The Significance of Lifestyle on a Person with
It is well-documented that human mental health
emerges from a complex interplay between genetic, psychological, lifestyle, and
other factors. In addition, people are also exposed to numerous environments.
These environmental exposures (e.g., green space, noise, air pollution, weather
conditions, housing conditions) might trigger mental disorders or be protective
factors, facilitating stress reduction and mental recovery. *The
International Journal of Environmental Research and Public Health. (2018).
Mental Health and Environmental Exposures. V.15.
For a person with dementia, protecting the brain
through stress-minimisation is paramount. As advocates of a stress-free
environment, Leaf believes that the most effective dementia care is delivered
by care home teams whose housing conditions enable desired lifestyles—ways of
living that are likely to reflect the lives of residents when they lived independently.
Too often do we come across care home designs
that present a clinical environment with white-washed walls, staff-access-only
kitchens, and not a biscuit crumb to be seen. It’s a model that’s used time after time. To a
point, it works, but that doesn’t mean that there isn’t a better way, a method
that plays to the core needs of a resident with dementia, supporting their wellbeing
and giving them their freedom within a protected environment.
Research-led and evidence-backed, a person-centric
system for dementia living will put lifestyle and environment at the centre of human
existence. At Leaf, every day, we see our
residents benefiting from levels of involvement according to their ideas,
whether that be using the kitchen to help with baking, peeling the potatoes, or
setting the table. It is what they have always done, what they know, and what
they love. We do all we can to support our people with safe, everyday
living in their otherwise altered world.
It is essential to recognise that the environment
of a dementia care home can either facilitate or discourage human interaction
and involvement with activities based on its layout, its décor, and its
surrounding smells. Let us think about how we feel when we meet a friend for
coffee. On a chilly Autumnal day, we might seek out a cozy chair situated in a
bright window of a coffee shop, a warm radiator to our left, and a view of fresh
sausage rolls on the counter to our right. The experience enrobed in smells of
freshly brewed coffee and low conversational tones of others catching up with
loved ones. We feel safe, and we enjoy the experience. Why should a care home
feel any different?
A comfortable, visually appealing space—decorated
walls and eye-catching lighting—designed to promote interaction, encourages
visits from family and friends, and elongates the time that they might choose
to stay. With a similar vibe to the coffee shop, we provide afternoon tea as
our residents sit in comfortable chairs, play games, watch TV, or listen to
music. Our people are safe yet independent, relaxed but still engaged.
We have noticed that a peaceful and visually
pleasing setting can positively influence an individual’s behaviour and enhance
motivation to get involved with others through daily activities. Living conditions
that reflect a person with dementia’s previous home can have a positive impact
on their health and wellbeing.
Observation has taught us that empowering our
residents to live a lifestyle that closely reflects the one that they knew
helps to validate them as a person. Our residents are supported by
professionals to cope in daily life, surrounded by the things they love,
situated in a bedroom that has been furnished in the style of their own home or
It is a cozy Autumnal evening; our residents are assisted
by staff as they pour their tea. As they munch into the afternoons home bakes, biscuit
crumbs fall to the floor, and a web-spinning spider in the windows-arch becomes
this evening’s conversational topic. There is chat, laughter, warmth, and there
are smiles. The crumbs will be swept, and the cobweb cleared. This scene is the
epitome of safe, supported, authentic living.
Just as our body recognises
that it is supposed to move, our brain too expects to receive stimulation.
Joint movement and mind stimulus often go hand-in-hand; the more we move—the
more engaged our brain becomes, and the more involved our brain—the greater our
desire for movement. This body-mind link is no different for those with dementia
and remains critical to wellbeing.
positively impacts the joints by easing joint stiffness, reducing joint pain,
and by strengthening the muscles that surround our joints. Mental stimulus has
been proven to keep us alert, reduce anxiety, and can help in reducing sleep
disturbance. Combining both physical activity and mental stimulus is paramount to
overall wellness and can sometimes slow the progression of dementia
There are more than
400 different types of dementia, and their prevalence is on the rise. The most
common, and consequently, best understood are Alzheimer’s Disease and Vascular Dementia.
