The challenge of dealing with the needs of people with dementia is greater when the caregiver does not know what those needs are (Elderly neighbour with dementia is a victim and needs help, Nov 19).

Even people with dementia may fail to understand what they need; they just know they are uncomfortable and are unable to communicate it to others.

We are social people; we thrive in the context of relationships. So do many of those with dementia, who are often desperate for human companionship and an escape from loneliness.

It is easy to forget that they are unique people with needs, abilities and potential. All too often, the needs and feelings of people with dementia are discounted even within families as well as by those in the community.

Recognising people's dignity requires us to try to understand what they intend and, as much as possible, ensure that they understand us.

When those with dementia have trouble choosing the right word, they might appreciate a suggestion; at other times, they might find that insulting. A great deal of sensitivity is required in our efforts to respect their dignity.

At such times, we can articulate what we think they mean and ask them if we are right. If we try to correctly interpret their efforts to communicate, we are respecting their dignity.

Respecting autonomy is not always easy. At times we have to protect people with dementia from making mistakes that would undermine their dignity and discredit their reputation.

It has often been said that there are four Ds in our later years: depression, disease, dementia and death.

Any one of these can be difficult, but for many, dementia is the greatest challenge.

Sherman Goh Keng Hwee