How to keep yourself safe when you care for someone with dementia

October 20, 2022

The specialist Admiral Nurses who work on our Dementia Helpline sometimes receive calls from families saying the person living with dementia is in such an intense state of distress that they become verbally or physically aggressive – often because they see everything around them as a threat.

In some situations, this can lead to their carer feeling at risk of harm.

It’s a good idea to have some strategies to help everyone stay safe and bring the situation under control.

Strategies to keep safe

Always aim to remain calm when met with heightened emotions. Try not to mirror the person’s emotions or behaviour: for example, if they are shouting, try to speak in a low and steady tone.

Repeating a phrase like, “I’m sorry if I’ve upset you, but I am here to help” may help to calm the person.

If you are standing, move an arm’s length away and turn your body slightly sideways to seem less threatening to the person.

Put yourself on their level if you can – for example, if they sit down, you can sit down too.

An Admiral Nurse on the Helpline

If it is safe to do so, give the person you are supporting some space to calm down and feel less anxious. Move to another room and come back after 10 to 15 minutes to see how they are.

Keep the home environment as clear and clutter-free as you can, especially around exits and entrances – this will help provide both you and the person you care for with space to move and adapt in difficult situations and reduce the risk of falls.

Contacting family and friends

If things feel very uncomfortable or unsafe, find a room in the house away from the person with dementia where you can phone a friend or family member for support. The bathroom is often the most convenient place, and you can lock the door if you need extra protection.

Having a code word to use, such as ‘pineapple’, can be useful to save time explaining that you need help in a crisis. You can discuss this with other family members or friends so they understand what is happening if you call.

Experiment with things that may help to calm the person you care for in advance of any event that may be unsettling – for example, playing their favourite music, going for a walk, or spending some time in the garden or other outdoor space.

Leaving the house

If the person wants to leave the house, it is often best to let them go rather preventing them leaving in case you or they are hurt in the process. You can follow them at a safe distance or call for help from a neighbour, relative or friend, or the emergency services.

The Herbert Protocol is a scheme that involves collecting useful information about a vulnerable person to help police locate them if they are missing – you can use this template form to inform the local police service at the time if the person goes missing.

Keep a ‘go bag’ of useful items somewhere you can access it quickly in case you need to leave in a hurry. Include a spare house key, phone charger, change of clothes, snacks and a drink, and a list of important contact numbers and medications. This can also be useful if the person with dementia requires an unplanned hospital visit.

The main thing to remember is that the person’s behaviour is being caused by their dementia, and if you can respond in a controlled manner, it will pass. It is also helpful to understand that the person believes they are under threat – and this triggers the part of their brain that is responsible for regulating emotions such as fear and anger. This can lead to behaviours that sometimes seem illogical, irrational and overreactive, including verbal and physical aggression.

Support services that can help

If you or anyone else is in a situation where you feel your safety is at risk, please call 999 to speak to the emergency services. They are there to keep you and the person with dementia protected and get you both help. Professional services want to enable people to live at home as long as possible and will only resort to finding a place of safety for the person with dementia if the situation becomes too precarious at home, and any intervention will help you manage the situation to keep everyone safe.

It is important that you feel supported with these difficult experiences, so please talk to a trusted family member or friend. For advice from a dementia specialist Admiral Nurse, please call our Helpline on 0800 888 6678 or email helpline@dementiauk.org.

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