Dementia care missing common sense #DAM2015 Day 14

Source: via

Source: via

It is Day 14, and almost the middle of Dementia Awareness Month 2015, and I decided the topic of Dementia and common sense was a worthwhile one to write about, as I believe generally speaking common sense is missing in our care.

I often think about common sense, and wonder it has gone these days, not just in dementia care, but almost everywhere. Perhaps it’s the farm girl coming out in me, but I think common sense is becoming a lost art, and one we should work on retrieving, especially in dementia care.

The desire and intent to improve and to provide better care for people with dementia seems high in the sector, especially amongst service providers and researchers, and for that, I am truly delighted.

However, whilst we do need evidence based practice, we also need some good old fashioned common sense in our core plans. This definitely seems to be missing… We have all this ‘education’ and evidence based research to inform us, but very little common sense being used in dementia care. Here are a few examples…

We all know the positive effects of sunlight on mood, and the health issues such as vitamin D, and then we wonder why people living in residential care become unhappy, and whose symptoms of dementia get worse. Surely it is logical that never going outside into the sunshine, will lower mood and happiness, and reduce the vitamin D in our bodies, both potentially negatively effecting dementia symptoms.

We all know the positive effects of daily exercise, but mostly, people in residential aged care are lucky to get any exercise at all, other than to the bathroom or dining room, and that is often with help to save time. We know the negative effect on our physical and emotional health, including falls risk, when we don’t exercise, therefore also negatively affecting people with dementia.

We all know the positive effects of healthy, nourishing food, made from fresh produce, served to us in a way that look appetising and appealing, and smells and TASTES good. We also know how we would feel if we are made to eat food that is boring, mushy or that we dislike, and not wanting to eat the food served up to us also affects the person and their dementia.

We all like to feel we have control, and that having some control of our own life increases many thing, such as our positive outlook and self esteem, and yet, all control is taken away from people living in residential care. This is, in spite of the fact, residential aged care is beautifully marketed as your new home. Really, your new home, and you can’t get out (no, you are not given a key), and you have almost no say in how you live, when and what you eat, the music you listen to, or the activities available to you?

People with dementia are already losing control of their functioning, their capacity, their abilities, so to take even more control away from them when they go into residential care can only make them sad, unhappy, anxious and yes, even angry. This additional lost control might also have something to do with some of the ‘behaviours of concern’ many are currently being physically or chemically restrained for…

We all know the positive effects of meaningful activities, of engaging in the hobbies and activities we enjoy, such as gardening, music. Yet, I often see activity rooms in residential care, and ‘day’ respite, full of people looking bored, playing Bingo or doing other meaningless group activities. This allows for fewer staff, and less work in planning, but is not person centred in any way.

We all know the positive effects of normal socialising and going out to community events, yet rarely do I ever hear of people in residential care being taken out to social or community events like concerts. Instead, we bring them in-house to the residents, all sitting around the ‘day or activity room’. Surely it would be far more fun going OUT to the theatre or the movies, and that not doing so, negatively affects people with dementia as well.

We know that many of the family and friends drop away when someone is diagnosed with dementia, and then, when they move into residential care, visitors dwindle even more. Research clearly support this. So, supporting people who live in a residential care homes to socialise in normal ways, has to be good for them in ways other than it being person centred. Improving mood, happiness and well-being, perceived or otherwise, as well as giving them back some sense of control has to be a good thing, surely?

We know that for all other disease or illnesses, changing lifestyle factors improves our chances of recovery or reducing the impact of the illness. Increasing exercise, rehabilitation, improving nutrition, getting sunlight, and working our brains hard, are all positive interventions that improve our wellbeing, even if they are not a cure.

It makes good common sense to provide care for people with dementia that provides the same support as any other disease. Who knows, if they start to feel happier simply due to increased serotonin from exercising, and have less falls because of some regular resistance and balance exercises, it might actually be good for them, even slow down the deterioration caused by dementia. It might even reduce their ‘challenging behaviours’ as well…

Let’s bring back some good old fashioned common sense, especially in the dementia care sector.

I could go on… but the day is long, and tomorrow will be upon us very soon, when at least until the end of September, I have to do it all again as I am committed to posting two blogs every single day! Yep, she really must have dementia…

19 thoughts on “Dementia care missing common sense #DAM2015 Day 14

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  6. Oh Kate, how very very true. Common sense to be something not heard of in Residential care especially! I am forever being at a complete lack of words when “common sense” doesn’t seem to be understood! How can it be used if people just do not have “it”.


      • Kate – I have been reading your blog for long while and I do so agree with you.

        Activity and sunshine – (even a little potter down the road) alleviates feelings of despair.

        I work as an Expert by Experience – for the UK Care Quality Commission – and we, as (in this case), are chosen for our experience (of being older) to inspect residential care alongside a registered inspector (or two). I have an MSc in Gerontology – but most of my fellow Inspectors have in their tool kit – an active awareness of HOW THINGS SHOULD BE – what is possible to make life for the residents a great deal better – and this is more than enough! .

        Our task is to talk to the residents as much as possible – to find out what they do all day – their interests – food – their general well-being. Professional Inspectors access records drug charts and so forth.

        In a few exceptional Residential Homes there will be an Activities Organiser who is solely responsible for keeping the residents happy and as well as they can possibly be. What a difference to the climate of a Home this brings – no longer sitting with heads resting on chests (the saddest position).

        So happy New Year Kate and family in Australia –


      • Thanks Enid, it was interesting to read your comment, that a “few exceptional Residential Homes there will be an Activities Organiser” – this should be mandatory in all homes, surely? We still have so far to go… take care x


  7. This post is so timely. I started my new job today as wellbeing coordinator in a care home. I feel strongly that the improvements you mention need to be made and I will be working hard to make sure they do in our little home.


  8. This is such a great post! A an Occupational Therapist (albeit one that hasn’t practised for a number of years) all the points you make above resonate as not only true but essential. Maximising independence and creating or finding meaning in daily tasks and occupations is significant to quality of life for all people. It IS common sense…. Thank you for raising the alarm. I will be returning to the work force in the next few years and think I might spend some time exploring this topic as i prepare…


  9. We are also aware of the common sense in supporting Care Partners. Where is the training and real support for the likes of me who are on duty 24/7? Now that would be common sense: to support Care Partners just a little more.


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