As our parents move in to Shakespeare’s ‘Sixth stage of man’ many of us in our middle age are busy with our careers and bringing up children.  We often take our parents for granted and forget they are ageing.  If we see them regularly, we may not notice subtle changes or if we live elsewhere and rarely see them, we may get a shock at their decline between visits.  Compounding this, most parents don't want to be a 'bother' and aren't good at telling their adult children they need help.
 
It can be a shock to see our parents slowing down and not coping. We may have no idea how to deal with their changing state. Some of us respond by ignoring or minimising the situation, while others will behave more like a bossy parent.  More often than not, even with the best intentions, we don't know when and how to respond. 
 
In my experience with my own mother and observing others it's best to start talking with your parents early in their retirement, and keep talking about all the different scenarios that may happen as they age, good and bad.  For each scenario, find out the options for care or help and discuss these with your parents. Most importantly, find out what they want to happen in each case. 

It may help to start by arranging a power of attorney, and who will be responsible for their health, welfare and finances should they become incapable of making those decisions.  A change in the ability to manage one’s affairs could happen suddenly after a health event, like a stroke, or slowly as a result of dementia.  It’s best to be prepared.
 
Become informed with your parents on how ageing may affect them and how they may look after themselves to extend their independence and enjoyment of life.  There is plenty of information on the Internet to help with this.  I suggest you look at local reputable resources.
 
Regularly check in with your parents, and ask them if there is anything they are struggling with.  If so, discuss alternative ways of managing the problem area. Be observant, and if you notice there has been a change in, say, the standard of house keeping, tactfully discuss this with them.  Again, it is helpful if you've discussed at an earlier time how to manage these changes and how best to broach the subjects with them.

Changes you may notice include, a drop in:

•   household cleanliness and tidiness
•   household and garden maintenance
•   personal hygiene and grooming
•   weight and lack of food in the fridge and cupboards
•   bills being paid on time 
•   managing trades people and technology
 
It is well worth having these hard conversations with your ageing parents as it helps take some of the stress out of their decline and allows you to more readily enjoy their final years.
 
If your parents are struggling at home our friendly therapists may be able to help them maintain their independence. Just contact us at Therapy Professionals
 
Ph:                              03 3775280
Email:                        [email protected]

‘The sixth age shifts
Into the lean and slipper’d pantaloon,
With spectacles on nose and pouch on side;
His youthful hose, well sav’d, a world too wide
For his shrunk shank; and his big manly voice,
Turning again toward childish treble, pipes
And whistles in his sound. Last scene of all,
That ends this strange eventful history,
Is second childishness and mere oblivion;
Sans teeth, sans eyes, sans taste, sans everything.’
 
William Shakespeare – As you like it.  “The seven stages of man.”

Pain is a universal human experience, yet we understand very little about the mechanics of it.
As a result, our treatments are still fairly rudimentary, says pain medicine specialist Dr Abdul Lalkhen.
His new book Pain: The Science of the Feeling Brain is for people who struggle to manage their own.
 
The nature of an individual’s pain needs to be understood from the outset, Dr Lalkhen tells Kathryn Ryan.

“The way to think about pain is, it’s an experience. We talk to one another and somebody says, 'Oh I’ve got pain' and there is an assumption we automatically know what that person means.

"It is a unique experience and whilst the biology and bits of our body used to detect damage are pretty much the same, when those signals reach the brain they are interpreted through our unique cognitive and emotional framework to produce that experience of pain. Using pain merely as a guide to disease is often misleading because of the different way that it is expressed.

“Pain and suffering are intimately linked, but they’re not necessarily the same. I think it’s also important to distinguish between the pain from damage – if you step on a drawing pin and damage the skin the brain needs to know about that problem because obviously if you didn’t attend to it then it could get infected and it would threaten the organism. That’s a simple kind of brain problem, which is usually resolved by removing that drawing pin.

“But when things become more complicated and long-term – for example, if you have diabetes and your nerves are damaged as a consequence of diabetes, the body then reacts by producing abnormal sensations all of the time, rather than the drawing point, which is time-limited and that requires a different approach in terms of managing that pain alarm.

