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What Are the Three Golden Rules of Dementia?
Date Updated: January 3, 2025
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The Three Golden Rules of Dementia are the basis of the SPECAL method, developed by the UK charity Contented Dementia Trust. Designed to guide the communications of caregivers for people with dementia, the principles seek to relieve stress and enhance life satisfaction for those impacted by cognitive decline.
Rule One: No Direct Questions
According to the Contented Dementia Trust, the first golden rule advises against asking direct questions that require factual information. The trust reasons that individuals with dementia may no longer have certain facts available to them, so asking questions they can’t answer draws attention to this deficit. Moreover, increased awareness of their diminishing capabilities may lead to unnecessary discomfort, confusion and distress.
Rule Two: Listen and Learn
The charity’s second guiding principle tells caregivers to listen to people with dementia and, rather than relying on their own point of view, answer questions based on the individual’s perspective. The rationale is that feelings matter more than facts for people with cognitive decline, so shifting the way they receive information can increase positive feelings and reduce negative ones. Adapting communication styles requires careful consideration concerning information and language. The trust suggests that following this rule reduces anxiety for those with dementia.
Rule Three: No Contradiction
The last of the “Three Golden Rules” for dementia states that caregivers should avoid disagreeing or arguing with someone impacted by cognitive conditions, such as Alzheimer’s disease or vascular dementia. The Contented Dementia Trust explains that people with dementia likely draw on memories formed before their diagnosis to interpret and make sense of current events. According to the charity, avoiding conflict increases contentment for all parties.
Although many experts discount the SPECAL approach and the Three Golden Rules, researchers from King's College London have found some merits in the method.