Due to symptoms like confusion, memory loss, and communication issues, health conditions like dementia can place people at greater risk of neglect and abuse.
Safeguarding refers to a set of approaches designed to reduce this risk by monitoring and intervening on behalf of vulnerable adults, including those with dementia.
Here, we’ll look closer at why safeguarding is important for dementia and offer five general practice tips.
What is safeguarding?
Safeguarding is a term used in the UK and Ireland to describe the measures put in place to protect people’s health, wellbeing, and human rights – allowing them to live free from abuse, harm, and neglect.
It essentially means working with people and any relevant professionals (such as, health or social workers) to support and keep them safe.
As well as children, safeguarding is used to protect a wide range of adults – particularly those considered ‘vulnerable’ or ‘at risk’, such as adults with learning disabilities, physical disabilities, and dementia. Safeguarding can be used to protect carers, too.
According to the Care Act 2014, there are six key principles of safeguarding. These are…
- Empowerment – supporting and encouraging people to make their own decisions
- Prevention – aiming to act before harm occurs
- Proportionality – prioritising the least intrusive response in line with the risk presented
- Protection – support and representation for those in greatest need
- Partnership – communities have a role to play in preventing, detecting, and reporting abuse and neglect
- Accountability – transparency is required in safeguarding practice
Note: Wales and Northern Ireland have their own safeguarding legislation.
According to the Care Quality Commission Safeguarding is fundamental to high-quality health and social care.
Why is safeguarding important for dementia?
Safeguarding is important for ensuring the health, safety, and wellbeing of people with dementia because the condition can cause cognitive symptoms which place them at greater risk of abuse or neglect. For example, memory loss and communication issues can make it difficult for people to protect themselves.
Carers of people with dementia can also be at risk of abuse or neglect – particularly if they’re overworked, isolated, or under severe amounts of stress.
As a result, raising safeguarding concerns can improve the health and safety of individuals and carers. For example, it may lead to a home or carer’s assessment being carried out to examine the need for further support.
If you’re currently caring for someone with dementia, you might be interested in Dementia UK’s article on keeping safe when you care for someone with dementia, which covers everything from personal safety to risk assessment, and what to do in a crisis.
Note: Safeguarding is important whether or not the person caring for someone with dementia is a paid carer or a family member. Paid carers are legally required to take safeguarding training.
Safeguarding and dementia – 5 general practice tips
Now we know why safeguarding is important, what are some steps that can help to prevent abuse when caring for people with dementia? We’ll cover some general practice tips below.
1. Create a safe, calm, and familiar environment
Creating a safe, familiar environment is key when caring for people with dementia and ensuring their wellbeing.
For example, removing trip hazards, such as clutter, loose rugs, and extension cords, and improving lighting – particularly in hallways, stairways, and bathrooms. Other steps, like using clear labelling, colour-coding, and simple furniture arrangements can also help to make an environment more dementia-friendly.
Medication should be stored away securely to prevent accidental overdose. Using a pill box or daily list to help make sure medications are taken correctly can also be helpful.
For more information, check out this guide to making the home safe for a person with dementia from Dementia UK.
2. Communicate effectively
Caring well for a person with dementia is largely dependent on your ability to build a good relationship with them and communicate effectively. Often, this involves tailoring your approach to suit their cognitive abilities.
Maintaining a calm, reassuring demeanour, avoiding complex language, and using non-verbal cues, such as gestures, facial expressions, and touch, can be helpful. Above all, it’s important to focus on the person’s feelings – listening to any worries they have and working to understand their perspective.
On the other hand, Professor Tom Kitwood outlines several negative practices to avoid when caring for and safeguarding people with dementia. These include asking questions too quickly; treating them like a child; and acting as if they’re not there – for example, asking a carer questions that patients are better placed to answer.
Experts at Community Care have also highlighted several interview techniques, questions, and considerations that can be helpful for effectively gathering the information you need for a successful safeguarding risk assessment. For example, looking out for body language which may convey pain or fear if the patient is non-verbal. You can find more information on these on the Community Care website.
3. Encourage independence
One of the main fears that many people being cared for struggle with is losing their independence. And, if this becomes a reality, it can significantly impact their mental health and wellbeing.
However, supporting and encouraging people to make their own decisions is a key aspect of good safeguarding practice.
For example, this means respecting their preferences and involving them in conversations and decisions around their care as much as possible.
4. Look out for signs of distress or potential harm
Another aspect of good safeguarding practice is watching for early signs of distress or potential harm.
It’s worth keeping in mind that people in distress or at risk of harm won’t always say so – and this can be particularly true for dementia patients, who may struggle with communication. As a result, paying attention to non-verbal cues, such as body language, mood changes, or physical symptoms that may signal distress, is equally important.
5. Seek support
Partnership is central to successful safeguarding practice, with communities playing a key role in preventing, detecting, and reporting abuse and neglect.
This means it’s essential to raise concerns with the appropriate organisations if you have concerns about a person’s wellbeing.
Plus, caring for someone with dementia can be challenging, so leaning on the support of others can help to make things manageable. For example, reaching out to local dementia care services for guidance and support, or encouraging family and friends to get involved in their loved one’s care and support.
Who should I contact if I have safeguarding concerns?
Generally speaking, if you’re concerned that someone with dementia is at risk of abuse, your first point of contact should be your local authority’s safeguarding team.
However, there are some cases when your local authority safeguarding team won’t be the most appropriate response to keeping people safe. For example, there are agencies available to help if a person is being harmed, or at risk of harm – even if a formal safeguarding response isn’t triggered, such as domestic abuse services.
If someone is in immediate danger, it’s important to contact the police. If you’re a paid carer, your company will have safeguarding procedures in place to deal with these types of situations.
Alzheimer’s UK has a more in-depth guide about what steps to take if you have safeguarding concerns.
Recognising the signs of and reporting abuse
For safeguarding to be effective, it’s important to understand the definition of abuse and potential signs to look out for.
According to the Alzheimer’s Society, abuse is when someone causes another person harm or distress. Abuse can take many forms, ranging from disrespect to inflicting physical or mental pain; and can occur in a person’s home, hospital, care home, or a public place.
Often, the people who commit abuse take advantage of being in a close relationship with the victim – for example, a friend, family member, or paid carer who the person trusts. According to the Alzheimer’s Society, signs of abuse can sometimes be difficult to spot but may include…
- A sudden change in behaviour
- Not eating enough
- Unexplained bruising or injuries
- Low self-esteem
- Changes in how the person looks
- Missing personal items
Note: There are many potential signs of abuse; this list isn’t exhaustive. If you have any concerns about how you or someone you know is being treated, it’s important to tell someone.
Final thoughts...
Health conditions like dementia can place adults at greater risk of neglect and abuse and good safeguarding practice is key for looking after their health, safety, and wellbeing.
For further reading, head over to the care section of our website. Here, you’ll find information on everything from paying for care to choosing the right care home.
Do you have any more information or insights into safeguarding and dementia that you’d like to share? We’d be interested to hear from you in the comments below.
