By Admiral Nurses Kerry Lyons and Mutsai Hove-Bird, as well as Admiral Nurse Professional and Practice Development Facilitator Sarah Russell.
Updated 4th January 2021
The national Covid-19 vaccination programme began on the 8th December 2020 with the Pfizer/BioNTech vaccine. The Oxford /AstraZeneca vaccine has now also been approved for use. Both are very effective vaccines given in two doses. The first dose offers some protection; the second dose is required to complete the course.
There is currently no evidence to say that both vaccines will not work on new variants (types) of Covid-19. Further government advice is available here.
Click here to read the statement from the UK Chief Medical Officers on the suggested prioritisation of both vaccines and click here for the current NHS advice about the time between doses.
Both vaccines are for adults over the age of 18 years. The Joint Committee on Vaccination and Immunisation (JCVI) is prioritising the first doses of vaccine for as many people as possible on the priority list. This will include many people living with dementia, who are over 65 and/or will be living with other long-term health conditions.
The vaccine is not compulsory but is recommended,especially in the case for people at highest risk of catching the infection and of suffering serious complications if they catch it.
If you are close to the person with dementia, such as being their carer, relative or their registered Lasting Power of Attorney (LPA) for Health and Welfare, then you may want to think how you can prepare and support them to have the vaccine.
1. Getting prepared
Give yourself some time to find out more about the Covid-19 vaccine from trusted sources. Please see here for Dementia UK FAQs on the Covid-19 vaccine, as well as reading the NHS guidance for your country:
Ask the care provider what their vaccination programme plans are. This willgive you time to discuss and address any potential questions you or the person with dementia may have.
Consider what you already know about the person’s past wishes, choices or experiences of vaccinations; for example, do they usually have the annual flu vaccine or have they had any side effects in the past?
2. Gaining consent for the vaccine
Before the vaccine is given, consent must beobtained from the person receiving it.
If they are unable to give consent, then consent must be obtained via a ‘best interest’ decision (which is compliant with the Mental Capacity Act 2005).
A ‘best interest’ decision is when someone is unable to make a decision for themselves, so the decision may have to be made for them.
If you or a family member has registered Lasting Power of Attorney (LPA) for Health and Welfare for the person with dementia, you can make health decisions on their behalf, including whether they should receive vaccinations. When making decisions about your loved one’s care, it is important to get the views of doctors or other healthcare professionals in charge of their care. All treatment options should be clearly outlined so that you as the person with the LPA knows the benefits and risks of each option. You must also take the person’s previous wishes or views into account.
If there is no LPA for Health and Welfare in place, then healthcare professionals must make a decision in the person’s ‘best interests.’ This is based upon their previous wishes and decisions as well as close consultation with friends, family members or anyone else who knows the person with dementia closely.
All consent has to be documented and the government has provided templates for this. Please see here for Dementia UK FAQs on the Covid-19 vaccine.
3. Fully explain, be honest and respect the person’s independence
It’s important that the person with dementia retains their independence and feels in control, as much as possible.
Make sure you choose a time and place that suits them.
Keep noise and distraction to a minimum.
Use short sentences and simple language to explain what needs to be done and why it is important.
Give the person time to hear and ask you any questions.
Pause between each of your sentences.
Visual prompt cards can be used to provide further explanation as well.
A warm and friendly tone can help to relieve any nervousness that the person with dementia may have about receiving the vaccine.
4. Choose your timing carefully
Sometimes people with dementia can need more time to do and understand things than others. Be patient.
If the person is experiencing heightened anxiety or distress, rebook the vaccine at a different time and consider how you can support them next time.
5. Statements that might be helpful
Some of the below statements may be helpful to support a person with dementia and help them feel more comfortable about having the vaccine:
“The injection is to protect you from the Covid-19 virus”
“The injection won’t give you the Covid-19 virus”
“Some people can get a sore arm, headache or fever after the injection”
“I would like your permission to give you the vaccine”
6. When the vaccine is given
Find out if you can support the person with dementia, by accompanying them to have their injection. This will depend on the particular care setting and the policies they have in place.
Make suggestions as to how to support the person with dementia, for example asking if the vaccinator can introducethemselves, especially if they are wearing a mask or visor, and reminders that the vaccine is given by an injection in their arm.
Consider distraction techniques whilst the injection is being administered by the health care professional; this can be conversation, music, a reassuring touch or hand massage. Getting them to hold a favourite item can also bring comfort.
7. After the vaccine
Reassure the person with dementia after the vaccine, whilst being mindful of your tone and body language.
You could offer a drink afterwards, or do a favourite activity of theirs, or rest if they are feeling tired.
Check to see how they are feeling as it might have been a tiring time for them as well as for any physical side effects.
For more informationabout the Covid-19 vaccine see Dementia UK FAQs here
Find more helpful resources from The Royal College of Psychiatrists here.
Coronavirus: questions and answers
We have put together a list of commonly asked questions to our Helpline, which we will update as the situation develops and as new questions arise