WITH the Covid-19 vaccine rollout having started for priority groups, the national charity, Dementia UK, has released guidance on supporting people with dementia before, during and after vaccination.
The below advice has been created by the charity’s dementia specialist Admiral Nurses who recognise the need to support people with the condition at this time, particularly as people diagnosed can have communication challenges and reduced comprehension. Many people living with dementia will be in these vaccine priority groups, with the condition more likely to affect older people with other long-term health conditions.
Admiral Nurses work alongside families with dementia, giving compassionate one-to-one support, expert guidance and practical solutions which can be hard to find elsewhere. They are continually trained, developed and supported by Dementia UK.
The advice applies to anyone who is close to the person with dementia, who may want to think about how they can prepare and support them to have the vaccine. This can include a carer, relative or a registered Lasting Power of Attorney (LPA) for Health and Welfare.
1: Getting prepared
Give yourself some time to find out more about the Covid-19 vaccine from trusted sources, such as the NHS.
Ask the care provider what their vaccination programme plans are. This will give you time to discuss and address any potential questions you or the person with dementia may have.
Consider what you already know about the person’s past wishes, choices or experiences of vaccinations; for example, do they usually have the annual flu vaccine or have they had any side effects in the past?
- Gaining consent for the vaccine
Before the vaccine is given, consent must be obtained from the person receiving it.
If they are unable to give consent, then consent must be obtained via a ‘best interest’ decision (which is compliant with the Mental Capacity Act 2005).
A ‘best interest’ decision is when someone is unable to make a decision for themselves, so the decision may have to be made for them.
If you or a family member has registered Lasting Power of Attorney (LPA) for Health and Welfare for the person with dementia, you can make health decisions on their behalf, including whether they should receive vaccinations. When making decisions about your loved one’s care, it is important to get the views of doctors or other healthcare professionals in charge of their care. All treatment options should be clearly outlined so that you as the person with the LPA knows the benefits and risks of each option.
You must also take the person’s previous wishes or views into account.
If there is no LPA for Health and Welfare in place, then healthcare professionals must make a decision in the person’s ‘best interests.’ This is based upon their previous wishes and decisions as well as close consultation with friends, family members or anyone else who knows the person with dementia closely.
All consent has to be documented and the government has provided templates for this.
- Fully explain, be honest and respect the person’s independence
It’s important that the person with dementia retains their independence and feels in control, as much as possible.
Make sure you choose a time and place that suits them.
Keep noise and distraction to a minimum.
Use short sentences and simple language to explain what needs to be done and why it is important.
Give the person time to hear and ask you any questions.
Pause between each of your sentences.
Visual prompt cards can be used to provide further explanation as well.
A warm and friendly tone can help to relieve any nervousness that the person with dementia may have about receiving the vaccine.
4: Choose your timing carefully
Sometimes people with dementia can need more time to do and understand things than others. Be patient.
If the person is experiencing heightened anxiety or distress, rebook the vaccine at a different time and consider how you can support them next time.
- Statements that might be helpful
Some of the below statements may be helpful to support a person with dementia and help them feel more comfortable about having the vaccine:
“The injection is to protect you from the Covid-19 virus”
“The injection won’t give you the Covid-19 virus”
“Some people can get a sore arm, headache or fever after the injection”
“I would like your permission to give you the vaccine”
- When the vaccine is given
Find out if you can support the person with dementia, by accompanying them to have their injection. This will depend on the particular care setting and the policies they have in place.
Make suggestions as to how to support the person with dementia, for example asking if the vaccinator can introduce themselves, especially if they are wearing a mask or visor, and reminders that the vaccine is given by an injection in their arm.
Consider distraction techniques whilst the injection is being administered by the health care professional; this can be conversation, music, a reassuring touch or hand massage. Getting them to hold a favourite item can also bring comfort.
- After the vaccine
Reassure the person with dementia after the vaccine, whilst being mindful of your tone and body language.
You could offer a drink afterwards, or do a favourite activity of theirs, or rest if they are feeling tired.
Check to see how they are feeling as it might have been a tiring time for them as well as for any physical side effects.
For more information, about the Covid-19 vaccine see here from Dementia UK and here from the Royal College of Psychiatrists
Dementia UK’s Admiral Nurse Dementia Helpline is also available to anyone who has any queries about dementia. It can be contacted on 0800 888 6678 and firstname.lastname@example.org.