Caring for someone with dementia is difficult at every stage, but the earliest stages of Alzheimer’s disease and other forms of dementia often present the greatest challenges for family members and caregivers.
While some disease processes are highly predictable and produce relatively uniform symptoms that can be managed with proven solutions, every person’s experience with dementia is unique, especially during the early stages. A variety of physiological, environmental and other factors impact the symptoms that appear and their severity.
Because of this variation, it would be impossible to prescribe specific instructions on dementia care that would apply in every situation. However, there are approaches and behaviors that should be universally avoided with dementia. Here are 4 things NOT to do when caring for someone with dementia.
Do not say “Don’t you remember?”
If a person is experiencing short-term memory loss due to dementia, his or her brain is most likely unable to create short-term memories. In this situation, you should either take steps to reorient the person to reality or “play along” with what the person believes is true, depending on the person and specific circumstances.
You should not suggest that the person should remember something that he or she is physiologically incapable of remembering. While saying something like “remember, we talked about this last week at the park” might jog your memory, it will only serve to agitate a person with dementia. If the person with dementia doesn’t have a memory of something happening, it did not happen in that person’s mind.
Do not say “I’ve told you a thousand times!”
People with short-term memory loss caused by dementia tend to ask the same questions repeatedly. This can understandably become tiresome and frustrating for family members. There are various opinions about how to handle these looping situations, but there is no question that you should not say something like, “I’ve answered you a million times!” or “You just asked me that!”
Confrontational statements like these do not help. People with dementia do not choose to forget things or repeat themselves. Their behavior is being caused by irreversible (as of now) changes happening in their brains. Blaming the person with dementia for exhibiting these symptoms is akin to blaming someone with two broken legs for being unable to walk.
Do not argue.
People with dementia often get confused. They might believe an old memory is more recent or get two memories mixed up. Again, these are not choices the person is making, but they do form that person’s current reality. If the topic at hand is inconsequential, there is no reason to argue.
For example, it simply doesn’t matter if your dad thinks a friend used to live in Florida but you know she lived in Alabama. You do not need to win every argument. If his brain is telling him the friend lived in Florida, you are not likely to convince him otherwise. Let it go! Head off an argument by offering that maybe he’s right, you could be misremembering.
Do not talk about them as if they aren’t there.
Do not talk about the person with dementia as if he or she is not present. I once visited a client and her niece. While we all sat together in the living room, the niece told me about her aunt’s daily routine without ever looking at or acknowledging her aunt directly. I directed a question to the client to invite her into the conversation, but the niece quickly said, “she doesn’t know,” and answered the question for her.
The client probably didn’t know the answer, but there is value in making her feel present and included. We certainly shouldn’t belittle or disparage people with dementia any more than we would anyone else. While the aunt probably did not remember that specific conversation, she may well have retained the feeling that her niece’s treatment caused.
