Humanitude and Dementia: A Revolutionary Care Technique

The concept of "Humanitude" has gained recognition as a compassionate and effective care technique for individuals with dementia. This approach prioritizes the well-being and dignity of both caregivers and patients, creating a sense of safety and comfort. Its respectful and humane approach is why many favour it in dementia care. But what exactly is the Humanitude care methodology? In this article, Noriaki Osako explores the core principles of Humanitude, the practical steps to implement it, and the "four pillars" that form the foundation of this thoughtful care methodology.  

What is Humanitude?

What is the purpose of Humanitude?

The four pillars of Humanitude

The Five Steps of Humanitude

Benefits of Humanitude

The Essence of Humanitude

In 1979, French physical education teachers Yves Ginest and Rosette Marescotti introduced the term "Humanitude." Derived from a French word meaning "regaining humanity," Humanitude refers to a care technique for individuals with dementia that emphasizes respect, empathy, and human connection. The methodology gained traction in Japan around 2014, where it is now widely practiced in caregiving, nursing care, and home care settings.   

The core purpose of Humanitude is to restore and maintain both physical and cognitive functions, with care tailored to each individual’s unique needs. This approach is guided by three key goals, each accompanied by specific caregiving methods.   

How to care for someone with dementia through Humanitude is to promote both physical and mental recovery. It is essential not to provide excessive support, as this can hinder the individual’s ability to regain independence. For instance, if the goal is to help a person walk, caregivers may encourage them to stand while drying their body, allowing them to perform tasks they are capable of rather than offering complete assistance.  

Humanitude stresses care that aligns with the individual’s wishes, preserving their current abilities and promoting opportunities for spontaneous recovery. Care should be collaborative, respecting the person’s autonomy, rather than one-sided. 

In addition to recovery, Humanitude focuses on preserving the individual’s dignity and independence. Even when full recovery may not be possible, a holistic approach is necessary regarding how to care for dementia patients. This involves maintaining and enhancing physical functions through appropriate rehabilitation and creating a secure environment that supports the person’s well-being. Caregivers respect the individual’s wishes and provide support to help them live as independently as possible.   

When restoring or maintaining physical or cognitive function becomes difficult, Humanitude emphasizes preserving the individual’s dignity and providing compassionate care that allows them to live peacefully. Caregivers respect the person's self-determination by encouraging them to do what they can for themselves, avoiding forced care. For example, when interacting with the individual, caregivers should call out to them, encouraging participation, and ensuring that their dignity is upheld until the very last moment, supporting them in living a life that reflects their true self.  

The four pillars of Humanitude represent core caregiving principles that help caregivers form positive, meaningful relationships with dementia patients while addressing their emotional and physical needs. These pillars embody fundamental aspects of human interaction and provide a structured approach to adapting to the changing needs of those with dementia.

The first pillar is the "skill of looking." Eye contact is a powerful tool that communicates care and connection. Looking directly at a patient conveys honesty, while maintaining a horizontal gaze signals equality, and prolonged eye contact stimulates intimacy. Caregivers often focus on the specific body part they’re assisting with, but attention to eye contact is crucial. The way a caregiver looks at a patient—whether their angle or expression—can unintentionally evoke feelings of intimidation or distrust, so it’s essential to maintain a mindful and compassionate gaze during care.

The second pillar is "the skill of speaking." Silence during caregiving can be tempting, but Humanitude emphasizes the importance of how to talk to someone with dementia to convey care. Using appropriate, calming words and speaking slowly helps reassure the patient, cultivating a sense of security and strengthening the relationship. Thoughtful conversation creates a comforting atmosphere and builds trust.  

The third pillar is "the technique of touch." Physical touch is a common part of caregiving, whether it’s assisting with dressing or walking. However, touch can be perceived negatively if done thoughtlessly, making the person feel their freedom is being restricted. How do you treat someone with dementia? Caregivers should use a broad, gentle touch, avoiding abrupt movements, and move slowly. This kind of mindful touch conveys respect and care, helping the patient feel comfortable and understood.  

The fourth pillar is "the skill of standing." Standing is fundamental to human physiology, activating various bodily functions and serving as an expression of our humanity. Yves Ginest, one of Humanitude's founders, advocates for patients to stand for about 20 minutes a day as a preventive measure against becoming bedridden. Caregivers can gradually incorporate standing into daily routines, such as having the person stand while being dried or walking to the toilet. It’s important to adjust this based on the individual’s physical and mental condition, ensuring it remains within a manageable range.  