“The same is true with conditions like arthritis and more widespread conditions like fibromyalgia and lower back pain, which we don’t fully understand, but we’re certain normal biological alarm systems malfunction.

“We try to apply simple solutions to those complex problems, often with deleterious results to the person. We kind of throw a blanket over those signals by giving people opioids but that then leads to further changes in brain chemistry, which cause further problems."

Some people experience a 'pain alarm system' going off all the time but not flagging actual damage to the body, Dr Lalkhen says.

That alarm may seem a lot 'louder' when there is a stressor in their environment, such as a domestic row or a work-related dispute.

Modern medicine’s approach to pain modulation has a place in treatment, but risks need to be weighed up against benefits, he says.

“The reality is the alarm is pretty much the same all the time, but it is your response to it [that fluctuates]. Living well with chronic pain is really about learning to understand that process. And for a doctor to say, ‘I can perhaps reduce the volume of that alarm, the problem is the drugs I may use may also have side effects, and you, therefore, learning how to pace your activities or avoid stressful situations that make that alarm louder, that is another way of learning to help yourself cope with persistent pain.”

Explaining the nature of pain to patients helps reduce the fight-or-flight state of worry about what it may be signalling, Dr Lalkhen says.

This allows the person to relax and reinterpret their pain as something they can more easily cope with.

Acute pain can be a huge challenge to treat, though, he says.

“I completely understand there are times when the pain is intractable and severe but there should always be an attempt made to try and have the individual understand the problem. That’s not easy and sometimes patient’s push against it because they just want a simple solution.

“But in my experience, unless you have that conversation and people are able to move to that point where they understand the problem, that is why they’re experiencing that severe and intractable pain and they’re expressing that degree of distress is simply an inability or not having had the issue had clear, or really struggling psychologically to come to terms with what they’re feeling.

"And if you just respond to their distress - which is a perfectly normal human response - with medication, that’s where it tends to lead to the escalation of [opioid use] for example, with really quite disastrous effects long-term.”

Support, empathy, caring and compassion play an important role in recovery from longer-term pain, Dr Lalkhen says.

“All pain aspects require a holistic, biological, psychological and social approach if they are to be managed appropriately, and really that’s what the book is aimed at – to try and unpack all that and try and help people understand what it is they’re going through.”

The basic physiological function of pain involves a signal to the brain that the body is in danger, and as such anything that threatens us will lead to an unpleasant physical experience, he says.

When we stand on a drawing pin, a system of pain is triggered, first by localised inflammation releasing chemicals.

"Those chemicals attached to nerve endings have specific receptors called non-receptors… so that mechanical damage of the drawing pin is converted into an electrical signal from your peripheral nerves to your spinal cord, which is a sort of junction box.

"Those messages are then relayed, and if you imagine fireworks going off in the night sky different parts of the brain and they go to the parts of the brain that deal with the where, the what have I experienced before, how am I interpreting it in that context, and so the brain perceives that there’s a problem and the brain then decides how important this drawing pin is – this injury, what does it mean. It can then increase the number of signals to the brain or decrease it. So, the experience of pain is produced in the brain as a consequence of that system.

"Now, usually once you take the drawing pin out and the foot heals, those chemicals are no longer present and the nerves are no longer stimulated so the signalling stops and in time the pain stops.”
When that system goes wrong, people develop chronic pain which persists in the absence of ongoing tissue damage.

In the case of a mechanical problem like a slipped disc compressing a nerve, the pain caused by the distortion of the nerve, as well as the inflammation produced as a result of the compression, may remain even after successful surgeries due to nerves being sensitised.

Managing this kind of persistent pain can involve medications and a spinal cord stimulator, which can put a break on nerves that are hypersensitive.

Treatment of conditions like fibromyalgia, where the body's pain alert system is constantly on, must take a holistic approach, Dr Lalkhen says.

