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Why dementia care demands a SPECAL approach

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One in six of us will develop dementia at some point during our lifetimes. For a condition that affects so many, it is surprising that we’re only just beginning to take steps towards understanding and trying to minimise its negative impact on quality of life.

SPECAL offers an innovative approach that can be practised by anyone – from professional live-in carers to friends and family members – and has already improved the lives of countless people with dementia. Find out more about this approach, and how you can integrate it into your interactions with loved ones.

What is SPECAL?

SPECAL began as an acronym (Specialised Early Care for Alzheimer’s) and describes the work of the Contented Dementia Trust, whose charitable aim is to promote lifelong well-being for people with dementia. The SPECAL method of managing dementia offers a particular understanding of the condition from the perspective of the person with it, and supplies the crucial insight needed by anyone wishing to help and support that person.

The SPECAL method enables carers to understand the particular memory change brought about by dementia, and then to work positively with this change rather than trying to defeat or ignore it. The methodology is simple and relevant to both professional and non-professional carers who learn to use an innovative and highly effective set of carer tools, and techniques. The SPECAL method has been found to aid condition management by:

• Increasing confidence
• Slowing the rate of deterioration
• Reducing medication to a minimum
• Enabling independent living for longer

Practitioners use the analogy of a photograph album to explain how normal memory works. The album represents the person’s memory system; the photographs in the album represent the person’s individual experiences which are stored unconsciously on a continuous basis throughout life to providing an accessible record of facts and associated feelings. We use the album all the time to reference recent photographs to provide context and continuity in our life.

When a person develops dementia, their ability to store new photographs with both facts and feelings becomes compromised. A new type of photograph starts to appear in which the facts of what has just happened are not stored – just the feelings. In the absence of recent facts - information that we all take for granted will be available to us -, the person will very reasonably go back through their album to pages before dementia started, and using older facts to make sense of the present. Feelings are more important than facts for the person with dementia – they will always know how they have just been feeling but they may not know the facts of exactly why. The SPECAL method presents a way of sustaining well-being, focussing on feelings first and foremost and working positively with the person’s natural coping strategies, rather than unwittingly compounding their disability.

How does the SPECAL method work in practice?

According to the Contented Dementia Trust, SPECAL’s Three Golden Rules are:

Don’t ask direct questions

• They may not have the recent factual information they need, and you may cause unnecessary distress. It is surprising how much information you can glean without asking direct questions!

Listen to the expert the person with dementia – their statements and questions are highly significant

• Don't bring your own world in until you have understood where they are at and matched your pace to them
• Learn what interests and holds their attention, and base interaction around these themes
• Recognise the importance of feelings, which are storing all the time
• Stop talking as soon as they start, and avoid interrupting them – you will learn far more that way!
• Avoid giving them bad news – they have more than enough of their own already!

Don’t contradict

• Don’t argue with them about the photographs they choose to use. Start where they are at, and go from there. Consider everything they say as ‘interesting’, take care of their feelings first and start from there. This is a far safer route than active disagreement.

The Good Care Group are proud advocates of the SPECAL method, and have seen first-hand the good it can do for people with dementia. You can find out more at www.contenteddementiatrust.org

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