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Are there any considerations we need to look at for someone with dementia in respect of their dignity?

With dementia, it's very common that dignity and respect is an issue and there's actually a gender role and if you go onto the internet and look at dignity in respect to gender, google that, you'll find a page that is dedicated to that. Take their advice and because every case is different and everyone has different needs.

In the real world, is there any ways you can help to respect someone's dignity?

When you've got someone who's newly diagnosed with dementia, obviously their world changes. We need to look at are they being dressed properly? And a lot of it goes through that side. So we're looking at, if they are struggling with dysphagia which is an issue with eating, are we producing and giving them food that they can comfortably eat and using utensils that they can comfortably use? Are we dressing them correctly? Are we giving them the ability to dress themselves? Are we making sure that we don't change the environment too much? And as an example of that, would they be embarrassed if someone came in and their hoist was in the living room? Are we asking those people to leave the room while we are hoisting them? Which we should ideally be doing.

So it's various things that we need to look at. If they are incontinent, are we making sure they're cleaned properly? Because if they aren't, no one likes to smell and sometimes, especially if they're highly medicated or not hydrating properly, that can be quite a strong smell. So we need to ensure that we do clean up as much as we possibly can, dress them correctly, make sure any medical equipment is out of the way. Would they like people to know their medication and what medication they're on? Let's clear up medication from the room. And maybe even looking at bathing and personal care, are we taking them down to the hairdressers? Are we bringing the hairdresser into the home? Because all of those things will make them feel better and that will give them their dignity.

Don't try and avoid them. One of the biggest challenges within dementia is if I had cancer, I'd tell my friends, I'd get all the help I needed. They'd offer to look after my children, walk my dog, they'd make sure that they contacted me when I've gone to the hospital. With dementia, it's a hidden disease. People are quite embarrassed about it. They don't like to tell the community, and in fact, if they do tell the community, a lot of the community won't help in the same way they would with other diseases. So with that, we've got to look at how that person feels when their family may be avoiding them. And this is where proper dementia training comes in because that way we can give you the knowledge to be able to deal with that, so you understand what sub-vocalization is. So you understand why they're wandering, why they're following you around and things like that.

So even in a care home, it may be this person is in a care home, you're visiting the person, and the carer asks you to leave while they maybe move them or something, and sometimes the family might say, "Oh no, it's my mother I'm going to stay." What should you do there in regard to their dignity?

A good care home will tell the family member to leave, there are no doubts about that. There are a few reasons why. Firstly, health and safety legislation, if you're moving someone in a hoist they could run over the feet. That's a major issue, then you've got potentially a medical issue and may be sued, so they need to ask them to leave the room. The second part is, families, do like to get involved. Now, unfortunately, by putting someone who needs it into a care home, you're giving the responsibility to that care home. So, therefore, that care home will need to be in control of putting on a hoist, putting them into a sling. And it's been various cases throughout the years where people have popped them into a sling and maybe a family member has pulled a loop off or say, "I don't do it like that." Well, these are trained professionals and we need to trust them.

The third issue is if someone is incontinent. We are taking them off of the bed, and maybe they've got faeces and urine in places they don't want to see their family members, their daughters, their sons, maybe even their grandchildren looking and even husbands and wives. So we should ask them to leave the room and make sure that they understand the reasons why, and if we explain it properly they won't have an issue.