When I talk with families caring for someone with dementia, I can almost always count on hearing a list of losses. “She can’t drive anymore.” “He can’t remember his appointments.” “She can’t prepare meals.” “He can’t use his phone the way he used to.”
And I understand why those things come first. Every ability someone loses usually means the caregiver has one more thing to manage. But if all we look at is the can’t-do list, we miss a really important part of dementia care.
We have to ask: What can this person still do, and how can we help him or her keep doing it?
That may mean changing the environment. It may mean simplifying a task. Sometimes it simply means changing the way we ask.
The Goal Isn’t Independence at All Costs
Sometimes caregivers think helping means doing everything for the person. Other times, they feel like allowing help means the person has “lost” another ability. Neither extreme is very helpful.
What I want families to look for is the middle ground. How can we provide enough support that the person can still participate?
For example, someone may no longer be able to cut a piece of meat with a fork and knife. That doesn’t necessarily mean the individual can no longer feed him or herself. Could the food simply be cut before it arrives at the table?
That small change protects independence without drawing attention to what has become difficult. We can do this in so many areas of dementia care if we stop thinking only in terms of “can” and “can’t.”
Ask whether the Environment Is Helping or Hurting
I use four words when I teach families to evaluate an environment: friendly, familiar, functional, and forgiving. A friendly environment makes the person feel safe. A familiar environment includes things he or she recognizes. A functional environment is arranged in a way that makes everyday tasks easier. And a forgiving environment allows mistakes without making the person feel ashamed.
These four things can completely change how successful someone is.
I once worked with a family whose father had moved into memory care. He had slept with the same quilt for years, but it was too large for the new bed. It would have been easy to say “The quilt doesn’t fit, so we’ll buy another one.”
Instead, the family had the quilt resized. Why? Because it was familiar. He didn’t have to remember when he bought it or explain why it mattered. It simply felt like his.
Familiarity creates comfort.
Little Environmental Changes Can Prevent Big Frustrations
Sometimes caregivers are searching for a complicated solution when a simple one works better. If someone is always asking the time, make sure the person has a clock he or she can actually see from where he or she sits. If the person keeps confusing the phone and the television remote, reduce the number of objects around him or her.
If the individual can no longer find the bathroom easily, use a simple sign or arrow. People with dementia often have difficulty processing too much information, so a long explanation isn’t always better than one clear visual cue.
The same principle applies when we leave the house. I spoke with one daughter who hated taking her mother to medical appointments. Her mom could still walk, but she became distracted by everything around her. She might wander toward the front desk, stop to look at magazines, or become overwhelmed moving through the building.
By the time they reached the exam room, both of them were frustrated. We talked about using a transport chair.
The daughter initially resisted because her mom didn’t “need a wheelchair.” But that wasn’t really the point. The chair wasn’t replacing her ability to walk. It was helping her manage a difficult environment.
Once you start thinking this way, you stop asking, “Can she still do this?” and start asking, “What would make this easier?” That’s a much more useful question.
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Let Mistakes Happen
This is where a forgiving environment comes in. Someone with dementia may still love an activity even after he or she can no longer do every part of it perfectly.
I saw this often with bingo. A resident who had played for years might begin having trouble tracking the letters and numbers. The easy answer would be to say bingo had become too difficult.
But something beautiful would often happen instead. Another resident would move her chair closer, and when she covered her own number, she would quietly help her friend cover hers.
Nobody announced that the person needed help. Nobody made her feel like she shouldn’t be there. She still got to play bingo.
The same thing applies to someone who has played cards with friends for decades. Maybe she misses a turn now. Maybe she makes a mistake. If the people around her understand what’s happening and simply help, she may still be able to enjoy that tradition for a long time.
Try to Adapt Before You Eliminate
One of the most helpful rules in dementia care is: substitute instead of subtract.
When something stops working the way it used to, our first instinct is often to remove it completely. But removing something can also remove comfort, routine, and independence.
Phones are a good example. Someone may begin calling people repeatedly, dialing at inappropriate times or getting confused by all of the different functions on a smartphone. That can become a real problem.
But taking the phone away may also remove something the person has always associated with safety and connection. Before removing it entirely, can it be simplified? Could you reduce the contact list? Could you use a phone with large buttons or pictures? Could you limit who can be called?
The answer may eventually be that the phone has to go. Dementia is progressive, and what works today may not work six months from now. But adaptation deserves a chance first.
