Loss and Grief in Dementia

Section 4
teLLInG A peRSOn WItH dementIA ABOut
A ReCent deAtH from (34,63).
1. DELIVERING THE NEWS OF A DEATH:
• Deliver a warning shot such as " I have some bad news about...." and assess if the person wants
to have more information. Respect their wishes not to know if they indicate this to you.
• Find a suitable time of day when the person is at their best and well rested. Be aware this may
need to be judged on a day to day basis, as it can fluctuate for the person with dementia.
• It is best if news is delivered in a quiet space on a one to one basis rather than in a large group.
• Use body language to express your sadness, hold the person’s hand or hug them, whichever is
most appropriate to your relationship with them.
• Avoid euphemisms like ‘passed on’ or ‘passed away’. Use the word ‘died’ or ‘dead’.
• Allow lots of time for the interaction and be prepared to repeat the information.
• Give the person a chance to absorb information in their own way. It may be helpful to use visual
supports such as photos or pictures to support the person to receive information in a way that
they can understand.
• Be prepared to deal with whatever response the person has – the person may react in a way
which would not be considered to be a conventional response to the news they have been given.
They may appear not to respond or notice or they may laugh or cry – accept whatever happens.
2. OBSERVE THE PERSON WITH DEMENTIA’S REACTION TO THE NEWS
• Pay attention to the person’s response to facts about their loss. Does the knowledge seem to
register with them cognitively or emotionally? What do they believe to be the case about the
deceased person?
• Monitor the person’s behaviour after exposure to the loss – Did the person show signs of
disengagement, withdrawl, anxiety , agitation or sadness after exposure to news of the death?
Are these new behaviours? If they have been noted before, have they increased in intensity/
frequency? Other changes such as changes in sleep patterns, appetite, level of activity may
indicate the person’s level of distress either specific to the loss or specific to the circumstances
surrounding the loss (e.g. family dynamics and reactions).
• It may be appropriate to record this information in the person's care / support plan. Ensure that
your approach and observations are updated regularly in liaison with the team.
3. INVOLVE AND SUPPORT THE PERSON WITH DEMENTIA TO BE PART OF THE RITUALS
FOR THE DECEASED PERSON
• If the person who died was close to the person with dementia, they should be involved as much
as possible in discussions about the funeral and in making arrangements.
• If appropriate, involving the person with dementia in funeral planning will help to embed awareness
of the death and create more references for gentle reminders such as sympathy cards etc. (64).
• Give the person the opportunity to be part of the rituals involved in a death and observe their
communication and level of distress throughout these events. It may be appropriate to visit the
church/ funeral home/wake at a quiet time if possible before the funeral.
• Involve the person in the usual rituals which are appropriate to their relationship with the person
who died. This may involve sorting out possessions. of the deceased or give them some particular
items to support them in remaining connected to the person. This can help embed the information
that the person has died and support them to reminisce. Use photos, tell stories, visit the grave
– it is important to give opportunities to the person to process their loss and allow them to share
how they feel.
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Loss and Grief in Dementia