As the disease progresses, professional caregiving—beyond that of
families—becomes the most practical solution to the increasing needs of a
person with dementia, but how important is it for a person with dementia to
continue their engagement with activities and Cognitively Challenging Tasks
can be categorised as planned or unplanned, social or emotional, and range from
outings, to exercise, to CCT. Skills needed for daily-living might also be considered
an activity, such as preparing food, clearing the table, folding napkins,
watering the plants, or talking about your day while sharing a cup of tea. Participation
in these activities is crucial in keeping the mind of a person with dementia
to the individual is critical to enjoyment—Some individuals with dementia can
easily find themselves overstimulated by noise, crowds, and constant movement. It
is essential to be mindful of a person’s needs and their anxiety triggers,
consequently being selective with outings and activities. Someone that has
always enjoyed the garden may be happiest planting up vegetables, while an ex-office
worker may find peace organising papers or with access to a computer, or a
mechanic might be in their element sorting through nuts and bolts. Others might
simply enjoy watching sport, taking a walk, or immersing themselves in arts and
Ixworth Court Dementia
Care supports this approach to individuality, allowing our residents to live a
life that closely reflects the one that they were used to. We recognise and
celebrate person-specific interests and abilities while being mindful of changes
in capability as a person moves through the dementia stages.
Studies into dementia
evidence that many people affected by the disease often retain their ability
and desire for both movement and rhythm—an excellent opportunity for dementia care
homes to organise activities that encompass dance, exercise, and music from
their generation. Such activities promote movement, engagement, and can encourage
positive feelings. It can be helpful to explore and implement activities that enable
an individual to build on remaining skills and talents for enjoyment instead of
of MindStart Dementia Activities and Occupational Therapist (OT)—once said,
‘Lose your preconceived notions about how the activity should be done or what
the end product might be, as people in the middle and late stage of dementia
are not capable of understanding the goal of an activity’. We think this is
great advice, and we operate with an emphasis on the enjoyment of a hobby or
when planning activities:
devices such as tablets or smartphones are great tools—they can be used to support social connection
through the likes of Skype and YouTube. Explore dedicated dementia apps for
support with games, puzzles, and other activities
with limited mobility can get active too—exercises can be done sitting down. Pom-poms or colurful scarves can be
incorporated to encourage the moving of hands, arms, shoulders, head, legs, and
water-based exercise if suitable—water-buoyancy lowers the impact on joints while still providing enough
resistance to keep joints flexible and help maintain muscle.
residents to help with running the home—cooking, cleaning, and tidying away can help increase
a person’s sense of purpose
family to help create a memory bag—memory bags filled with pictures, curios, scented soaps, and anything
that holds a strong memory for the person with dementia will help enable them
to remember the things they love
There are endless
activities that care homes can consider for their residents, and we are happy
to share with others what has worked well for us, given the individual needs
and abilities of our residents. Ixworth Court Dementia Care home use Able2B—a not-for-profit organisation that provides
fitness opportunities to people with limitations. COVID-19-led isolation has
seen Rachael Hutchinson—Consultant Orthopaedic Surgeon, and Jon Thaxton—retired
professional boxer and personal trainer offering free, daily, Zoom-adapted
classes via Able2B@Home, targeted at people in care homes.
The classes offer our
residents something different—they provide an opportunity for expertly adapted
exercise while providing a sense of community spirit. They bring care homes across the UK
together. You can find out more at www.able2b.co.uk. These classes have been the catalyst for Edith, a
resident at Ixworth Court, to leave her wheelchair and find her confidence in
walking again. Together, we can keep our bodies and minds active and maximise individual
How much do we
take for granted our ability to satisfy our own needs? When we are cold, we
reach for a jumper; when we are restless, we go for a walk; when hunger strikes
we head to the kitchen; when it’s warm, and our mouth is dry we reach for a cold
beverage, or if it’s nippy outside, a cup of tea snuggled on the sofa with a
Responding to our
core needs are not just part of everyday survival, but critical to regulating
our mood. You might be familiar with the term Hangry, a twenty-first-century
word used to describe a person that presents with signs of hunger-associated anger,
often caused by a drop in blood sugar levels, but a symptom that quickly
diminishes once food is consumed. The effects of thirst and dehydration have
their impacts too, and in a person with dementia, a lack of fluids can quickly bring
about excessive tiredness, confusion, irritability, and medical emergencies
that can include Urinary Tract Infections (UTI’s) requiring hospital admission.
Now, let us turn
the dehydration leads to confusion statement on its head. While thirst
in any person can indeed lead to confusion, confusion itself can be the
catalyst for dehydration, let me explain.
Let us assume that
your loved one has been diagnosed with dementia, after much deliberation and
exploration of dementia care homes you and your family have made the difficult
decision to place your dementia diagnosed person into care. Already coping with
the confused state that dementia brings, your person with dementia will be
adjusting to large groups of new people that include other residents along with
uniformed health care professionals, they may find themselves surrounded by
people they don’t know and in an environment that feels largely unfamiliar. In
some instances, this onslaught of new faces means that a care home environment can
add to the confusion of someone that is already struggling to make sense of
their world. That person may well look for ways to exit the building in an
attempt to return to the home they left behind—they just want to go home.
