Do’s and Don’ts when Dealing with Dementia

A man thinking about dealing with dementia.

Contributed by Christine Binney

Dementia is a general term used to describe a decline in mental ability that is severe enough to impair a person’s ability to perform everyday activities. The most common type of dementia is Alzheimer’s disease, which accounts for 60 to 80 percent of all cases. Common symptoms of dementia are problems with short-term memory and the ability to concentrate, with symptoms usually progressing rapidly over time.

Understanding how to care for someone with dementia can be difficult for anyone. You are exploring uncharted territory with your friend or loved one. It can be a scary and confusing time for both of you.  To make the journey a bit less stressful, follow these do’s and don’ts when dealing with dementia.

Do come to terms with the fact that your relationship with the dementia patient is going to change over time.

Don’t assume that just because the relationship is different, it can’t be fulfilling and meaningful.  You can still enjoy time together in ways that bring you closer.

Daily tasks
Do find subtle ways to step in when a dementia patient needs help that they may not be ready to ask for. Many dementia patients refuse to seek help in performing daily tasks that have become difficult due to their decreased mental functionality. This can be based on fear, pride, or a need to maintain control. Tasks that used to be second nature to them, like balancing a checkbook or taking medication, may become difficult to manage. If you notice that things are slipping, gently ask if you can help out. Rather than focusing on the person’s incompetence, focus on the difficulties of the task itself. For instance, instead of blaming your loved one for overdraft fees on a bank account, tell them that the bank may have made a mistake and that the paperwork is confusing. Offer to help them navigate the process.

Don’t bombard someone who is dealing with dementia by providing a long list of all the tasks that they have floundered with. Don’t question their ability to handle a situation outright or else they’ll become embarrassed and frustrated which will put them on the defensive.

Aggressive behavior
Do remain calm when you encounter aggressive behavior. People with dementia may exhibit hostile speech or actions in response to feeling confused, helpless or scared. Use what you know about the person to try and understand the feelings that are making them behave in such a way. Work to de-escalate the situation by calmly shifting the focus.

Don’t engage in an argument or be contradictory. Don’t correct everything a dementia patient says to you, as the accuracy of the information is not as important as the thought or feeling they are trying to convey. Don’t forget that this aggressive behavior is not deliberate, but is often just a symptom of the dementia.

Therapeutic lies
Do understand that honesty is not always the best policy when dealing with dementia. Sometimes, “therapeutic lies” or fibs are the best course of action when dealing with dementia patients.  It may seem counterintuitive to lie to your loved one, but it may keep them from experiencing mental anguish, anxiety and confusion. For instance, a patient with dementia may ask where their spouse is daily, constantly forgetting that he or she passed away years ago. Instead of opening up old wounds every time the subject is brought up, a caregiver may simply say that the spouse is out at the store. It is not always necessary for a dementia patient to be grounded in reality.

Don’t try to reason with patients in the middle to late stages of dementia, as they have lost their sense of logic. Figure out what is going to make the dementia patient feel the safest, even if that is a therapeutic lie instead of the truth.

Do remember to always treat someone with dementia with respect. Many patients have a fragile sense of self-worth, so it’s even more important to treat them with courtesy. Use their name when speaking to and about them, include them in conversations, don’t talk over their heads, and respect their privacy.

Don’t talk like they aren’t in the room, scold or criticize, invade their privacy, or brush their feelings aside.

Self care
Do take care of yourself. When you are providing care for someone with dementia, you will experience a physical and emotional toll on your body. Caregivers of dementia patients often report sleep deprivation, poor eating and exercise habits, and postponement of their own medical appointments. Remember that caregivers operate best when their own needs are taken care of.  It’s like the common in-flight adage which says to put your own oxygen mask on before assisting others with theirs.

Don’t let your stress get out of control. There is no denying that caring for a loved one with a disease like dementia is extremely stressful, but if you find you are regularly experiencing severe signs of stress, then speak with your doctor immediately.

Do rely on friends, family members and service providers for respite care. Check out the post How to Reserve Time for Respite to understand how Lotsa Helping Hands can be used to schedule much-needed breaks.

Don’t shoulder the burden alone. It’s important to take time for yourself to rest and recharge.

Do remember that while certain types of dementia don’t have a cure, there are still treatments available that may improve symptoms. Medications and non-drug therapies can both be successful in dealing with dementia.

Don’t give up hope. Increased research funds and clinical studies can lead the way to effective new treatments.