From time to time, the question arises about whether people living with dementia should wear something that identifies their condition in public.
Suggestions often include a lanyard, badge, or pin that signals to others that the person has dementia and may need a little patience or understanding.
At first glance, the idea appears practical. If people knew the reason behind certain behaviours, perhaps situations would be interpreted differently and misunderstandings could be avoided.
However, the question becomes more complex the more closely it is examined.
Should people living with dementia have to identify themselves in public?
And perhaps more importantly, who does that expectation serve?
Why visible identifiers are suggested
When lanyards or badges are suggested, the intention is usually positive.
Public spaces such as cafés, leisure centres, shops, libraries, and public transport are busy environments where people often need to make quick decisions about how to respond to situations. When behaviour feels unusual or difficult to interpret, uncertainty can quickly turn into discomfort.
A visible identifier can act as a signal that behaviour may have a different explanation. It helps people reframe what they are seeing.
Instead of thinking:
“Why is this person behaving like this?”
people may instead think:
“This person may need a little patience.”
In that sense, a visible prompt can reduce misunderstanding and help others adjust their expectations. For staff working in busy environments, it can also provide reassurance that they are responding appropriately.
From that perspective, the idea appears practical and well-intentioned.
Why the issue is more complicated
Visible identifiers raise an important ethical question because they require someone to publicly disclose a medical condition.
Dementia continues to carry significant stigma and many assumptions about behaviour, personality, and capability. When people hear the word “dementia”, it can sometimes trigger expectations about what someone might do or how they might behave.
For some people living with dementia, wearing a badge or lanyard may feel helpful and empowering. It can prevent misunderstandings and make everyday interactions easier to navigate.
For others, it may feel uncomfortable or unnecessary. Feelings about visible identifiers vary widely within both dementia and wider disability communities. Some people prefer to make their condition visible in order to advocate for understanding, while others prefer to keep this information private.
Once information is displayed in a public space, control over who sees that information is lost.
This is one reason many practitioners approach visible identifiers cautiously unless they are clearly something the person themselves has chosen.
The safeguarding consideration
There is also an important safeguarding dimension to consider.
Visible identifiers can unintentionally signal that a person may be cognitively impaired or more easily confused. While many members of the public respond with patience and understanding, it is important to recognise that not everyone in a public space has good intentions.
Publicly identifying someone as living with dementia could potentially increase the risk of exploitation, financial abuse, coercion, or other forms of targeting by individuals seeking to take advantage of perceived vulnerability.
This does not mean visible identifiers should never be used. However, it highlights why the potential benefits and risks both deserve careful consideration.
The tension underneath the discussion
When this topic is explored more closely, it often becomes clear that two different concerns are being discussed at the same time.
One concern is about supporting the person living with dementia.
The other is about helping other people feel comfortable and confident when responding to behaviour that feels unfamiliar.
Both of these goals are valid.
However, they do not always lead to the same solution.
When visible identifiers are suggested, responsibility can unintentionally shift towards the individual rather than the environment around them.
In other words, the expectation can become that the person living with dementia should explain themselves, rather than communities becoming more confident in responding to difference.
Choice, capacity, and shared decision-making
When someone is able to decide for themselves, the choice about whether to use a visible identifier should sit with the individual.
However, dementia is a progressive condition and there may be stages where a person no longer has the capacity to make or revisit this decision independently. In those situations, decisions may involve family members, carers, or those with legal authority to act on the person’s behalf.
Where this happens, the guiding principle should remain the person’s wishes, values, and best interests.
Alternatives that maintain choice
Some people living with dementia choose to carry small information cards that explain they have dementia and may need a little patience. These can be shown when needed and kept private at other times.
This approach allows the individual to maintain greater control over when and how they share that information.
Others prefer medical alert bracelets, badges, or lanyards because they personally find them helpful in preventing misunderstanding.
Across dementia advocacy organisations, people living with dementia express a wide range of views about these approaches. Some welcome visible signals that encourage patience, while others prefer solutions that allow them to decide when to disclose information about their diagnosis.
In many situations, misunderstandings can also be reduced through greater awareness within community spaces. Behaviour that initially appears challenging often has understandable roots in confusion, distress, changes in routine, or difficulty processing information.
Recognising this can significantly change how situations are interpreted and handled.
Where should responsibility sit?
Visible identifiers are not inherently right or wrong. For some people they provide reassurance and clarity. For others they feel unnecessary or uncomfortable.
What matters most is that decisions are guided by the individual’s wishes wherever possible, alongside thoughtful consideration of both benefits and risks.
At the same time, more people living with dementia are continuing to participate actively in everyday community life.
This raises an important question.
Should the responsibility for preventing misunderstanding sit with the person living with dementia, or with communities becoming more confident in how they respond?
The most constructive answer may lie somewhere between the two.
Ultimately, approaches that preserve dignity, personal choice, and safety are more likely to create genuinely dementia-inclusive communities than approaches that rely on people publicly declaring their diagnosis.
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If this resonated with you, I’d love to hear your thoughts — or share it with someone who might find it useful. You might also find this useful: Why Language Matters in Dementia