"It really starts with education. It starts with what chronic pain is and it doesn’t rely on ongoing damage. Most people get into a cycle where their understanding is that pain is due to damage, therefore if I did more, and I had more pain, I’m doing more damage they then stop moving, which makes muscles and joints stiff and when they do move they get pain and they end up getting caught in this cycle of distress and disability.

“Breaking that cycle involves understanding the condition and then supporting [the person] to rehabilitate it by teaching them how to manage that pain.”
​
Dr Abdul Lalkhen is a member of the Faculty of Pain Medicine at the Royal College of Anaesthetists in the UK and a visiting professor at Manchester Metropolitan University.
 
Ref: RNZ
 
https://www.rnz.co.nz/national/programmes/ninetonoon/audio/2018830916/an-anatomy-of-pain-how-the-mind-and-body-experiences-pain

“I think you could easily do that in ten to fifteen minutes and still get a benefit.”
Reasons for the benefit are threefold, he says.

“The cells turn over to make the blood vessels less stiff and more compliant, but there are other mechanisms too when you stretch a muscle it might promote the release of some metabolites in the walls of you blood vessels and it makes the blood vessels dilate so it makes the blood vessels less resistant to blood flow.”

There is a nervous system component too, Prof Chilibeck says.

“When you’ve done a stretching routine it seems to activate the part of your nervous system that makes you more relaxed.”

He also believes people with very high blood pressure would benefit – not just those with moderately elevated levels.

“I think the worse you are the more benefit you are going to end up seeing. I think this would be very encouraging for someone that has very high blood pressure.”
 
Ref: RNZ (Radio New Zealand)
 
https://www.rnz.co.nz/national/programmes/sunday/audio/2018782622/study-shows-stretching-more-effective-than-walking-to-lower-high-blood-pressure

​Nutritionist Claire Turnbull has tips for keeping your fruit and vegetables fresh for longer; what to keep in the fridge, how to store them, and what to do when you do find vegetables looking limp.

It's estimated the average New Zealand household throws away 86kg of edible food each year, worth $644.

Many veggies can be resuscitated, she says, by cutting a bit off the stem and putting it in water.

“It's like a plant. You know, if you get a rose and it's looking a bit flat, if you chop up the stem, put it in fresh water, it will come back to life again and vegetables are much the same.”

The fridge is your friend but check the temperature, Turnbull says, as some fridges are running too warm.

“We need to keep it below five degrees, 70 percent of Kiwis have their fridges too warm. So it’s well worth going into your fridge today and checking that, particularly if you're opening it and closing it regularly.”

Most vegetables will last better in the fridge drawer, because it’s designed to make the ideal climate for them, she says.

Never leave cut salad in its plastic bag in the fridge, Turnbull says.

“As I get that home from the supermarket, I chop it open, chop the bag open, put a piece of paper towel down each side of the bag. So that could be rocket, baby spinach, coleslaw.

“And I promise you, you'll get at least an extra two days out of it more than you would have, because otherwise it basically sweats in the bag.”

Even better transfer to a brown paper bag, she says.

“Take everything out of a plastic bag that you can, most vegetables actually work really well in a plastic box like a sustainer type box with paper towel in it.

“But not in a plastic bag that can sweat and brown paper bags or those net bags are good for basically most vegetables.”

She is a great believer in paper towels, she says. Cheese, for example, lasts better in a plastic container with a paper towel inside.

​Chilled fruit can lose flavour, so store in the fridge and take out what you need for the day she suggests.

“I bought some nectarines the other the day because they're on special and I put eight of them in the fridge and I put three of them out and then every day just kind of keep rotating them like that until the end of the week, and I buy some more.

That rotation is good because eating things straight out of the fridge isn't particularly pleasant.”

Some veggies are best kept apart, she says.

“Even though onions and potatoes both like the dark, you are definitely best to keep them apart because they cause each other to sprout.

“You'll get more life out of them if you separate them and put them in a different place.”
In fact, most root vegetables prefer the dark, she says.

“Anything that would naturally sprout is much better in the dark. So, potato, kumara, onions, garlic, all of those kinds of things are definitely best kept in the dark.

