Social life in advanced dementia

Social life remains a need for everyone who has dementia even until the final palliative moments at end of life. They may have profound impairment but we can stop it becoming profound disability if we stimulate social life with them.

We are social beings. We need and crave contact with others. Our entire make up is geared to interaction. We have language to express our inner experience to others. We crave to be understood by another who recognises us. We know this by paying attention to the relief that floods us when someone really understands us, gets us.

Social life is talking, holding, touching, listening, looking at each other, stroking, kissing, massaging, turning your head to look. All these small actions are what we might call micro-behaviours and if we pay attention to them in the person in our care we can see the small indicators of a desire to make social contact, to connect, bond with us.

The person with dementia lying in a chair without verbal language, unable to walk, toilet themselves, dress themselves, or eat independently, may crave social connection just as much as you and I do. Let’s look for the small micro-signs that tell us they are wanting to be connected.

Perhaps they are unable to show us even small signs. However, when you make the contact watch for their response. This response can be a micro smile, eye-contact, head-turn, flinch or flicker of movement. This is social response to our approach and contact. Engage and sustain your contact and you will notice small signs of change, lower stress, less agitated movement, less calling out, less moaning and groaning. Perhaps you may even notice signs of engagement now, sustained looking where there were closed eyes.

We can meet and engage successfully with the person with such profound impairment. We can stop it becoming profound disability if we make the connection with them and stimulate social life with them.