When a person with
dementia finds themselves further confused, it can trigger anxiety, agitation, or depression; these emotion-led
states can prevent an individual with dementia from wanting to drink, often exacerbated
through the avoidance of social situations where they might share cups of tea
across a kitchen table or meet in the garden on a warm day for a glass of
confusion for a person with dementia is key to maintaining good health through
sufficient hydration. Making their new home as welcoming, safe and familiar as
possible, and filling the void of what they have left behind by encouraging
involvement in the preparation of home-cooked food, or providing the freedom to
grab a snack from the kitchen will help with their settling. Let us not
underestimate, too, the joy of smelling flowers in the garden or listening to
the birds sing, these experiences and more are all vital to a person’s
state-of-mind and will help in driving down confusion.
will see your person with dementia enjoying life, enabling them to connect better
with their environment and those within it. With enhanced connection, those
with dementia will feel more enthused to socialise regularly, and consequently,
eating and drinking will become a more natural part of their day. Through a
maintained fluid intake, physical and mental wellbeing can be optimised, and
hospital intervention reduced.
Leaf Care Dementia
Care Homes have a reputation for minimising the confusion of residents through
the advocating of small-group-living. We actively place people that have
similar outlooks on life together, maximising their opportunity for attachment
and closeness. We offer a homely environment that feels familiar, one that intentionally
reflects the typical home they left behind. If you have any questions or think
we can be of further support to you, please contact us at firstname.lastname@example.org
It is indeed my pleasure to write to you during these difficult times amidst the Coronavirus pandemic. I understand that you will be busier than ever supporting your loved ones be it the checking in with them and sending your love , or the providing of hands-on care, and I’m writing to let you know how we can help.
Services has five available rooms at our Dementia Care Home in Ixworth,
Suffolk, but we’re not selling rooms, we’re selling a joyous haven where
families bond and relationships flourish. Rated
Good by the Care Quality Commission (CQC) in 2019, we offer
small-group-living, compassionate leadership, advanced care, and a bank of
shared knowledge evidenced through our online Blog.
At the time
of writing, our care homes are Coronavirus-free, and we believe that this is no
happy accident, but instead, a testament to the levels of due diligence
conducted within our premises through well-governed internal policies aimed at
keeping our people safe, well, and content.
Care, we can offer solutions to your placement challenges and can alleviate
your day-to-day pressures. Those placed have the freedom to live a life that
closely reflects the one that they are used to, inclusive of their hobbies but
with round-the-clock care that is aligned to their needs. We would be delighted
to share more information with you about our care homes that comprise how we
operate, our relationships with external partners, and how we set ourselves
apart from others.
available rooms are limited, and we don’t want you to miss out. For further
information, email us at email@example.com or call us on 01603 618111. *Please be patient
with us as we are currently receiving a high number of calls and emails. We
will respond to your query as soon as possible.
PS, we are
in this together, putting people at the centre of our actions, and we look
forward to hearing from you.
PPS, I have
attached our most recent Blog below, titled, Keeping your loved ones
safe in the face of a pandemic. I hope that it offers some insight into our
Keeping your loved ones
safe in the face of a pandemic
On the 23rd March
2020, the Coronavirus pandemic forced a UK lockdown—a government-imposed ban on any movement inside the country
and the closing of all nonessential businesses—as a way of keeping people safe
and in an attempt to reduce the rate at which this disease spreads.
The broader impacts of a pandemic are
gargantuous for any business, but for organisations such as care homes and
hospitals,—whose primary responsibility is to protect their people—
the required adjustments to manage and contain
such a threat to human life can feel overwhelming.
With those over 70 years of age carrying an
increased risk of dying from the virus, and those 80 or older, even more so,
dementia care homes certainly have their work cut out for them, with most
residents falling within the vulnerable age categories. A further challenge for
both care home managers and carers is helping those with dementia to understand
the severity of the pandemic and the need for strict measures, without causing
alarm or triggering a state
What protective measures should dementia care
homes be taking?
Like any organisation that employs or houses large
volumes of people, businesses have both a morale-based and Government-led
obligation to make alterations to processes and procedures to help reduce the
community-spread of the virus, and by flattening the curve, reduce fatalities
by buying our NHS time to treat, and scientists time to learn and create a
vaccine, but what extensive measures should care homes be taking?
