular times of day?
    Have you noticed any regular precipating factors?
    & importantly, what support are you getting?

  • Accepting that everyone with dementia experiences the condition differently is an important first step.

  • Thanks Emily. This came up yesterday aswell. There is going to overlap (clear communication, patience, persistence, kindness, sense of humanity, teamwork) but this course will not be looking at learning disabilities per say.

  • I think you would surprise yourself in how many skills you actually have Maura.

  • Hi Irene, thank you for sharing the details of what you know about dementia. Please note that this course does not look closely at the specifics of diagnosis in dementia, however there are two other courses on Futurelearn that do.

  • Agreed. Reading body language and listening to non-verbal utterances is incredibly important.

  • Wise words indeed.

  • I'm sure some of your skills will be absolutely transferrable Beatriz. Patience, calmness, kindness, clear communication ......

  • Are there any behaviours that you find particularly challenging Jean?

  • Indeed you are right Derek, caring for someone with dementia can takes it’s toll on those around them.

  • Whilst we do not talk directly to caring for people with Down’s syndrome, a lot of the strategies transfer between people from all backgrounds.

  • I believe you are the first to comment this year Michael, so thank you.
    Heightened sense of colour and over attention to wires? Would you care to explain further?

  • I hope that there will be material in this course which will help you Judy, as you say being a full time Carer is physically and mentally exhausting.

  • And that is an important component of the course Wendy, that you learn from the experiences of others.

  • & through your experience Louise I am sure you may be to help others deal with caring for a loved one through their dementia.

  • You are relight Barb, the response of loved ones can have a really important impact on deescalating challenging situations.

  • Hopefully the course and the conversations will prove useful to you Annie.

  • Whilst people’s personalities change as the dementia progresses it is often hard to predict how their personality will change.

  • Hello Michelle, particularly in the third week we look at communication and deescaltion skills.

  • Something to bear in mind Colin is that everyone will have different behaviours and different triggers. Routine, familiarity, clear communication and trying to minimise frustrations are all important.

  • Being a supportive family member, even from afar, can be invaluable.

  • I'm sorry to hear that this course did not meet your expectations Claudia, but thank you for seeing the course through to the end regardless.

  • Hello Bettina, thank you for staying in touch with us. I agree that we should be empathatic, I agree that we should strive to find ways to connect with people & to try & understand their world, and to communicate heart to heart. All of these are components of best practice.

    Truth & lies are on a spectrum and there is a grey area in the middle wherein we...

  • Thank you for your comment Bettina.

    Lying to anyone is never easy or comfortable. The pragmatic decision being made is that telling a therapeutic lie to someone with dementia is done with the best of intentions. As discussed by us as educators & many of the participants, sometimes being honest causes unnecessary distress and the value behind the lie is...

  • That's an impossible question to answer Karina, all violence (verbal or physical) happens in a context, to understand the violence you need to understand the context. Dementia adds a massive layer of context!

  • Thank you for the lively discussion below; I have to say that predominately people seem to be in favour of therapeutic lying. Whilst most of us would not condone lying under normal circumstances there is an understanding that as carers/ nursing staff we are tring to minimise the distress for the person with dementia.

  • It is also about protecting the person from unnecessary distress and helping the person to feel safe.

  • And with thanks to Joy Lambert:

    • Forgetting to drink
    • Solution: Leave fresh water in glasses beside the bed, on the table, beside the armchair. Offer hot or cold drinks at regular times.

    • Forgetting they have eaten
    • Solution: Remind them they have just eaten; tell them it won't be long until (the next meal). Offer a fruit snack. Ask if hungry and...

  • Hi,
    I’m going to hand responsibility for contributing to the discussions and moderating the MOOC over to my colleague & friend Nutmeg Hallett. From this week here are the suggestions thus far about different techniques which may help with helping patients like Peter to eat more:

    • Consider the portion size to make food appear more...

  • You are right Jane, end of life arrangements are incredibly important and need to be discussed within families, regardless of the condition. I think what makes it more important/ difficult in dementia is getting the timing right. In week 1 there was lots of conversation about denial of diagnosis and outcome which makes an already challenging conversation...

  • Unfortunately the Schreiber article is not open access so therefore we cannot not repost it here.

  • What is your line of work Karen?

  • But remember that although are being deceitful you are doing it with the best of intentions, to minimise your mother's distress and upset.

  • Realigning the person to reality is a great and noble idea if & when you are confident that the person can retain the information and are also able to emotionally process what they are being told.

  • & when you do have to adapt your language to suit the situation, remember you are doing it with the best of intentions.

  • & this goes to the point of trying to think about what lies behind the question and then trying to address that.

  • & when we do lie for therapeutic reasons it is important to remember the intention behind the lie ... to keep agitation and distress to a minimum.

  • But there is also a sense of staying with familiar routines, to carry on with greetings that have always been used, is important. The familiarity of routines and language is comforting.

  • Good communication skills always play a role, the ability to be truthful but graceful are important skills to have. Emphasising that the person is safe, that the person, is respected, that the person is being listened to are sometimes more important than directly answering the question that the patient was asking.

  • Hi Chuck, it is not necessarily a precursor to dementia, though many people with dementia have it. The idea being that as it gets dark many of us believe we should be heading home for the evening. So if someone is in a care facility, like Peter is, as it gets dark each evening then they become agitated as they want to 'go home.'

  • & sometimes we have to remind ourselves of that; we can try to meet people's expectations and we can try our best to deliver highly individualised care but sometimes we will not be able to meet the standards that are set.

  • Unfortunately the article isn't open access so I can't post it here.

  • Thanks for this Joy, it really does sound like you are speaking from experience!

  • Hi Suranjan, this sounds like an awful experience for you. Please read the comments made throughout this discussion as there are some really useful comments being made.

  • I've noticed that too in my experience, that people's tastes genuinely change and so it is worth revisiting foods that have been previously rejected.

  • Indeed this does happen with some people, particularly those people who have frontotemporal dementia. Usuall this can be managed by presenting small portions, portions which are carefully cut and also limiting people's access to food.

  • Good, I'm glad you managed to watch the video.

  • Hello Everyone,

    This is pretty much the end of week 1 and I have to say I have enjoyed moderating the comments & participating in the discussions. I'm grateful that people seem to be enjoying the course and that there is dialogue between participants. I recognise that I haven't contributed to the euthinasia discussion, part of the reason being is that I...

  • Try using a different internet platform Annie - someone else had this problem too.

  • E Maureen, thanks for sharing; you must have a wealth of experience to draw upon.

  • No, that makes sense Celia.

  • And that point about mixing with strangers is important to remember.

  • Sorry Gordon, as Peter is fictional we didn't create a back story about his financial situation!

  • Jo, do you have q link for Montessori homes for people with dementia?

  • Hi Caroline, hope you learn some new skills and ideas from this course; in my experience woman and men can present as equally difficult in their challenging behaviour.

  • The type of 'dementia' that is related to alcohol abuse is Wernicke-Korsakoff syndrome.

  • So the pressure is on then Joanna to impress you enough so you recommend this course to your colleagues! What technology are they developing?

  • I hope this course gives you some new tips and skills but please also share from your experience, Penny.

  • In week 2 we discuss 'therapeutic lying', so in this instance saying that you can hear children crying too and going off to calm down the distressed children. Pragmatic, yes, but is it ethical?

  • Covered in both weeks 2 and 3 Debbie.