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One Couple Found a Way to Keep Going Out to Eat
A man in one of my groups once shared a great example of this. He had always taken his wife out to eat, but as her dementia progressed, restaurants became harder.
She would look at the menu, order something, and then forget what she had ordered. When the food arrived, she might become angry and insist the waiter had brought the wrong meal.
Her husband was embarrassed. His wife was upset. The server didn’t know what was happening. Going out started to feel like more trouble than it was worth.
Instead of giving it up, he made a small card. Before they sat down, he handed it to the hostess and asked that it be given to their server.
The message was simple: “Let my wife order whatever she wants. Please bring her a hamburger, fries, and a Coke.”
She could order anything that sounded good. Then the familiar meal arrived, and she was happy.
That little card allowed them to keep doing something they both needed. Going out encouraged them to get dressed, leave the house, walk, interact with other people, and break up the day. For a full-time caregiver, that mattered too.
Sometimes we think we’re adapting only for the person with dementia, but a good adaptation can improve life for the caregiver as well.
Pay Attention to the Energy You Bring In
Caregivers are human. You get tired. You get frustrated. You repeat yourself. You have moments when you think, We just went over this.
But with dementia, our tone and approach can have a huge effect on what happens next.
I saw this constantly in memory care. A caregiver might walk into someone’s room first thing in the morning, pull the covers back, and say it was time to get up. The resident would become angry or resist.
Then we would slow everything down. Turn on the light. Say hello. Introduce yourself. Touch the person’s arm gently. Give him or her time to wake up.
The entire outcome could change.
Sometimes we focus on the person’s “behavior” without asking what happened immediately before it. What did we say? How did we approach the individual? Was the room loud? Were we rushing? Could we have done something differently?
Those questions matter.
When Something Disappears, Think like a Detective
People with dementia misplace things. Sometimes they forget where they put an item. Other times they may intentionally hide something because they feel safer knowing it’s protected.
Either way, caregivers can spend a lot of time searching.
I once helped look for a missing set of dentures. We searched everywhere. Eventually someone suggested checking inside the toilet tank.
That sounded ridiculous until we opened it. The dentures were sitting at the bottom.
That story always makes people laugh, but it also teaches a useful lesson. Things may show up in places that make no sense to us.
If your loved one frequently loses a particular inexpensive item, buy a second one if you can. Reduce clutter, use clear storage containers, and pay attention to the places where he or she regularly tucks things away. Once you know your loved one’s habits, searching gets a little easier.
Stop Testing Your Loved One’s Memory
One of the easiest communication changes caregivers can make is to stop beginning sentences with “Do you remember?”
“Do you remember who visited?” “Do you remember what we talked about?” “Do you remember where we’re going?” For someone with short-term memory loss, those questions can immediately put him or her on the spot.
Instead, just provide the information. “Rick came to visit today.” “We’re going to the doctor this afternoon.” “You had a great lunch with your daughter.”
You haven’t changed the facts. You have simply taken away the test.
I also encourage caregivers to avoid phrases like “You’re wrong,” “You used to be able to do this,” and “Why can’t you do this?” Those words highlight the loss when our job is to support what remains.
Success Looks Different with Dementia
There’s no single trick that makes dementia care easy, and there will be times when something truly cannot continue. But before you remove an activity, object or routine, look for ways to adjust it.
Can the task be simplified? Can the environment change? Can another person quietly help? Can you give the person a purpose instead of an instruction? Can you preserve part of the experience even if the whole thing no longer works the way it used to?
That’s where so much good dementia care happens: in the small adaptations.
It’s in the moments when someone helps with the bingo card instead of taking it away. It’s in the hamburger and fries that allow a couple to keep going out to dinner. It’s in the old quilt that still feels like home.
And it’s in the caregiver who stops focusing only on what has been lost and starts asking what can still be preserved.
Caring for a loved one with dementia can be challenging, but compassionate help is available. Certain age-related conditions can make it more challenging for older adults to age in place safely and comfortably, but experts in 24-hour care for Northern Kentucky seniors are available around the clock to help aging adults manage their health. Whether your loved one is living with dementia or recovering from a stroke, you can trust the professional caregivers from Assisting Hands Home Care to enhance his or her quality of life. Call us today to talk to one of our compassionate Care Managers about our high-quality home care services.
For those interested in learning more about dementia, I host a monthly Real Talk webinar that explores one important dementia-related topic in greater detail. Learn more about upcoming sessions and register here.
