Beth Britton, Trainer and Social Care Consultant
While we have heard a lot over the years about supporting people to live as well as possible with their dementia, ongoing risk-reduction post-diagnosis hasn’t always been a significant feature of those conversations.
This year’s World Alzheimer’s Month[1] of ‘Never too early, never too late’ tackles this topic head on, looking at how ongoing risk reduction can benefit people diagnosed with dementia.
For anyone accessing social care at any point in the life course of their dementia, their provider will play a key part in this. With limited pharmacological interventions, building ongoing risk-reduction into an individual’s support plans will enable them to benefit from the latest guidance on how to live better from both a medical and social perspective.
Ongoing dementia risk-reduction – What is recommended?
Of the 12 dementia risk factors highlighted by Alzheimer’s Disease International, only two (less educational in early life and air pollution) are beyond a care provider’s influence.
We can all support people with dementia to remain physically active (in whatever way the person can participate), reduce/quit smoking, reduce alcohol consumption, keep to a healthy weight /reduce obesity, reduce the risks of a head injury (from falls etc), control hypertension and diabetes with good health planning, identify hearing impairment and support the use of hearing aids, provide support to minimise depression (which is often under-diagnosed and poorly understood) and provide intelligent social contact (genuine peer-to-peer engagement with likeminded individuals and relationship-centred support from staff).
As Paola Barbarino, Alzheimer’s Disease International CEO, says: “Addressing these risk factors post-diagnosis empowers individuals towards improving their health and wellbeing, potentially enabling people to live independently for longer. It is #NeverTooLate to start, however, it is always important to consider individual circumstances and discuss those with your doctor.”
What do people living with dementia recommend?
Whilst scientific recommendations are always welcome, it’s invaluable to understand from people living with dementia what they would recommend care providers offer people who are living with dementia and drawing on their services. People with dementia told me:
“External social contacts are vital, as is outdoors stuff, especially gardening. Most importantly though, ask people living with dementia what they enjoy(ed).” George Rook
“Find out what each person’s hobbies were. Take trips outdoors where there is wildlife and birds. The calmness of nature can be so therapeutic. Crafting with others can be a great way to interact, bringing conversions and laughter.” Gail Gregory
“For everyone to have the chance to do outdoor activities or just to be outdoors, even in colder months (wrap up warm).” Teresa Davies ‘Dory’
“I’d recommend CBT work using out-of-the-box thinking so that it is adaptable to each person, their age, culture and personal preferences.” Julie Hayden
“Everyone needs access to music and activities that are meaningful and inclusive.” Tommy Dunne BEM
“Give people choices, exercise, fun, the chance to be outdoors, activities in the community (not an activity room), physiotherapy and speech therapy if needed.” Kate Swaffer
“Allow people to feel the outside fresh air and provide outside space for them to sit or walk in no matter whether a member of staff is available or not. Have windows that open and can be sat at to watch the birds outside.” Wendy Mitchell
“Music would be my recommendation – use our Purple Angel Mp3s[2] which are free for all with dementia in the UK and uploaded with the person’s choice of music.” Norman McNamara
“To assist, remind and support, not take over and do everything for us because the more you ‘do’ the less we will be able to. Find out who we are and tailor services for us, offering stage-appropriate care that is pro-active not re-active.” Chris Roberts
From ongoing risk reduction to cognitive rehabilitation
If ongoing dementia risk reduction is to become a mainstream provision, cognitive rehabilitation is surely the next step to equip people with specific strategies to retain their autonomy in everyday activities, providing a greater sense of hopefulness and emotional well-being as epitomised in ‘My Life, My Goals’ [3].
To understand more about this, I spoke to Jackie Pool, Dementia Specialist Occupational Therapist and author of ‘From Dementia to Rementia’: [4]
“Cognitive rehabilitation can be focused to relearn a lost skill or knowledge set, learn new ones and practice compensatory techniques to ‘fill in the gap’ in the person’s abilities. The optimum environment for this learning to take place is one where the person has maximised brain health through good nutrition, hydration, good sleep, pain management, exercise, access to the outdoors and social connections – elements identified through this year’s World Alzheimer’s Month theme and indeed by the people living with dementia who have contributed to this article.”
[1] https://www.alzint.org/get-involved/world-alzheimers-month/
[2] https://purpleangel-global.com/mp3-players/
[3] http://www.innovationsindementia.org.uk/2021/09/my-life-my-goals/
[4] https://www.hachette.co.uk/titles/jackie-pool/from-dementia-to-rementia/9781839973154/
