Namaste Care

Namaste Care is a person-centred small group program designed for people living with advanced dementia. Its aim is to combine meaningful, one-to-one sensory activities in a calm environment with ‘loving touch’ [1] to produce a sense of pleasure and wellbeing. [2] The program is led by a trained in-house facilitator but encourages family members and staff involvement. Ideally, the program runs twice daily in two-hour sessions, seven days per week. [2] Namaste Care is designed to take place in a tranquil room with pleasant aromas, soft lighting, calming music or nature sounds. [3] The person living with dementia might be offered a continuous food and drink service, hand and face cleansing and massage, nail painting, and different items to touch such as feather boas, soft toys, and fabrics. [4]

This evidence theme on Namaste Care is a summary of the issues identified in a scoping review of dementia research. If you need more information on this topic, try using the PubMed search below.

There is plenty of support for Namaste Care with aged care providers. [2] At the same time, there is still little research evidence demonstrating the benefits of the overall program for the person with dementia. [5] However, one review assessed the evidence of the effectiveness of the individual components of the program. [2] It found generally positive evidence of benefits for the following elements of Namaste Care: 

• Lavender for reducing agitation and other responsive behaviours and improving sleep quality
• Diffused or massaged lemongrass and eucalyptus oil for reducing agitation
• Multisensory stimulation for reducing verbal agitation
• Group music interventions, including singing, for reducing anxiety and enhancing social participation
• Exposure to nature, including videos, live and robotic animals, and cuttings from the garden for improving mood
• Offering dolls to people living with dementia for improving communication and social interaction, and reducing anxiety, responsive behaviours, and social isolation 
• Exposure to pets, especially dogs, for evoking positive responses from people living with dementia in care homes. This includes improvement in mood, communication, and sense of self-worth, along with a reduction in depression, aggression, and agitation. (It is worth noting that people living with dementia responded to a robot dog with almost the same level of engagement as with a live dog.) [2]

Some elements of Namaste Care are supported by less conclusive evidence as different studies reported contradictory findings. These elements include: 

• Bright light therapy for improving sleep and reducing depression 
• Playing background music during mealtimes for reducing responsive behaviours
• Massage, although generally well tolerated by participants, had no consistent effect on responsive behaviours
• Food and drink offerings for increasing hydration and nutrition.

The conclusions from the review might help carers decide which elements of Namaste Care to try, however, it does not guide them in knowing the best combinations to use, or their ideal duration. Interactions might occur between multiple components (e.g., massage and aromatherapy) that strengthen or lessen the overall impact of the program. [2]   

According to the review, the research on Namaste Care components had some weaknesses. For example:

• There were few studies assessing each component.
• Findings across studies were often contradictory.

• Learn more about Namaste Care by borrowing an e-book about the program from the Dementia Australia library (free registration required) or watching an introductory video here.
• Explain the approach to families to gain their support and involvement.
• Work with the family to learn more about the person’s life story, likes and dislikes. This will help with tailoring activities to the individual.
• Observe the times of day when individuals have difficulty settling or become agitated. This is often before bed or during personal care in the morning. Try providing some of the simpler elements of Namaste Care during one of these times and observe what happens.  
• Offer choice to allow for personal preferences.
• Be aware of allergies, discomfort, or safety issues (e.g. people’s feelings about dogs).

• Namaste Care requires staff training and communication with family and visitors who may agree to be part of the program. 
• The program in its truest form requires up to four hours of paid staff or volunteer participation time per day. This will need careful consideration at the outset if staff commitment is to have the ongoing support of management and the organisation. 
• Staff involvement in Namaste Care brings its own benefits. They have more opportunities to get to know the people in their care, including what they enjoy and what might cause or help with managing responsive behaviours.   
• Staff might be encouraged to promote the outdoors and nature for the wellbeing of people living with dementia, in balance with safety risks. Contact with nature could be virtual if access to the outdoors is not possible. [2]

1. Simard J. Help me, help me. Ann Palliat Med. 2017;6(4):405-7.
2. Bray J, Brooker DJ, Garabedian C. What is the evidence for the activities of Namaste Care? A rapid assessment review. Dementia. 2021;20(1):247-72.
3. McNiel P, Westphal J. Namaste Care™: A person-centered care approach for Alzheimer's and advanced dementia. West J Nurs Res. 2018;40(1):37-51.
4. Nicholls D, Chang E, Johnson A, Edenborough M. Touch, the essence of caring for people with end-stage dementia: A mental health perspective in Namaste Care. Aging Ment Health. 2013;17(5):571-8.
5. Bunn F, Lynch J, Goodman C, Sharpe R, Walshe C, Preston N, et al. Improving living and dying for people with advanced dementia living in care homes: A realist review of Namaste Care and other multisensory interventions. BMC Geriatr. 2018;18(1):303.