Don’t fear the freezer, she says, you’d be surprised what freezes well.

“Often if I'm buying say three containers of milk from the supermarket because that's what I need for my family to last a week, I freeze one. I'll go through the first two and get the frozen one out near the end of the week - milk freezes really well”

Those with veggie gardens are seeing a surplus now and the freezer can help here too, she says.
​
“A lot of the vegetables you can blend them down and freeze them. Even courgettes, if you chop them up into small cubes, you can actually put a few into a smoothie just to give it a bit of extra veg.”
 
Ref: RNZ
 
https://www.rnz.co.nz/national/programmes/ninetonoon/audio/2018828713/how-to-store-fruit-and-veg-and-reduce-food-waste

Improved support for disabled New Zealanders
Minister for Disability Issues Media Release 3 September 2025

Disabled people, their families and carers will gain choice and control around flexible funding when improvements to the disability support system are rolled out from early next year.
 
“The disability community has made it clear they want the freedom to make their own decisions on what supports and services they need,” Minister for Disability Issues Louise Upston says.
 
“We’ve taken that feedback on board.  We know some difficult decisions had to be made in 2024 to limit ongoing acceleration of costs. Since then, we have done more work to make sure disabled people, their families and carers have a system they can trust and is easy to use.
 
“Last year’s Independent Review found disability support services had unsustainable spending increases, lack of clear criteria for access to flexible funding, and an inequitable and unfair postcode lottery for disabled people around the country.
 
“Underlying all these were long-standing issues that had not been tackled over time.
 
“Since then, our Government has made real progress in stabilising services, with this year’s Budget funding $1 billion over four years towards meeting the increasing costs of disability support services, including $240 million for residential care.
 
“Now we can confirm the next phase, giving disabled people and their families and carers more clarity, certainty and choice.
 
“My absolute priority is to ensure the disability support system is more consistent, transparent, sustainable and fair.”
 
The changes announced today will only apply to disability support services   and funding allocated by Needs Assessment Service Coordination organisations (NASCs). The changes do not include supports and funding allocated by Enabling Good Lives (EGL) sites, as further consideration would be needed for there to be any changes to the current EGL operating model.

• To ensure the coordination of supports is consistent across the country, there will be a single assessment process and allocation used by all NASCs.
• NASCs will develop personalised support plans.
• Families and carers will be considered as part of the assessment where their needs are relevant to the care of the disabled disability support user.
• The purchasing guidelines, including March 2024 amendments to them, will no longer apply.
• Flexible funding users will have more choice and control but will need to keep their spending within their budget 
• People can seek a reassessment if their circumstances have changed, but otherwise will not receive more funding if they use up their budget early.

​“The improvements have been informed by what more than 1,800 disabled people, their families and carers told DSS they wanted in nationwide community consultation this year,” Louise Upston says.
 
“We know about 38,500 people already use flexible funding, with more than 90 per cent of them accessing it through a NASC.
 
“While it will take time to implement the new system, these changes are significant for disabled people, families and carers.
 
“They build on improvements already made to stabilise the disability support system while longer-term work is done to strengthen it to reflect the Enabling Good Lives vision and principles,” Louise Upston says.
 
The website www.disabilitysupport.govt.nz has more information on the changes and will be updated regularly.
 
 
Ref: https://www.beehive.govt.nz/release/improved-support-disabled-new-zealanders

Arthritis
 
There are over 100 types of arthritis. Each type of arthritis is different, therefore, needs different treatment.  Arthritis may cause pain, stiffness, swelling, tenderness or inflammation of the joints or affected areas.  It can also prevent some movements which are necessary for the activities of daily living.
 
It is important that people should try to learn as much as possible about this disease so that they may be able to understand how to control it.
 
Did you know that:

• arthritis affects people from all age groups
• arthritis cannot be cured but may be controlled
• arthritis is a disease which usually lasts a lifetime but, in many cases, there are periods in which few or no symptoms are apparent (periods of remission)
• arthritis means that you have change in one or more of the following parts of your joints

 
Functional parts of a joint:
 
Cartilage:
A tough material that cushions and protects the ends of bones. (Example of arthritis in this part: osteoarthritis.)
 
