Loneliness, withdrawl and unment need
During Dementia Action Week, we need to talk more openly about loneliness, withdrawal, and the quieter presentations of unmet need that are so often overlooked within dementia care and support.
When people think about “distress “in dementia, they frequently imagine visible presentations such as shouting, agitation, or physical expressions of frustration. Yet some of the most significant unmet needs present in much quieter ways.
At the Dementia Services Development Centre, we know people who gradually withdraw from conversations, communal spaces, relationships, and meaningful activity and trying to communicate something to us. They may spend more time alone, become less engaged socially, lose confidence within busy environments, or appear increasingly passive and disconnected.
Too often, these changes are accepted as an inevitable progression of a dementia or ageing.
But we must challenge ourselves to think more deeply than that.
Sometimes withdrawal reflects environments that have become overwhelming or difficult to interpret. Sometimes it reflects repeated experiences of communication breakdown, sensory overload, loss of confidence, or feeling excluded from conversations and decisions. Sometimes people disengage because the world around them has become increasingly difficult to navigate while others continue expecting them to function in the same way they always have.
This is why understanding emotional wellbeing in dementia matters so much.
People living with a dementia do not only need physical care or clinical intervention. They need environments and cultures that support connection, familiarity, reassurance, belonging, and emotional safety. They need opportunities to continue expressing identity, maintaining relationships, and participating meaningfully in daily life.
At the Dementia Services Development Centre, we continue to advocate for approaches that recognise the powerful relationship between environment, communication, emotional wellbeing, and lived experience. A quieter environment, improved acoustics, supportive communication, familiar routines, opportunities for meaningful occupation, and spaces that reduce pressure can make a significant difference to how someone feels within a service or community.
Importantly, this is not about “doing activities” to people. It is about understanding what helps someone feel confident, secure, valued, and connected.
Dementia Action Week should encourage all of us — professionals, families, organisations, and communities — to recognise that not all distress is loud. Some people stop asking for help altogether. Some simply withdraw.
And when that happens, we must be careful not to mistake disengagement for contentment.
Because every person living with a dementia deserves not only safety and support, but also connection, belonging, and opportunities to continue being themselves.
