What is SPECAL dementia care?

How can SPECAL dementia care benefit my loved one?

If your loved one has dementia you probably want to know about all the different methods and approaches to caring for them. One of these is called SPECAL care

In a nutshell

Specialised Early Care for Alzheimer’s, known as SPECAL, is a unique – and sometimes controversial – method of caring for a person with dementia. The main aim of SPECAL care is to keep someone with dementia feeling calm and contented, even if it means that the carer becomes reliant on therapeutic lying  and reminiscence therapy as ways to ensure this happens.

Some carers swear by the SPECAL approach, saying it’s made their loved ones feel happier and more confident, lessened distressing behaviour such as anger and aggression and has even reduced their need for medication.

However others say the SPECAL approach is demeaning to those with dementia, difficult to implement and far too simplistic.

Here’s what you need to know so you can make up your own mind.

Three golden rules

The SPECAL approach advises carers to stick to these rules:

1. Don’t ask direct questions
This includes anything from, ‘what would you like to wear today?’ to ‘what shall I cook for lunch?’
Direct questions are simply too stressful for someone with dementia who may not have enough factual reserves or cognitive ability to answer them. Realising they don’t ‘know’ the answer can then make them feel upset and anxious.

Instead try giving a simple choice, such as, ‘would you like to wear your red skirt or the blue trousers’ (hold them up so they can see them too). Or ‘Do you fancy chicken or fish for lunch?’ These are far easier questions to answer but should still ensure your loved one has choice and feels respected.

2. Listen and learn from the person with dementia
Feelings are more important than facts in SPECAL care which places far more emphasis on making the person with dementia feel good even if this means telling therapeutic lies or half-truths in response to awkward questions, particularly questions concerning loved ones who’ve passed away. Saying, ‘your mum can’t visit today,’ is far kinder than, ‘your mum died 20 years ago.’

3. Don’t contradict
If your loved one insists it’s 1964 try to stop yourself from correcting them. The past may feel far more real to them than the present, after all, memories from 1964 are probably easier to recall than those from yesterday. If they wants to ‘live’ in 1964 right now, and it makes them feel happy, why should you try to stop them?

Did you know? The SPECAL method was developed by Penny Garner whilst caring for her mum Dorothy who had Alzheimer’s. When Penny’s son-in-law, the psychologist Oliver James, heard about it, he wrote the best-selling book Contented Dementia in 2009 which explained the approach in detail.

FOR: Those in favour of SPECAL care say:

• It places the wellbeing of the person with dementia at the heart of the care – so it is entirely person centred.
• It works positively with dementia, rather than trying to ignore or defeat it.
• It can bring a massive improvement in the quality of life of those living with dementia and their families.

AGAINST: Those who have doubts about SPECAL care say:

• It takes away choice and control from people with dementia.
• It encourages ‘systematic’ deception.
• It claims to work for ‘everyone’ with dementia, but every person – and every dementia journey – is unique.

In conclusion

Many carers who come across SPECAL find some of its recommendations very helpful, others realise they were already ‘doing some of it’ anyway and feel reassured. Generally speaking, most people gain something positive from knowing about the SPECAL approach.