Synovial membrane:
A thin layer of tissue which surrounds the joint and contains and produces a lubricating fluid (synovial fluid).  This fluid oils the joint and is also responsible for keeping the cartilage healthy.  (Examples of arthritis in this part:  rheumatoid arthritis, gout.)
 
Bursa:
A small sac located near the joint which contains a lubricating fluid.  This sac allows smooth movement of muscle across muscle and tendon across bone. (Example of inflammation of this part: bursitis.)
 
Muscle:
The muscles are elastic tissues that work together to move the bones by contracting and relaxing.  (Example of involvement of this part:  fibrositis.)
 
Tendon:
Tissue fibre which attaches muscle to bone.  (Example of involvement of this part:  tendonitis.)
 
Ligament:
Tissue fibre which attaches bone to bone. (Example of arthritis in this part:  ankylosing spondylitis.)

OSTEOARTHRITIS
 
Also called:
 
Degenerative joint disease
Degenerative arthritis
Osteoarthrosis
 
What is it?
 
Osteoarthritis is a degenerative disease which most often affects the ‘weight-bearing joints’ ie ankles, knees, hips, spine.   The cartilage breaks down, tears, or rips and leaves the bone surfaces without a cushion.
 
How do I get it?
 
The cause of arthritis is not definitely known, but it can be caused by one or more of the following factors:
 

• normal wear and tear
• injuries to joints
• the natural ageing process
• heredity
• abuse of joints
• insufficient use of joints

 
How does it affect me?
 
Bony growths or ‘spurs’ may appear in the affected joint, causing intense pain and limited movement.
 
Due to the lack of cartilage, bone surfaces rub together resulting in pain and limited movement.
 
 
RHEUMATOID ARTHRITIS
 
What is it?
 
Rheumatoid arthritis is a disorder which involves many of the body’s systems and often affects the toes, ankles, knees, shoulders, elbows and fingers.  The synovial membrane which lines the joint, becomes inflamed.  About one person in 100 of the population have rheumatoid arthritis, and two to three times more women do than men.
 
How do I get it?
 
There is no known specific cause of rheumatoid arthritis, but the latest theories suggest that it develops from a viral or bacterial infection.
 
It is an auto-immune disease, which means your body is attacked by its own defence mechanism.
 
How does it affect me?
 
Rheumatoid arthritis causes many problems because it works on many of the body’s systems.
 
Some of the problems are:
 

• pain
• swelling
• weakness
• fatigue
• stiffness
• weight loss
• fever
• joint deformity

 
 
Reference: Healthy happy ageing:  a positive approach to active living
Yvonne Wagorn, Sonia Théberge, Dr William R Orban

The number of people aged 65 and older is expected to increase from 790,000 to 1.4 million in 2048, so around 24% of New Zealanders. Let’s face it; most of us will grow old in cities.
It was once assumed that seniors who could afford to would move to the suburbs, live in a gated community, or spend their days relaxing at a beachfront summerhouse. For many of us today, this is too expensive. Staying in cities might also mean staying close to family and friends, and where we grew up or raised children.
 
Most of us don’t want to move around in old age. Those who downsize are more likely to move to a smaller home within that same community. Some cannot move because of a lack of options, which plays it part in the housing crisis.

Since the turn of the century, most OECD countries have committed to reducing the number of people living in traditional institutional care in favour of ‘ageing in place’. New Zealand policies from the 2000s reflect this, where integrated health and disability support and home-based services championed senior independence and freedom.

Perhaps we’re stuck in the 2000s, though. Urban centres live the widening gap between the super-rich and poor. Retirees with financial security can access personalised care and upgraded housing, but those without it face challenges like long wait times for publicly funded support and below standard housing.

Generally, our urban spaces are not designed to meet the needs of older people, a growing issue as our population ages. Our cities often don’t enable older people to participate or be included in public life.