Here, The Leaf Care Group shares the vital
measures that care homes should be taking to keep their dementia care residents
and staff safe:
Until the Government lifts restrictions, there should be no
external visitors to dementia care homes. Leaf locked down our care home a week earlier
than Government recommendations, influenced by global trends and information
received on how the disease was spreading in other EU countries. We urge all care homes to be vigilant of the
possibilities of a second surge of the virus when lockdown measures are lifted
and to keep staff well-reminded of how to remain safe, both inside and outside
It can prove lifesaving to keep a daily log of where staff
have been and with whom they have been in contact. At Leaf, we take the
temperatures of all of our team and have them complete health questionnaires
before the commencement of their shift. We have encouraged some of our care
workers to live-in, reducing their contact with people outside of our care home.
Our staffing teams only work for Leaf, and we don’t employ agency staff.
All residents that travel throughout the care home should be
asked to comply with social distancing, in line with government guidelines, and
monitored by care home staff. At Leaf, in-house seating is set two-metres apart
to reduce contact between residents.
Care duties (where possible) should be completed within
social distancing guidelines. At Leaf, we have been using barrier-led nursing techniques since
the outbreak of the pandemic, with all staff using masks and goggles for
nursing or close contact tasks, regardless of any sign of infection.
Personal Protective Equipment (PPE)
All staff should be provided with PPE to help protect them
and those around them. Leaf supported the timely issuing of PPE with ongoing
weekly training that includes updates on PPE supplies along with staff support
Health Checks on Residents and Staff
Coronavirus-based symptoms in residents and staff should be
recorded and monitored daily. Those that present with symptoms associated with
Coronavirus should abide by self-isolation Government guidelines in the
knowledge that there is access to healthcare as and when required. Leaf are
advocates of Coronavirus testing any resident or person within the care home
who presents with symptoms, minimising chances of the disease spreading and
allowing us to implement isolation measures.
Reducing Team Sizes
Where more than one carer is needed to complete a specific
task, carers should be mindful of operating in groups as small as they can,
with as much distance between people as possible.
Adherence to Crisis Management Strategies
should be proactive in both establishing and implementing safety measures while
working within their care home business model and its supported frameworks.
The acceptance of
new residents into a care home during the pandemic should be placed on hold.
Leaf has not accepted any new residents into our care home since the outbreak
of Coronavirus to ensure that our residents remain safe. Now that Coronavirus testing
is available, we are requesting that testing procedures are implemented, before
considering any new admissions, ensuring safer working practices.
require a medical assessment from a visiting professional, we have a designated
isolation unit where residents can be treated in line with social distancing
guidelines. If an individual requires hospital care, we can safely integrate
them back into the care home, regularly monitoring them and abiding by 14-day
isolation recommendations. Our contained units comprise four rooms that include
a kitchen area, dining room, living area, and bedroom.
How to stay connected when your loved one is in
During this challenging time, and where
residents are isolated from family and friends as a means of protecting them,
residents are exposed to further challenges that include anxiety, depression,
and deflation; It will be helpful for them to know that their new ordinary
is temporary and that they are not alone. There are uplifting things that you
can do to stay connected with your loved ones that include phone calls, video
calls, texting, sending scrapbooks, or sharing photos.
The daughter of a resident here a Leaf Care Dementia Homes recently shared,
Thank you for organising the video calls with Mum, they are a life-line for her and us while all this is going on’—Wonderful evidence of actions that can make a world of difference.
What support is available?
Leaf currently has five available residential
rooms situated out on the wing of the care home. These rooms can be used to
quarantine residents that are presenting with symptoms or can be available for
your person with dementia if currently living with you at home. The rooms can
be utilised to support families that are caring for a loved one, should the
carer need some respite, or become unwell themselves with Coronavirus symptoms
and require time to recuperate while keeping others safe. Located in the countryside, our care home
creates a sense of haven for our residents. If you would like to make a room
enquiry, please call us on 01603 618111.
Keeping your loved ones safe in the face of a pandemic.
On the 23rd March 2020, the Coronavirus pandemic forced a UK lockdown—a government-imposed ban on any movement inside the country and the closing of all nonessential businesses—as a way of keeping people safe and in an attempt to reduce the rate at which this disease spreads.
The broader impacts of a pandemic are gargantuous for any business, but for an organisation such as care homes and hospitals—whose primary responsibility is to protect their people—
the required adjustments to manage and contain such a threat to human life can feel overwhelming.
With those over 70 years of age carrying an increased risk of dying from the virus, and those 80, even more so, dementia care homes certainly have their work cut out for them, with most residents falling within the vulnerable age categories. A further challenge for both care home managers and carers is helping those with dementia to understand the severity of the pandemic and the need for strict measures, without causing alarm or triggering a state of alert.
What protective measures should dementia care homes be taking?
Like any organisation that employs or houses large volumes of people, business have both a morale-based and Government-led obligation to make alterations to process and procedures to help reduce the community-spread of the virus, and by flattening the curve, reduce fatalities by buying our NHS time to treat, and scientists time to learn and create a vaccine, but what extensive measures should care homes be taking?
