Loss and Grief in Dementia
Final-Guidance-Document-3-Loss-Grief
Final-Guidance-Document-3-Loss-Grief
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Guidance <strong>and</strong> Resources<br />
teLLInG/ RemIndInG A peRSOn WItH dementIA<br />
ABOut A LOSS WHICH OCCuRRed In tHe pASt<br />
A person with dementia may repeatedly ask for a person who died many years ago or look for<br />
someone from their childhood days. This creates a dilemma for family members <strong>and</strong> healthcare<br />
staff – do you tell them that a person is dead each time they ask or do you deflect or distract<br />
the person. Below are some tips to guide your practice:<br />
1. Consider key questions about the person <strong>and</strong> their ability to register, process <strong>and</strong> react to the<br />
loss (see page 29)<br />
2. If you do decide to tell/rem<strong>in</strong>d the person about their loss, be very clear on your reason for<br />
do<strong>in</strong>g so. Be aware that the person with dementia may be experienc<strong>in</strong>g a different reality <strong>and</strong><br />
you need to always promote <strong>and</strong> respect their personhood <strong>and</strong> take a person centred<br />
approach.<br />
3. Always validate the person’s emotions by pay<strong>in</strong>g attention to the feel<strong>in</strong>g beh<strong>in</strong>d the words. If<br />
a person with dementia is look<strong>in</strong>g for their mother for example, they may be look<strong>in</strong>g for security,<br />
comfort or familiarity/ home. Use photos, music, smells, objects, stories or other momentos to<br />
support the person to remember <strong>and</strong> connect with their loved one.<br />
4. Work as part of a team: It is not recommended that you make decisions related to truth-tell<strong>in</strong>g<br />
alone. F<strong>in</strong>d out about the person's previously stated will <strong>and</strong> preferences. Talk to the family<br />
about how they respond to their family member. Agree as a team how best to deal with difficult<br />
questions relat<strong>in</strong>g to losses which may have occured a long time ago.<br />
5. Where a person has more advanced dementia, you may need to use a variety of approaches<br />
before f<strong>in</strong>d<strong>in</strong>g one which works best for the person. It may help to rem<strong>in</strong>d them of the death<br />
or it may be better to reassure <strong>and</strong> distract the person while validat<strong>in</strong>g their emotions. Objects<br />
<strong>and</strong> photos may support some people while not be a support to others. Once you have<br />
developed an approach that works well, document what works best for them <strong>and</strong> ensure that<br />
everyone support<strong>in</strong>g that person gives the same/ similar response. This may be recorded <strong>in</strong> a<br />
care plan. Hav<strong>in</strong>g a consistent response is very important to ensur<strong>in</strong>g a person with dementia<br />
feels secure <strong>and</strong> trust<strong>in</strong>g of those support<strong>in</strong>g them.<br />
6. Th<strong>in</strong>k about what will best support the person or comfort them <strong>in</strong> the event they become upset<br />
<strong>and</strong> share this <strong>in</strong>formation with the team.<br />
7. Review your approach regularly based on the person’s chang<strong>in</strong>g condition <strong>and</strong> ability to<br />
process <strong>and</strong> react to the <strong>in</strong>formation they are given.<br />
<strong>Loss</strong> <strong>and</strong> <strong>Grief</strong> <strong>in</strong> <strong>Dementia</strong><br />
31
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