Ageing with dignity in cities (and beyond) takes more than just policy; it demands infrastructure. The entire community benefits when we design public places, land use, and spatial planning that are comfortable for older people and intentionally include them.

Why Inclusive Urban Spaces Matter

In 2022, the Office for Seniors released an age-friendly urban places guide outlining the city design practices that benefit older people. Director of the Office for Seniors Diane Turner says that making a community age-friendly doesn’t just help older people; it helps everyone.
​
“It means that as people age, they can continue to live the lives they want  and stay connected to the people and things that matter to them,” she said.

The guide comes as part of the United Nation’s Decade of Healthy Ageing. Launched at the end of 2020, the collaborative plan is led by the World Health Organisation (WHO) and aims to accelerate global efforts to address the needs of our ageing populations. The WHO says that population ageing and urbanisation are two of the biggest social transformations of the 21st century.
Hamilton, New Plymouth, and Auckland are some of the New Zealand cities that have joined the WHO’s global network for age-friendly cities.
​
Yet cities and communities rarely tackle these two changes at once by considering the older population in design processes, whether it’s accessible transport, public seating, or barrier-free buildings, to name just a few age-friendly features. How great is a city to live in if people cannot comfortably grow old there?

The ’15-minute city’ is one where someone can fulfil most of their daily life in a 15-minute radius of where they live. From Portland to Melbourne (with its 20-minutes neighbourhoods), these centres have strong local economies, more equitable and inclusive community spaces, lower transport emissions, better air quality, better health and wellbeing outcomes, the list goes on.
It’s a list that mirrors the changes needed to support urban seniors. They feature accessible transport, barrier-free buildings, public seating, and facilities to ensure safety and convenience. They encourage active living, social connection and culture. To create truly age-friendly cities is to address the systemic social issues of urbanisation.

The Case of Toyama City

Japan is the world’s leading ageing society. This year nearly one third of its population will be aged over 65. Since the 2000s, Toyama City has made an effort to be age-friendly, its Compact City Strategy focusing on age-friendly developed public transport, senior activities, and subsidised housing within a 500-metre radius of train stations to encourage city density.
Innovation is a key value for Toyama City. Known as the ‘City of Medicine’ since the Edo Period (1603-1868) its long been the centre for traditional medicine in Japan. Its age-friendly urban strategy sees this longstanding history for improving its citizens’ wellbeing enter a modern era.
 
Toyama is a global exemplar for senior urban spaces. City mayor Masashi Mori says the compact city plan approach is “all carrots, no sticks” where residents are encouraged to move around and get involved in their community, but aren’t punished for their inertia. Over 65s have travel passes that cut public transport costs, and many city museums and attractions offer free entry to grandparents with their grandchildren, as two examples.
​
Mori looks at many metrics, and is encouraged by statistics like the proportion of over 65s in the city, which has steadily grown and remains above the national average. The proportion of Toyama requiring primary nursing care has also stayed flat at about 18.5%, a key figure for Mori that proves critics wrong.
 
Author: Ben O’Connell
Ref: Plus Living, 29 January 2025
https://plusliving.co.nz/urban-spaces-for-all/

Exercise
 
Movement helps a chest infection by loosening sticky sputum helping you to cough it up.
 
Move or exercise:

• on your feet walking, climbing, exercising
• from a chair swinging arms and legs up & down
• doing jobs about the house
• throw balloons/balls, stretch, swing or punch arms

​Huff Huff Cough
                     
Try a deep huff and feel the tummy working, huff again then follow this by a deep cough (you will still feel the tummy working).
This deep coughing will help clear the lungs.            

Warm moist air

Try a steamy shower. 
Close windows and door to make room steamy before you get in.  
The warm vapour and the vibrations of the water jets will loosen sputum. 
A warm spa or bath has a similar effect.
 
NB  Be careful when moving on wet surfaces
​

Therapy Professionals Ltd
            Phone                         (03) 3775280,
            Email:                          [email protected]
            Website:                      http://www.therapyprofessionals.co.nz
​

​Words can be helpful and uplifting, but also hurtful and frustrating depending on the situation. Here, we look at some words and questions to try to avoid when talking to a person with dementia.