Here, Leaf shares the vital measures that care homes should be taking to keep their dementia care residents and staff safe:
• No Visitors Policy
Until the Government lifts restrictions, there should be no external visitors to dementia care homes. Encourage contact with residents through video-chats.
• Staff Tracking
It can prove lifesaving to Keep a daily log of where staff have been and who they have been in contact with
• Social Distancing
All residents that travel throughout the care home should be asked to social distance, following social distancing guidelines, and monitored by care home staff.
• Barrier Nursing
Care duties (where possible) should be completed within social distancing guidelines
• Personal Protective Equipment (PPE)
All staff should be provided with PPE to help protect them and those around them, supported by weekly training that includes updates on PPE along with staff support options.
• Health Checks on Residents and Staff
Recording and monitoring any coronavirus-based symptoms. Those that present with symptoms should abide by self-isolation Government guidelines.
• Reducing Team Sizes
Where more than one carer is needed to complete a specific task, carers should be mindful of operating in groups as small as they can, with as much distance between people as possible.
• Testing and reduction of risk
Advocating for testing of residents or persons who are showing symptoms so we can prevent spread of the disease and ensure isolation is managed before the spread of the disease in the community and within the care homes
How to stay connected when your loved one is in care
During this challenging time, and where residents are isolated from family and friends as a means of protecting them, residents are exposed to further challenges that include anxiety, depression, and deflation; It will be helpful for them to know that their new ordinary is temporary and that they are not alone. There are uplifting things that you can do to stay connected with your loved ones that include phone calls, video calls, texting, sending scrapbooks, or sharing photos.
The daughter of a resident here a Leaf Care Dementia Homes recently shared, ‘I have attached the Life History work for Mum. Mum filled out a memory book a few years ago, so much of the content used is her memories that I have copied from the memory book. Thank you for organising the video calls with Mum, they are a life-line for her and us while all this is going on’—Wonderful evidence of actions that can make a world of difference.
What support is available?
Leaf currently has five available residential rooms situated out on the wing of the care home. These rooms can be used to isolate residents that are worried about symptoms or can be available for your person with dementia if currently living with you at home. The rooms can be utilised to support families that are caring for a loved one, should the carer need some respite, or become unwell themselves with Coronavirus symptoms and require time to recuperate while keeping others safe. Located in the countryside, our care home creates a sense of haven for our residents. If you would like to make a room enquiry, please call us on 01603 618111.
If your loved one is a resident with Leaf Care, you can remain involved in their care via our client portal on Care Control. If you have any concerns or questions about your loved one, please contact firstname.lastname@example.org or call us on 01603 618111. Please be patient with us as we are currently receiving a high number of calls and emails. We will respond to your query as soon as possible.
If you are interested in volunteering to support our key workers, please email email@example.com. *You will be asked a series of questions to enable us to screen for COVID-19. You can find further information on the Coronavirus here
A care home’s management of dementia is broad. It
involves ongoing care, support, and evaluation from—and not limited to—in-house
Health Care Professionals (HCP’s), families, social workers, nurses, GP’s, mental
health practitioners, and Dementia Intensive Support (DIS) teams. Timely comeback from external support teams is
essential in keeping both the individual and other care home residents safe.
Those of you that have been or are currently on a
dementia journey with a loved one will recognise that the onset of dementia can
bring about changes in behaviour and often impact an individual’s mental
wellbeing. It’s a sad reality of the disease, but if well managed, those
effected can continue to lead fulfilling lives, maintaining their interests,
and living as independently as possible.
Where shifts in behaviour become part of the
individual’s disease, a care home’s priority must be to keep them and those
around them safe while continuing to provide adequate care. If
challenging behaviour is a demonstrated behaviour, care homes must seek to
understand who is at risk, the frequency of occurrence, and look to identify
any triggers. Too frequently do we read newspaper headlines that
share stories of care homes that have failed to respond to the challenging
behaviours of an individual, conducts that can include assault on another
resident that on rare occasions, result in death.
Understanding what triggers challenging behaviour in
people with dementia is vital in determining the most suitable management
strategies and in knowing whether the presented behaviour should be referred
for extra support. There is an abundance of professional support teams out
there, and their services must be utilised.
Leaf’s process for assessing behaviour-challenged individuals
utilises a multi-agency coordinated response tool where, through the appropriate
narrative with both our dementia resident and HCP’s, we gain insight into
potential triggers such as underlying health concerns or symptoms, their current
medication, and the occurrence of any significant life events. All of these
things can affect the behaviour of a person, and through engagement, some of
the causes can be quickly resolved.
