Does Therapy Benefit Individuals with Dementia?

Sep 15, 2020

Dementia can be a difficult diagnosis, with a host of symptoms that are challenging for the individual and for their family members
Counsellor Daniel Fitzpatrick, who works with individuals with dementia and their families, explores how therapy can help
You can search for therapists and counsellors who work with dementia by using our questionnaire – find yours here

Therapy is a useful and proven tool for supporting people struggling with an abundance of mental health issues, a lot of which we are familiar with today, such as depression, anxiety, phobias etc. Dementia is for the most part still an unknown or misunderstood illness, even for those who may have had a loved one recently diagnosed.

The concept of dementia can be frightening. Symptoms can include memory loss, ceasing of bodily functioning, and eventually end of life. Whilst there is truth in this, it is of paramount importance that we realise a diagnosis of dementia does not mean the person’s life is immediately over. Think of it as adapting with an unfortunate change.

Dementia is the umbrella term for different conditions that affect parts of the brain, these would include Alzheimer’s, Vascular Dementia, Lewy-Bodies, Parkinson’s etc. With dementia, there are different stages the individual will go through and these stages are all unique to the person themselves. This can be overwhelming and scary for the individual who will at times feel like ‘the lost child in the supermarket’.

How therapy benefits people with dementia

An individual who is feeling low/overwhelmed/anxious may attend therapy to gain knowledge and insight into their issue or as a place to speak and be heard. Within dementia this ability to verbalise lucidly can be limited, therefore making it difficult for the individual to communicate their needs. Even if the person is struggling to verbalise, the warmth and empathy from the room will support them in engaging and encouraging them to live in the moment they feel most comfortable in.

Some of the arguments I have heard previously regarding therapy for individuals living with a form of dementia have included: “what’s the point? They won’t remember it anyway”. While that may seem valid – and, on average, an individual with dementia holds onto ‘in the moment conversations’ for an average for 30 seconds – it is important to remember that the feelings from the chat will last much longer and are specific to each individual (Sheard, 2012). While the person may not remember a beneficial conversation word-for-word, the lasting sense of how that has made them feel can be extremely useful when taking into account the difficulties they are experiencing every minute of every day. The emotion behind the dialogue leads the way in importance, over the content of the interaction.

There are many different techniques that can be utilised naturally in conversations with individuals experiencing dementia that have been successful in promoting boosts to self-esteem and an improved wellbeing overall. There is also the option of including the person in group therapy with family members, so the individual does not feel isolated or alone.

A person-centred approach is the leading way for supporting those living with dementia. The reason the person-centred approach in therapy or counselling is the best fit is mainly down to the idea that you don’t ask the person any direct questions, as this would cause the individual to become overwhelmed due to the reduced capacity of their memories.

The individual takes the lead, and with information provided in advance by family members, the therapist can engage in ‘verbal ping pong’ (James, 2012) where the person feels in control of their conversation as opposed to how they might feel in general circumstances, lost and mentally fatigued.

Therapy has also been proven to help reduce the need for anti-psychotic medications (Junaid & Hegde, 2007) lessening the need for medical interventions and the difficulties that may be associated with them.

Cheston et al (2003) evaluated six 10-week psychotherapy groups for people with dementia and found significant improvement in scores for depression and marginal benefits in anxiety symptoms which were maintained at follow-up. Whilst therapy is not a magic wand that will “cure” dementia, it is proven to be a beneficial.

The aim of therapy whilst working with someone with dementia is to focus on their abilities and strengths, rather than what they have lost; to engage, empower, and influence positive change in their lives.

The benefits of therapy for family members

There is truth in the statement that dementia does not just affect the individual, it affects everyone close to the person. Family members can find it increasingly difficult to manage the expectations of a loved one with dementia. One of the main things to consider is that there is no instruction manual for how a family member will or should feel while caring for someone close to them who has dementia.

It can sometimes be a long process and it is quite normal to experience many emotions such as guilt, numbness, anger, frustration, fear, loss, or despair, to name but a few. It can feel as though the bereavement process has already begun, even with the person still very much alive.

Therapy can offer you the time and space to verbalise the difficulties you are experiencing. It is not selfish to reach out for support; if anything, it is a fundamental part of your self-care.

Psychoeducation involving the person-centred model surrounding dementia can also be of benefit to families looking to gain more of an insight in how to implement plans or even building on conversational dialogue. Mainly though, the space in therapy should be for the family member to explore themselves and the challenges they are facing. It is quite easy as caregivers to neglect our own needs and find ourselves juggling more than we have the capacity to manage. This can contribute to a poor level of wellbeing, which can spiral if not addressed.

The concept of role reversal is also something to be mindful of. If a parent or grandparent has been recently diagnosed with dementia, the onus may fall on family to become the main carer. This transition can be challenging for several reasons, including the lack of time to adapt to this big change, and the pressure due to the uncertainty of what lies ahead.

Caring for a loved one living with dementia is not easy, it is quite the opposite, and it is valuable to know that the support is out there. A qualified therapist can listen, empathise with your scenario, and provide reassurance, no matter how unusual or overpowering it may feel.

Daniel Fitzpatrick is a verified welldoing.org counsellor in Altrincham and online

Cheston, Richard & Jones, K & Gilliard, J. (2003). Group Psychotherapy and people with Dementia. Aging & mental health. 7. 452-61. 10.
James, O. (2009) Contented Dementia. London. Vermillion.
Junaid O, Hegde S (2007) Supportive psychotherapy in dementia. Advances in Psychiatric Treatment. 13, 1, 17-23
Sheard, D. (2011). Achieving Real Outcomes in Dementia Care Homes. Dementia Care Matters
Junaid O, Hegde S (2007) Supportive psychotherapy in dementia. Advances in Psychiatric Treatment. 13, 1, 17-23