​
For a person living with dementia, being able to use language and communicate clearly can become more difficult over time. While the person living with the condition may have difficulties finding the right word, the words that other people use are important too. 
 
The type of difficulties a person will face as dementia progresses will be different for each individual, and the type and stage of the person's dementia will also be a factor. 
But good communication is key for all our relationships, and can make a difference to our quality of life. Rather than correcting or challenging someone with dementia, considering using these techniques to support your conversations:

1. Don’t try to jog the person’s memory: 'Remember when...?'

While it can be tempting to try and jog the memory of somebody living with dementia, this kind of question may highlight the fact that the person has memory problems.  It can also sometimes feel like the person is being tested.
This can be a frustrating or painful experience, and there’s also no evidence that prompting the person in this way will help them to recall or hold on to memories. It can be pleasant and comforting to talk about the past, however, it’s usually more helpful to lead the conversation and allow the person to join in. 

Try this instead:

Instead of posing a question, try leading with ‘I remember when…’. That way, the person can search their memory calmly without feeling embarrassed, then join in if they like.
 
2.  You don’t have to correct every mistaken belief: 'Nobody is stealing from you!'

When a person says something which you know is not true, your first impulse may be to correct their belief. This can be distressing for the person, as they are likely to be as convinced in their belief as you are in yours.

As dementia progresses, the person will find it hard to accept logic and so it may not be possible to convince them that their belief is incorrect. This can lead to confusion, bad feeling or arguments.

Try this instead:

Think about whether it is necessary to correct the belief at all. If it is not causing harm or anxiety, then you may not need to. If the belief is causing the person distress, comfort them and remind them they are safe. Try to keep your tone, body language and facial expressions calm and reassuring.

Gently encourage the person to shift their focus onto something they enjoy – even something as simple as a subject they like to talk about, or putting on a favourite television show. These distraction techniques can be very effective
 
3. Consider whether to remind the person of a death: 'Your brother died 10 years ago'

A person living with dementia may forget about a past bereavement or ask for somebody who has died. Reminding them of a loved one's death can be very painful, and they may react as though hearing the news for the first time all over again.

How to respond to these types of difficult questions will vary for different people in different circumstances, however, it's always important to show sensitivity and minimise any distress.

Try this instead:

For some people, encouraging them to talk about the person they are asking about can be comforting.  Distraction techniques can be useful, although try not to avoid the question if they keep asking, as this can cause the person to feel more anxious.

Find out how the person is feeling, sometimes asking about a particular family member or friend is due to the person having an unmet need, such as wanting comfort or reassurance.
 
4. Try not to let your emotions take over: 'I've just told you that'

It can be difficult answering the same question several times, especially when you are trying to keep frustration or upset from your voice.

However, reminding the person that you have just answered their question will not help them retain the information for next time, it is likely to just remind them of their condition. This can be distressing for you both. Bear in mind, that for them, it is likely to feel like the first time they have asked the question.

Try this instead:

Try to remember that the person cannot help repeating themselves. It is important for them to feel heard and understood.
​
Answer repeated questions calmly and patiently, with an even tone of voice. If you feel the need, take a break, and remove yourself from the conversation for a while.

​5. Open questions can be hard: 'What did you do this morning?'

Avoid asking too many open-ended questions about the past, as it could be stressful for a person with dementia if they can’t remember the answer. While it might seem polite to ask somebody about their day, it’s better to focus on what’s happening in the present.
 
Try this instead:

Instead of asking them about their day, speak briefly about your day and give them time to ask you questions about it.

They might then offer information about what they have done. Talk to them about the present and use items in the environment such as photos or ornaments to stimulate conversation.
 
6. Some questions may feel like a test: 'Do you recognise me?'

It can be distressing when somebody with dementia doesn’t recognise you, especially if you have a close relationship with them. Remember that it is likely to be upsetting for them to not recognise people around them too.

Asking the person if they know who you are can make them feel guilty or anxious if they don't remember or offended if they do. 

