What Are the Three Golden Rules of Dementia Care?

Dementia is more than just memory loss; it’s a progressive condition that affects thinking, behaviour, and the ability to perform everyday tasks. Millions of people around the world live with dementia, and as the population ages, this number is expected to grow.

Caring for someone with dementia requires more than medical knowledge; it demands empathy, patience, and deep understanding. That’s where the three golden rules of dementia come in. These simple yet transformative rules serve as a foundation for compassionate caregiving. Whether you’re a healthcare professional, family caregiver, or support worker, understanding and applying these rules can make a meaningful difference in the life of a dementia patient. 

In this article, you’ll explore what are the three golden rules of dementia, why they matter, and how they can be implemented in everyday care settings.

Understanding  the Golden Rules of Dementia

The golden rules of dementia care are designed to ensure compassionate, respectful, and effective support for individuals living with dementia. These simple yet effective rules focus on enhancing communication, building trust, and reducing stress. These rules are: 

1. Don’t ask direct questions 
2. Listen to the expert
3. Don’t contradict

Let’s explore the three golden rules in more detail:

1. Don’t Ask Direct Questions 

For individuals who have dementia, even the simplest questions can be challenging and frustrating. Asking what did you eat today? or do you know who I am? can create anxiety, especially if they can’t recall the answer. It can feel like a test they’re failing, and that repeated sense of failure can damage their confidence and mood.

Now, the question is, why does it happen?  

Dementia patients often struggle with short-term memory loss and confusion. Constantly being asked to recall information they don’t remember puts them under pressure and may lead to withdrawal, agitation, or distress.

What you can do is simply avoid memory-testing questions and focus on emotion and shared experiences rather than facts or names. Your tone, presence, sympathy and kindness will be remembered and have a positive effect on such patients.

2. Listen to the Expert

In dementia care, the experts are not just doctors or researchers; they can be caregivers, family members, and most importantly, individuals themselves. Each person with dementia experiences the condition differently, and paying attention to their cues, preferences, and behaviour can guide more meaningful and person-centred care.

Although medical knowledge is important, real-life experience provides insights that books can’t. The person living with dementia is the expert in how they feel. Their family may know their challenges, preferences, and habits better than anyone else. So, listening to them leads to better care plans and decisions.

You can observe their changes in facial expressions and body language, involve family members, and respect the patient’s dignity. Carers can personalise the care approach, reduce distress, and build a deeper connection by listening carefully.

3. Don’t Contradict 

An individual with dementia may say things that are untrue or seem illogical, such as believing they’re still working, asking about deceased relatives, or claiming it’s time to pick up children from school. Correcting or contradicting them can lead to confusion, sadness, or aggression.

Contradiction creates conflict and emotional pain. While trying to orient the person back to reality may feel natural, doing so often increases fear or resistance. Instead of helping, it can make them feel misunderstood or attacked.

Contradicting someone with dementia can harm the trust you’ve built. Instead, just validate their emotions and support their experience with kindness and empathy.

What are Signs that Dementia is Getting Worse? 

As dementia worsens, signs become more prominent, affecting memory, behaviour, communication, and physical abilities. People with dementia may experience increased memory loss and confusion, such as forgetting others’ faces, repeating questions, or losing awareness of time and place. Daily tasks like dressing, bathing, or managing medications become more difficult without help. 

Additionally, language skills often decline, with trouble finding words, following conversations, or speaking coherently. Moreover, behavioural changes, such as agitation, paranoia, depression, or social withdrawal may occur, along with poor judgment or inappropriate behaviour. Also, physical abilities deteriorate, leading to difficulty walking, frequent falls, and reduced coordination. These changes signal that dementia is progressing to a more advanced stage.

What are the 5 Things to Never Say to a Person with Dementia? 

When speaking with an individual with dementia, it is necessary to choose words that comfort rather than confuse or upset them. Certain phrases should be avoided to protect their emotional well-being: 

• The first one is asking do you remember? It can make them feel like they’re being tested and highlight their memory loss, which can be distressing. 
• Next, saying I just told you that can come off as impatient and dismissive, causing shame or anxiety. 
• Another one is that you’re wrong or that it didn’t happen, which can trigger confusion, as their perception of reality may differ due to the disease. 
• Next, telling them you already ate might upset them if they truly feel hungry or have forgotten to eat. 
• Lastly, asking who I am can create panic or embarrassment if they don’t recognise you.

Instead of these questions, focus on offering reassurance, accepting their reality, and communicating with empathy and patience.

Pillars of Dementia

When exploring what are the 5 pillars of dementia, it’s important to understand that these key areas form the foundation of effective and compassionate dementia care. The 5 pillars of dementia are: 

1. Early diagnosis is necessary as it allows individuals and families to plan for the future, access treatments that may slow progression, and receive proper support early on. It also opens the door to lifestyle adjustments and therapeutic interventions that can improve quality of life.
2. Person-centred care means designing care to the individual’s unique needs, preferences, history, and personality. This care focuses on dignity, respect, and meaningful interaction, ensuring that the person remains involved in all decisions regarding their care.
3. Support for Carers: Caring for someone with dementia can be emotionally and physically challenging. This pillar emphasises the importance of education, respite care, emotional support, and resources for carers to maintain their well-being and ability to provide effective support.
4. Community Awareness: Raising public understanding helps reduce stigma and promote a dementia-friendly society. This includes awareness campaigns, training for businesses and services, and encouraging inclusive practices that support individuals with dementia in living more independently.
5. Research and Innovation: Investing in research is necessary to discover better treatments, potential cures, and innovative care methods. Research and innovation also involve exploring technology, therapies, and interventions that can enhance the daily lives of those affected by dementia. 

At Lets Care All, we offer compassionate, expert-led dementia care services designed to support both such individuals. With a focus on dignity and connection, our services are designed to meet the specific needs of each individual. Whether you need in-home care services or professional advice, we’re here to help every step of the way.