3.8 Helping without taking over

When it takes the person with dementia a long time to start or do a task, or if you watch someone struggle to do something that used to be easy, it can be frustrating or upsetting. The temptation is often to ‘take over’ and do the task for the person. However, in doing so it may mean that they lose the skill more quickly and you will add that task to your list of jobs.

Setting up a task and providing encouragement can help the person maintain a skill and preserve their self-esteem.

Often people with dementia will have difficulty in planning or starting a task. The brain has a ‘starter motor’ that initiates activities which is often affected in dementia. There are ways we can help. The following three steps go from least help to most help in prompting to start a task.

• Step 1: Provide opportunity for the task to be carried out. Susan is always happy to fold the washing but never thinks to collect the basket from the laundry. Greg leaves the basket in the living room in sight of her favourite chair. Each time Susan spots the laundry basket she busies herself with the folding. You can think of this as ‘setting up the activity’ – doing the initial step that the person gets stuck on. Another example is washing up. Filling the sink with soapy water and having the dirty dishes stacked can be enough to get someone going.
• Step 2: Give a prompt. Rather than ask for the task to be done, just casually draw their attention to it. “I brought the laundry basket in” or “I’ve stacked the dirty dishes” can get the activity going.
• Step 3: If steps 1 or 2 don’t work, ask the person to do the task. “Would you be able to help me by folding the washing… doing the dishes?”

You can also consider avoiding some tasks altogether if they cause problems. (Sometimes we do things out of habit). For example:

• Ron was getting slower at getting ready in the morning. Sue suggested he grow a beard to avoid shaving “You had a beard when we first met and you looked great!”