The first of the five fundamental needs of Kitwood’s model is comfort.
Comfort can be physical and emotional. Physical comfort may come from having enough food, a bed that is right for us, or furniture that fits us. Comfort may come from living in a house that is the right temperature, not too draughty or dark, or too glary.
Emotional comfort may come with affection from people we love, validation of what we are saying or from being able to trust the reliability of people who keep turning up. It may be from the familiarity of doing activities that have always soothed us.
We need a temperature that is pleasant, not too hot, not too cold, and to dress accordingly. However, if we are forgetful and lack awareness of our surroundings we may go outside on a cold rainy day in a t-shirt and shorts. Or we may dress for winter weather when the day is hot and steamy, risking dehydration and sunburn.
Familiarity of our surroundings also gives comfort. We sit in the same chair. We walk the to the shops to buy the same newspaper everyday for years on end. We wear that old pullover or jeans because they are comfortable, familiar. We eat food because it is familiar and satisfying. More than that, to be in familiar comfortable surroundings, clothed in familiar clothes, with familiar people is pleasurable and calming.
And this is where we confront the stresses that dementia can cause. It is difficult to be comfortable when you can’t remember the people, the place, the clothing. In fact, it is more likely to be concerning and irritating. In other words, our need for comfort can be sabotaged by dementia and we can be plunged repeatedly into the discomfort of strangeness.
Personality and temperament may play a role here as we may vary on how much familiarity we need to feel comfortable. Some people thrive on new situations and enjoy wearing different clothes, engaging in novel activities and meeting new people. These people are not going to find the forgetfulness of dementia as discomforting as someone who relies on the familiarity of predictable routine for comfort.
Life experience may also influence how much comfort a person needs and what they utilise to provide that comfort. A former tradesman may want to be outside doing something rather than sitting inside and watching television. Then again, the former tradesman may be relieved to sit inside and be out of the weather watching his favourite football team. That may be just what he needs to do to signal to his brain that he can relax. It just depends.