The response tool ensures we can minimise triggers and,
when needed, supports us in making referrals to the most suitable HCP while
keeping agencies informed. We believe that professional curiosity serves to support
individuals with dementia positively, and we encourage their families to stay
involved with any recommendation that we make, helping us to make informed
decisions that are in the best interest of our residents.
In a person with dementia, behavioural challenges can
manifest at any time and present themselves in a multitude of ways. Our response
tool is complemented by the implementation of our Behaviour Management
Programme (BMP), and where necessary or beneficial, we call on support from
HCPs, DIST, and families of the individual.
Leaf Care has a non-medication-first-approach to
challenging behaviour, further supporting us in eliminating short-term causes
and allowing us to differentiate challenges in behaviour compared with those of
mental health. Where individuals are found to be mental health challenged,
alternative pathways are discussed. We further protect our residents and their
families by choosing not to ensure new residents with already identified behavioural
have a multi-agency agreed plan for the challenges which are manageable and
realistic, prioritising safeguarding, and minimising risk to our existing residents.
While there are a multitude of support teams that
serve to support HCP’s in times of need, there is still work to be done in
terms of emergency support response times to challenging behaviours in care
homes. We need better coordinated multi-agency pathways that give greater
transparency to the support available and the legal framework that binds them,
along with a more collaborative and inclusive way of operating. Leaf’s all-inclusive
approach to clinical assessments, reporting, and decision making, hope in some
way to drive change and improvement in the wider context of coordinated care.
Laughter, conversation, and the chinking of
wine glasses were just some of the sounds that delighted me as our residents
shared Christmas dinner with both their carers and their families at Ixworth
Court Dementia Village. The cooking from our in-house chef filled our care home
with delicious aromas that enticed residents to take their seats at the
beautifully dressed tables, amidst the Christmas tree and its decorations in
our contemporary styled restaurant.
Crackers were pulled, wine glasses filled,
and nutritious home-cooked food was served to the tables with all of the
expected Christmassy trimmings, it was a sight and sound to behold, and
heart-warming to see residents sharing this special time with their family and
Leaf Care regularly couple socialisation with
good food, but why is it important, and how does it positively impact a person
Special occasions have the potential to be
key triggers of positive emotions, and by connecting a special event with the
celebration and enjoyment of food, it encourages free-flowing conversation
between people and inspires reconnection where there is conflict. This approach
can help people with dementia to associate food with positive socialisation.
Abraham Maslow’s Hierarchy of Needs best
supports this observation at Ixworth Court Dementia Village—a theory in psychology;
it comprises five tiers, structured in a pyramid that from the bottom up, recognizes
the five core human needs as physiological,
safety, love and belonging, esteem, and self-actualization. The theory is considered
one of human motivation, with
physiological needs appearing at the bottom of the pyramid as a priority—that
includes air, water, food, shelter, sleep, clothing, and reproduction—these needs
must be satisfied before any person feels able to address the needs in the four
The want and ability to
eat can change in those with dementia, and this consequentially impacts nutritional
intake and health. As the disease progresses, those with dementia find shopping
for food difficult and preparing and cooking food a challenge. The disease over
time can affect swallowing ability, and using knives and forks can feel
uncoordinated and frustrating, but evidence suggests that when we step outside
the biomedical view of food provision and look closely at the relationships
people have with one and other and how they communicate over food, that there
is noticeable uplift in food consumption, and subsequently, quality of life.
When a person with
dementia regularly dines with carers, friends, or family, hunger, and the need
to eat is sophisticatedly managed. The person with dementia is not only eating
to satisfy hunger but also to socially engage, these two experiences then
become positively interlinked, and we notice an increase in both the amount and
the variety of food which is consumed and an increase in time spent at the
table. Improved food consumption can often enhance the mood in our residents,
and with a better frame of mind comes a desire to eat. Socialising with others
while eating can positively impact nutrition and overall wellbeing.
During 2019s Christmas
Dinner event at Ixworth Court Dementia Village, one family member shared that,
‘it was the first time that she had been able to sit down and enjoy a meal with
her Mum in 20 years’. In addition, we observed one of our residents at Ixworth Court,
enjoying dinner with his wife after being reluctant to leave his room for 12
resident Joyce said, ‘It was lovely to have my
family with me in the restaurant’, Peggy
told us, ‘I enjoyed the meal’, Edith shared, ‘I enjoyed a glass of wine’, Tony
said, ‘I like the crackers’, and Jennie seemed to enjoy having her best friend
Ixworth Court can’t wait for our next table celebration with a nutritious plate of food. In the meantime, why not visit our restaurant, you can dine with friends, family, or use one of our spaces for a corporate event.
