Caring for someone with Alzheimer’s disease or another dementia can be rewarding, frustrating, exhausting, and deeply personal. There is no single approach that works for every person or every day.
Dementia changes how a person remembers, communicates, solves problems, understands their surroundings, and completes familiar tasks. As the disease progresses, caregivers often need to adjust their expectations and approach.
The goal is not to correct every mistake or complete every task perfectly. The goal is to help the person feel safe, respected, connected, and as independent as possible.
Understanding Dementia
Remember that the disease is causing the change
A person living with dementia may repeat questions, resist help, become suspicious, struggle to find words, or act in ways that seem out of character. These actions are usually not intentional.
The person may be responding to:
- Changes in the brain
- Pain or illness
- Hunger, thirst, constipation, or fatigue
- Difficulty seeing or hearing
- Medication side effects
- Fear, confusion, or frustration
- Too much noise or activity
- An unfamiliar person, place, or routine
- A task that has become too complicated
Instead of asking, “Why are they doing this?” it may help to ask, “What are they trying to communicate or what might they need?”
Pay attention to sudden changes
Contact a health care provider when behavior, confusion, alertness, or physical ability changes suddenly. A rapid change may be caused by an infection, pain, dehydration, a medication problem, or another medical condition that needs attention.
Begin with what the person can still do
Remember that abilities can change from day to day
A person may complete a task independently one day and need help the next.
Try to:
- Allow the person to do as much as they safely can
- Break complicated activities into smaller steps
- Demonstrate what to do rather than only giving instructions
- Offer help before frustration becomes overwhelming
- Focus on effort and participation, not perfection
- Adjust your approach as the person’s abilities change
Doing everything for someone may be faster, but involving the person can help preserve independence, confidence, and dignity.
Keep communication simple and respectful
Dementia can make it difficult to find words, follow a conversation, process questions, or explain a need. Facial expressions, tone of voice, and body language may become especially important.
Helpful communication approaches include:
- Approach from the front and gently get the person’s attention
- Introduce yourself if the person seems unsure
- Speak slowly in a calm, reassuring voice
- Use short, clear sentences
- Discuss one idea or task at a time
- Allow extra time for the person to respond
- Ask one question at a time
- Offer two simple choices instead of an open-ended question
- Reduce background noise and other distractions
- Listen for the feeling behind the words
- Avoid quizzing, correcting, or saying, “Don’t you remember?”
- Avoid arguing or trying to prove that the person is wrong
Continue including the person in conversations. Speak directly to them, not only to the caregiver or other family members.
Discover additional strategies for connecting with your loved one through Compassionate Communication
Respond to the emotion, not only the facts
A person with dementia may believe something that is not accurate. They may ask for someone who has died, insist they need to go to work, or say they want to go home while sitting in their own house.
Repeatedly correcting the person may cause them to experience grief, fear, or frustration again.
Before responding, consider what the person may be feeling. Are they lonely, worried, bored, tired, or looking for a sense of safety?
You might respond with reassurance:
- “You miss your mother. Tell me about her.”
- “You are safe. I am here with you.”
- “Let’s sit together for a few minutes.”
- “Tell me what you like about home.”
Acknowledging the emotion and gently redirecting attention can be more comforting than insisting on the facts.
Make everyday tasks easier
Familiar routines can reduce the number of decisions a person must make and help the day feel more predictable.
Try to:
- Keep meals, bathing, dressing, and bedtime at generally consistent times
- Plan demanding activities for the time of day when the person is usually at their best
- Give one direction at a time
- Lay out supplies or clothing in the order they will be used
- Offer limited, manageable choices
- Allow plenty of time
- Reduce clutter and distractions
- Stop and try again later if the person becomes distressed
What worked yesterday may not work today. Flexibility is part of dementia care.
Learn more with Tips for Activities of Daily Living
Look for patterns when challenges occur
Keeping brief notes can help caregivers recognize what may be contributing to a difficult situation.
Write down:
- What happened
- What occurred immediately before it
- The time of day
- Who was present
- What the environment was like
- Whether the person may have been hungry, tired, in pain, or overstimulated
- How you responded
- What helped or made the situation worse
Patterns may reveal that a particular task is too difficult, an environment is too noisy, or a basic need is not being met. This information can also help a health care provider understand what is happening.
Create a safer, calmer environment
Small changes to the environment can support independence and reduce stress.
Consider:
- Removing tripping hazards and improving lighting
- Keeping commonly used items in consistent locations
- Labeling rooms, drawers, or cabinets when helpful
- Securing medications, firearms, cleaning products, and other dangerous items
- Using automatic shutoff devices when appropriate
- Keeping emergency numbers and a recent photograph available
- Planning ahead for wandering or becoming lost
Learn more about dementia and wandering
Work with health care providers
Caregivers often notice changes that may not be visible during a brief medical appointment.
Before an appointment:
- Write down specific changes and when they began
- Bring a complete list of medications and supplements
- Note changes in sleep, appetite, mobility, continence, mood, or behavior
- Ask whether pain, infection, medication side effects, or another condition could be contributing
- Prepare a short list of the most important questions
Whenever possible, include the person living with dementia in discussions and decisions. Ask about completing the appropriate permission forms so health care providers can communicate with the caregiver while continuing to respect the person’s privacy and choices.
Take care of the caregiver
Caregiving is demanding, and no one can do it alone. Needing help does not mean that you have failed.
Consider:
- Accepting specific offers of help from friends and family
- Keeping a list of tasks other people can do
- Joining a caregiver support group
- Scheduling regular breaks
- Using adult day care or respite services
- Staying connected with your own medical care, relationships, and interests
- Talking with a health professional if stress, anxiety, depression, or exhaustion becomes difficult to manage
Support is most helpful when it begins before a crisis.
You do not have to navigate Alzheimer’s alone
Alzheimer’s of Central Alabama helps people living with dementia and the families caring for them. We provide practical guidance, caregiver education, support groups, adult day care scholarships, dementia care scholarships, Project Lifesaver bracelets, and connections to community resources.
Call ACA: (866) 806-7255 or (205) 871-7970
Email: aca@alzca.org
Sources
This guidance is based on caregiver information from the National Institute on Aging and Alzheimers.gov. This page provides general educational information and is not a substitute for professional medical advice.
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