Safeguarding people with dementia

The enormity of the challenge of helping people to live well with dementia can be gauged by public attitudes to a condition many regard as ‘the beast’. A survey carried out by MORI in 2010 showed that one in three people in the UK are uncomfortable around people with dementia. The survey also showed that more than 50 per cent of people do not know enough about dementia to help someone who has it.

The findings were revealed on the same day as a new national awareness campaign was launched to educate the public about the condition and demonstrate the simple things that everyone can do to help people live with dementia.

It is difficult to come to terms with the mindset of someone who has dementia and how their attitude to managing money can change. They can become very forgetful as well as overly trusting, which can lead to increased vulnerability to abuse.

A carer quoted in the Alzheimer’s Society’s 2011 report, ‘Short changed: Protecting people with dementia from financial abuse

The Living Well campaign – promoted heavily on television, radio, the internet and newspapers – featured people with dementia, including Peter Dunlop, a former consultant obstetrician and gynaecologist.

In a video about the making of his commercial for the campaign in which people declare ‘I have dementia – I also have a life’, he explains that there is a ‘lot of ignorance about a lot of conditions’ and ‘things like Alzheimer’s and dementia are regarded as the 'beast''. He says: ‘It’s easier for someone to understand a heart attack rather than dementia. If they know what is going on that removes some of the fear.’

People with dementia can be extremely vulnerable due to the nature of their condition. Early symptoms can affect communication and reasoning skills and consequently they may not be able to understand or explain to others what is happening to them. The MORI research clearly demonstrates the stigma attached to dementia. A diagnosis and the life-changing decisions that follow (as highlighted in the feature, Planning for the future) can have a substantial impact on partners, families and friends – and on their relationship with the person with dementia.

This feature emphasises the importance of treating a person with dementia with dignity, maintaining their human rights and ensuring that appropriate safeguards are put in place to protect them in their home and from abuse.

Safety in the home

A person’s home can help or hinder their ability to live well with dementia. Poorly fitted mats or poor lighting can lead to trips and falls. Forgetfulness can result in a cooker being left on or a tap left running. A lack of spatial awareness (to be aware of yourself in the space around you) can lead to someone walking into a table, chairs or other furniture or objects. Disorientation can result in someone getting lost in their own home – perhaps being unable to find the bathroom, bedroom or kitchen.

A care worker has a key role to play in helping to ensure that a person with dementia lives safely in their own home. The person can be encouraged to talk about potential improvements (designed to enable them to live independently in their own home).

These can include:

A care worker can also encourage the person to seek expert advice from occupational therapists, social workers and fire service professionals who can recommend ways of reducing risks.

More information can be found in the Dementia-friendly environments section.

Safety and abuse

The Care Act2014 describes 10 types of abuse – physical, sexual, psychological, financial, neglect, organisational, domestic violence, modern slavery, self-neglect and discriminatory abuse. Abuse can include:

As a person comes to terms with a diagnosis of dementia and adapts to their new life, they may become vulnerable to abuse. A care worker should be aware of the different types of abuse and report any concerns to their line manager (who may then take up any issues with social services).

Recognising the signs of abuse

As a care worker, it is important to try to talk to a person with dementia about any concerns you – or they – may have. There may be a simple, innocent reason for someone having bruises on their legs (such as walking into furniture) or for becoming withdrawn or appearing sad (perhaps there has been some bad news, the person may be feeling unwell or has mislaid something important). However, a care worker should be alert to the possibility that abuse may be taking place, potentially by someone close to the person with dementia.

Signs of abuse can include:

A person with dementia can be vulnerable to financial scams. The Alzheimer’s Society revealed in December 2011 that thousands of people in England and Wales have been victims of financial abuse through cold calling, mis-selling or scam mail. The Society estimates that victims have collectively lost tens of millions of pounds and is calling for better protection for people with the condition.

Dignity and human rights

Everyone has the right to be treated with dignity and make their own choices in life. Human rights are relevant to everyday life and are designed to protect a person’s freedom and their ability to have control over their life and to be involved in any decisions that affect their life. Sometimes, as a care worker, it is hard not to intervene when certain choices do not match your ideas and beliefs. However, it is important that you treat a person with dementia with dignity and respect at all times (that is, addressing someone by the name they choose, listening carefully, speaking respectfully, respecting the person’s privacy and offering choices whenever possible). Occasionally, a care worker may have to remind families and friends to treat the person with the same dignity and respect (such as around privacy, making their own choices and allowing them to speak for themselves). This is possible provided it is dealt with in a polite and tactful way.

It may be difficult for a person with dementia to effectively communicate personal wishes and challenge any human rights issues. If a care worker suspects that a person with dementia is being abused or their human rights are being infringed, they should talk to the person first and then report any concerns to their line manager. It is important that concerns are reported accurately and that any policies and procedures in place are adhered to.

Talking about human rights in a video, Scottish Dementia Working Group, Rosemary Griffin, whose husband has dementia, says it is important that people requiring care and those providing care have a ‘common understanding of what human rights are all about... and that all people’s rights can be met to the best of everyone’s ability'. She says some professionals regard people as service users rather than as a person. Her husband Peter says it is ‘often the professional person who can’t relate to other people... I have experience of that'.

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