The brain is a complex yet magnificent organ that functions as the
hub of our sensations, intellect, and nervous activity. A specific part of the brain
called the hypothalamus is responsible for a human’s fight-or-flight response—sometimes
referred to as hyperarousal or acute-stress-response.
The hypothalamus protects us by alerting us and responding to
dangers without the need for a thought process. It’s an automatic built-in reaction.
Different parts of the brain allow us to assess vulnerability and decide on the
best course of action. When a brain is affected by dementia, the hypothalamus
is not able to effectively evaluate whether something is a threat, or whether an
individual is in danger, and so the well-functioning part of the brain assumes
it’s at risk and instigates a fight-or-flight response.
Depending on the type of dementia and the speed in which it
progresses, people with dementia can repeatedly face the mind-triggered
fight-or-flight response for 8-to-12 years—it’s exhausting for those with
dementia, and can be hard to watch for those that love and care for them.
Something as simple as misplacing their glasses can lead a person
with dementia to feel stressed, anxious, agitated, panicked, or threatened. The
acute-stress-response is then activated within their brain. The person may
quickly progress through thoughts of ‘I have lost my glasses’ to, ‘Where are my
glasses,’ to, ‘You find my glasses,’ and then as their stress-response calms,
When an object such as their glasses are lost, it’s helpful if we
can train ourselves to breathe, breathe in, and breathe out. If we show signs
of stress, it will likely impact on the person with dementia and inhibit their
coping strategies. They may quickly become irritated, panicked or angry,
desperately trying to find a way to escape their feelings.
Similarly, it is not uncommon for a person with dementia to
repeatedly ask the same question. When being asked the same question multiple
times, our coping strategy might be to avoid the question for fear of not
knowing how best to answer it time after time.
Being on the receiving end of this can make us tense our bodies,
and as a result, we notice a feeling of stress; we over breathe, reducing the
level of carbon dioxide in our blood, which, in turn, reduces blood-flow to our
brain and increases levels of cortisone in our bodies. We expect a high level
of cortisone when being chased by a tiger, but this stress response is
unhelpful when caring for someone with dementia.
Those that love and care for people with dementia can seek coping strategies
that teach us how to worry less, communicate better, and minimise the risk of
us sparking our fight-or-flight in response to dealing with some of the
challenging situations that naturally arise when supporting a person with
dementia. Slow, calm breathing can work wonders in re-setting our state of mind,
helping us to get alongside the person with dementia and support them in
managing their responses to perceived stress.
Once we have rebalanced, there are some effective methods in soothing
a person with dementia through a stressful situation, some I have included
below. Let’s be mindful of the fact that people with dementia are not tigers; we
don’t need to go a long way around to avoid them, but instead, we must equip
ourselves better to manage our stress-response.
Aid communication with your hands and fingers—
Using hand-gestures to guide to the left, for example, or to help
explain a shape can be helpful.
Don’t be afraid to lean on others for support—
If a person with dementia
is upset or unsettled, and you are running out of ways to calm them, don’t be
afraid to let someone else try; a fresh face or different approach is often
Give simple directions—
Explain things using single commands, allowing the person with
dementia to process what you are saying entirely.
Don’t underestimate the power of distraction—
Sometimes a change in focus for the person with dementia can be
helpful. Methods such a singing, looking at trees or birds from a window, or
sitting down with a warm mug of tea can be useful in calming a state-of-mind.
Move to a quiet environment—
If the environment that you are in is active, noisy, or unnerving,
consider moving to a quieter, calmer space where there are no competing sounds.
Smile or pay a compliment—
We all respond positively to a smile, and a compliment can inevitably
alter the way that a person is feeling. You could try ‘Wow, you look great
today’, or complement an outfit or their hair.
Give them the contact that they crave—
We all want human connection, don’t be afraid to take their hand
across the kitchen table or to ask them if they would like a hug.
The brain is responsible for processing sensory information, releasing
hormones, and regulating both breathing and blood pressure. While the affected
brain cannot be cured of dementia, by following the above methods, we can help
in soothing a person with dementia when experiencing acute-stress response; we
can help to reduce the intensity of their fight-or-flight.
Evidence suggests that the more we use our brain—diseased or not—the
better it functions. Leaf Care supports this suggestion by encouraging activities
and daily routines—such as reading, learning, exercising, and interacting—that
stimulate nerve cells to the brain.
The mind is remarkable; it decodes information derived from our many
senses, smell, touch, sight, taste, and hearing. Living in a care-environment
that plans events and activities and that encourages routines that stimulate
those senses has to be a good thing.
Just like you and I, people with dementia enjoy the time of
others and like to be listened to. They need to feel understood, and they want
to feel accepted. Home can be thought of as our safe-haven, a place of
conversation, acknowledgment, and love.