Try this instead:

The way you greet somebody with dementia might change depending on the stage of their condition – judge for yourself but keep it friendly. A warm hello could suffice, or it may help to say your name and your relationship to them each time.
 
7. Too much information can be overwhelming: 'Let’s have a cup of tea now, then after that we can go for nice walk and get lunch and something else to drink in that café you like next to the big church in town.’
​
Long, complex sentences can be difficult to grasp for somebody with dementia. It's difficult to process several ideas at once as cognitive abilities slow down, so it's better  give directions or instructions one step at a time.

​Try this instead:

Use short, simple sentences as much as possible. Avoid speaking too much in loud or busy environments, and wait until you have the person’s full attention before you start. During a conversation, give the person enough time to process what you are saying.
 
 
8. Try not to talk down to the person: 'I'll just help you use your little spoon there, love?'

‘Elderspeak’ - which can involve talking in a high-pitched voice, using words like ‘love’ or ‘deary’, and generally speaking to the person like they are a child - should be avoided.  This can be patronising and infantilising for a person with dementia. 

Try this instead:

Always remember the person behind the dementia.  It’s fine if the person needs you to speak slower than usual, but try to keep your tone of voice the same as with anyone else.  

Some people may like being called ‘love’ or ‘dear’, but unless you know the person it is usually best to use their name instead. This helps keep their dignity intact.
​
Dementia NZ also has many information sheets to help in understanding dementia challenges as well as practical tips on how to approach these challenges while keeping the dignity of your loved one in tack.
 
 
Ref:     Alzheimer’s Society UK
https://www.alzheimers.org.uk/blog/language-dementia-what-not-to-say

1.     Personal Care & Household Management\
          a) Personal equipment to enable a person to carry out personal care activities in their home,                work or place of study, such as:

            -  personal hygiene (washing and toileting)
            -  getting dressed
            -  transferring from the bed or chair
            -  getting in or out of the home       

        b)  Household Management equipment to enable a person to carry out essential                                         household tasks to return to, or remain safely in their home such as:  the preparation of
​               food and drinks, if they live alone or are by themselves for much of the day
       
2.    Walking & Standing
     
        a).  Walking equipment to support a person with walking and transferring.  

         b). Standing equipment to support a person to maintain a good functional position and body
              alignment in standing.

3.    Basic housing modification equipment to ensure safety at home such as basic reusable
       ramps.  

4.   Wheeled Mobility and Postural Management Level 1 and credential lying advice and
      recommendations related to wheeled mobility, seating and postural management solutions.  ​

5.   Communication Assistive Technology (CAT) level 1 high tech equipment such as iPads for
​      people who can use them independently.

Repairs and Maintenance:
 
The client or residential provider to contact one of the subcontractors listed below:
 
Mobytech Ltd (More Mobility Service Department)
            Physical Address:  93B Clarence Street. 
            Postal Address: PO Box 42049, Tower Junction, Christchurch 8149
            Phone:           Free phone:  0800 662 983   
                                   (03) 348 3460 Option 2 or 027 2340516
            Fax:                 (03) 348 3462
            Email:            [email protected]                                                                                               
            Website:        www.moremobility.co.nz
 
Mobility Services Ltd (Wheelchair Services (SI) Ltd)  
            Physical Address:  29 Shakespeare Road, Christchurch 8240
            Postal Address:  PO Box 7652. Sydenham, Christchurch 8240  
            Freephone:           0508 662 454
            Phone:                  (03) 366 8815 or 0275 383 584
            Email:                   [email protected]
            Website                www.mobilitysystems.co.nz
 
Rehab Enterprises, mobile workshop.
          Physical Address: 55 Ranfurly Street, Kaiapoi, Christchurch 7630
          Postal Address: 10 Barnard Street, Kaiapoi, Christchurch 7630

           Contact Owen Henwood on phone: 027 230 5974 or email: [email protected]
 
Total Equipment Care
            Ian Lappin
            Phone:  03 423 3574 or 021 180 1902
            Email:  [email protected]