Caregivers can follow these steps on how to care for someone with dementia applying the principles of Humanitude to provide respectful, compassionate care, grounded in the four pillars of the methodology.  

1. Prepare for a meeting

The first step is for the caregiver to announce their presence and seek permission to enter the patient’s personal space. This gradual, respectful approach helps raise the patient’s awareness while reducing anxiety and tension, laying the foundation for a positive and trusting interaction. 

Here’s a suggested approach for entering a room: 

• Knock on the door three times 
• Wait for about three seconds 
• Knock on the door again three times 
• Wait another three seconds 
• Finally, knock on the door one last time and say a few words before entering the room 

This structured routine helps ease the patient into the interaction, signaling respect for their space and building rapport.

2. Prepare for care 

Before beginning any care, be mindful of how to talk to someone with dementia. It’s crucial to greet and engage the patient in conversation. This step seeks to gain their consent for care rather than imposing it. Respecting the patient’s autonomy builds trust and ensures a collaborative approach to caregiving. 

If the patient does not agree to care within three minutes, avoid forcing the interaction. Instead, pause, step back, and try again later. Forcing care can damage the relationship, so it's essential to prioritize building trust and mutual respect between the caregiver and the patient. 

Positive communication is key to establishing a good rapport. For patients with hearing or visual impairments, caregivers should adjust their approach, such as using clearer verbal cues or positioning themselves where they are most easily recognized. Flexibility and patience are crucial in adapting to each patient's unique needs.  

3. Perceptual connectivity

Perceptual connectivity involves combining two or more of the four pillars of Humanitude to deliver thoughtful, continuous care. By consistently communicating with the patient through multiple senses, caregivers help them better understand and engage with the care being provided. 

For example, while gently drying the patient’s washed hair, the caregiver can maintain eye contact and offer reassuring words like, “You must feel refreshed now.” This integration of touch, sight, and speech strengthens the connection between the caregiver and patient, making the care experience more personal and comforting. 

4. Emotional anchoring 

At the end of the day, a key step on how to care for someone with dementia is to engage in patient conversation, reflecting on the day's events. This allows them to express their feelings and reinforces positive emotions and memories associated with their care. Use encouraging, uplifting language to convey that you enjoyed your time together, helping the patient feel valued and understood. 

How caregivers handle this closing interaction significantly impacts the patient’s willingness to accept care in the future, as it sets the emotional tone for their ongoing relationship. 

5. Promise to meet again

The final step is to leave the patient with a reassuring message about your next visit. By hinting at future care in a positive and friendly way, you create a sense of anticipation and comfort for the patient. This approach helps them look forward to your return and makes them more likely to accept care with ease. Ensuring that the patient feels respected and free from discomfort during each interaction is key to building trust and a relaxed, cooperative relationship.  

Humanitude avoids excessive nursing care, which helps prevent the decline of physical functions in patients. By respecting what patients are still capable of doing, it enhances their sense of self-efficacy, empowering them to maintain independence. Moreover, Humanitude honors the wishes of patients, reducing anxiety and confusion while providing psychological stability. 

Dementia often weakens patients' relationships with others, leading to increased feelings of loneliness and isolation. However, the Humanitude care methodology builds a bond of trust between patients and caregivers. This approach allows patients to feel fully cared for, understood, and accepted, significantly reducing feelings of loneliness and anxiety.

Humanitude promotes a comprehensive understanding of each patient, enabling caregivers to deliver personalized, high-quality care. By emphasizing mutual respect, this method not only improves caregiving outcomes but also brings caregivers a greater sense of joy and pride in their work. 

When Humanitude nurtures respectful, trusting relationships, patients are less likely to resist care, making caregiving smoother and less stressful. As caregiving is both physically and emotionally demanding, Humanitude helps ease interpersonal tensions, safeguarding the mental well-being of caregivers.

As people age, their sensory abilities—sight, hearing, touch, taste, and smell—naturally decline. For individuals with dementia, this decline is often aggravated by hospitalization or relocation, which can heighten feelings of fear and anxiety. These emotions may manifest as anger or despair, impacting both the patients and their caregivers. 

Humanitude was developed to address this emotional gap. How to care for someone with dementia through this technique is by focusing on communication through sensory perception, including sight, hearing, and touch. The four pillars of Humanitude provide caregivers with practical methods to apply these principles, emphasizing respect, empathy, and connection. The Humanitude care methodology not only supports patients in maintaining as much independence as possible but also helps reduce stress and burdens for caregivers, fostering a more positive caregiving experience.