If we think about what home means to us, it’s the smell of
coffee when we enter the kitchen or baked cookies from the oven. It’s the hung
curtains made from the fabric we painstakingly chose, the fresh linen on our
beds, the cat curled up in the corner of the room, a placed piece of pottery on
the dresser, or the neatly filled pots that edge a perfectly mowed lawn. These things, and more, define home. Home is
individual to us, and it’s a place of warmth, a place of safety that we share
with our loved ones, and a place where memories are made.
The move from ‘home’ to a care home is understandably unsettling
for all involved, and It’s not uncommon for residents of care homes to say that
they ‘want to go home,’ but for a person with dementia, the term ‘home’ may
describe something more than the place that they used to live. Often, when a
person with dementia asks to go home, they can be referring to a sense of home,
rather than home itself. Home could be somewhere they feel relaxed and happy,
possibly the place that they used to live, but perhaps too, an undefinable
place that exists only in their hearts. What a person with dementia feels is
not always easily translated into words that we, their carers and loved ones,
will easily understand.
It’s not uncommon to hear ‘ I want to go home’, ‘please take me
home’, and ‘why are you doing this?’ These words are difficult to hear and are
often followed with words of frustration that can include ‘I want my life back
as I knew it’, ‘I want me back as I was’, ‘I want everything like it was’, or
‘I want all the pieces back in place.’ These are expected emotions of a person
with dementia, but over time and as they settle into their new environment,
feelings of confusion and anxiety often calm.
A person with dementia has a disease of the brain. Like you and
I, they see, and they remember, but how they piece old memories, thoughts, and
new learns together in their mind can often get muddled. They might see you,
like you, or not like you based on the way that you behave, irrespective of who
you are and what your relationship is to them.
A visiting husband, for example, might be perceived as ‘that
nice man who comes to church,’ or the person with dementia might think that
their husband is twenty-years-old, that they too are twenty-years-old, and that
together they currently have a two-year-old child. As the disease progresses,
those with dementia can want to be young again, believing that they are, and
confusing the past with the present. They can want to go back to the house in
which they were raised or crave the presence of the people who raised them.
Here, at Leaf Dementia Villages, if a resident with dementia is
particularly distressed, we must consider whether they might be tired, hungry,
thirsty or unwell, or perhaps overwhelmed with feelings of unhappiness or
loneliness. The team at Leaf Dementia Villages provide regular reassurance to
our residents. We encourage exercise and exposure to natural daylight during
the day—which promotes good sleep at night—and an individual’s medication is
We help meet the changing needs of a person with dementia by
providing routine to visits and mealtimes, and we place emphasis on the
importance of recreating familiar surroundings such as the layout of their
bedroom, the preparing of food together in our kitchen and sitting down at our
kitchen table with others for cups of tea and dinner.
There is no denying that dementia can, over time, rob you of the
person that you knew, but experience teaches us that by avoiding confrontation,
providing reassurance of their safety, showing empathy, and sometimes diverting
conversations, we can help our loved ones to feel safe, valued and understood.
1 in every 14 of
the population aged 65 years
and over has dementia in the UK. There
are 850,000 people with dementia in the UK, with numbers set
to rise to over 1 million by 2025
Yet, we are lagging behind in how to care for people with dementia, the traditional care home and nursing home still look after its’ residents with dementia in the upstairs wings with rare access to the outside or daily experiences we enjoy.
night I met some friends in a pub enjoying a meal for a birthday chatting about
visiting their mother in a care home.
They talked about, how a performer sang for the residents… some of the
people with dementia joined them from the upstairs unit, mute in conversation
and at the end of the song, they were able to say how wonderful the songs were,
yet only to return to the wing upstairs wandering the corridors and remaining
These are popular misconceptions. Just because a person has dementia does not mean they can’t see, hear, or join in conversations about what is going on. The way people with dementia react to this confusion is different, some disengage, some cannot talk, some get frustrated, some get sad and in life, we all react in our own ways.
better is everyday living, eating and drinking at the table, eating a meal in
the restaurant with friends and family.
What the person with dementia sees within this is a sense of reality and
is able to join in as it has familiar experiences. The restaurant at Ixworth Court Specialist
Dementia Care Village is open to everyone the same as any restaurant in the
street with a chef cooking the meals and waiting staff serving the food. ‘Fish and Chip Friday’ is a British tradition and
is a popular event, we had a busy day catering for 20 customers joining
together to eat in a restaurant enjoyed by the residents, their families,
friends and locals. The laughter is wonderful to see and hear as the
people who live here still experience going out for dinner with their friends
and families and the happiness this brings.