Aggressive? more likely frightened

Professionals involved in the care of people with dementia owe
it to them to act, speak and write about them in a sensitive and
informed manner.

In 1985 my father had a serious stroke which changed the way
people saw him. Before the stroke he was described as a decent chap
who always did his best for others. Afterwards, he was described as
demanding, unco-operative and hard work. It was not difficult to
work out that the changes in his behaviour must be the result of
his condition.

In the first few weeks of his illness he was dehumanised by
nursing staff who talked and wrote about him in words that did not
value him as a person. I brought him home and looked after him
until he died.

I would like to say that in 2003 everything is different and
that staff caring for older people with dementia are well trained.
But I cannot say this is the case. Most people with dementia are in
residential or nursing homes and are cared for by staff who have
little knowledge and understanding of vulnerable people. Often the
only attributes a person needs are to “love old people” or have
common sense.

So what can be done? It could be argued that social care staff
need to be valued more and that this should be reflected in their
status, financial reward and terms and conditions. But this alone
would not necessarily make more compassionate and informed

Managers who inspire and lead by example are paramount. They do
not see a care plan as something that has to be done to satisfy
inspection but as a personal profile that sets out how an
individual’s needs can be met.

How anyone can talk about a person-centred approach and then
refer to people as demented, aggressive or as a PWD (person with
dementia) is beyond belief. Everyone in the field of dementia care
should use language that promotes dignity and respect. Words such
as aggressive, violent, and senile may not always be used
maliciously but are distasteful. The disease robs people of so many
things that the least we can do is ensure people are spoken to and
written about in an appropriate way.

Training which encourages staff to put themselves in the shoes
of people with dementia is invaluable. Rather than labelling people
aggressive isn’t it more accurate to recognise they may be
frightened, angry, disoriented or trying to defend themselves?

Joy Johnson is the personnel and training manager for
independent care provider HICA Care Homes.

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