How to Care for Someone With Dementia

Dementia affects every aspect of a person’s life, from memory and cognition to behavior and personality. It also affects family caregivers who not only face the challenging details of providing care for someone with dementia, but also bear the emotional burden of knowing a relationship with someone they love is slipping away.

James Schindler, MD, MPH, family physician and director of the Methodist Family Medicine Residency program at Methodist Medical Center of Oak Ridge, says it’s important to remember the humanity of the problem. Those who are diagnosed with dementia are aware of what’s happening to them, which can cause a mix of emotions and reactions. 

“We may laugh when a 4-year-old misplaces their shoes but become frustrated and upset when a family member with failing memory does so,” Dr. Schindler says. “Reduce the fear [persons with dementia] may have of rejection and ridicule by supportive understanding and using tools that help remind them of daily details.” 

Types of Dementia 

Dementia is not a single disease. The term encompasses a wide range of conditions, all characterized by cognitive decline. There are more than 100 forms of dementia, but the most common types include:   

• Alzheimer’s Disease is the most prevalent form of dementia, accounting for 60-80 percent of cases. It’s known for memory loss, confusion and changes in behavior. 
• Vascular Dementia frequently starts with strokes or other issues that reduce blood flow to the brain. Common symptoms are impaired judgment and difficulty with planning. 
• Lewy Body Dementia is characterized by abnormal protein deposits in the brain. Memory problems, hallucinations and problems with movement (similar to mobility issues related to Parkinson’s disease) are common. 
• Frontotemporal Dementia affects the frontal and temporal lobes of the brain. It can trigger changes in personality, behavior and language skills. 
• Mixed Dementia describes cases in which a patient experiences more than one type of dementia. Mixed dementia makes diagnosis and treatment more complicated. 

Understanding the Symptoms of Dementia 

“Early signs I often see involve the details of life – hygiene, use of medication, detail and direction confusion, and engaging less in conversations than was their previous pattern,” Dr. Schindler says. “With couples, I see the affected partner pausing more and the other partner ‘filling in’ the story without even being aware of the loss.” 

He adds that patients may become confused when driving and end up lost in a place that should be familiar. With frontal lobe impairment, they may be more impulsive or inappropriate in social situations. 

“When startled at night they may awaken and assume it’s morning, then proceed to get dressed and start the day,” Dr. Schindler says. 

While symptoms can vary depending on the type of dementia, here are some of the most common signs: 

• Memory Loss – Difficulty remembering recent events, appointments or conversations. 
• Difficulty with Tasks – Struggling with activities that should be familiar such as managing finances, cooking or driving. 
• Confusion – Disorientation, making it hard to recognize familiar places or familiar people. 
• Language Problems – Difficulty finding the right words, following conversations or understanding spoken or written language. 
• Mood Changes – Sudden shifts in mood, including anxiety, depression or agitation. 
• Sleep Problems – Disrupted sleep patterns, including insomnia or daytime sleepiness. 

How is Dementia Diagnosed?  

Memory loss and loss of focus can be caused by many different conditions, some of which are reversible. Any change in personality or health deserves a check-in with a trusted health professional. 

“Beyond that, some testing to see how severe the memory loss is can be helpful for the patient and family,” Dr. Schindler says. Diagnosing dementia usually includes a complete review of the patient’s medical history, a physical exam, cognitive and neurological tests, brain scans and genetic testing. 

Stages of Dementia 

Dementia usually comes in three stages. Each stage has its own challenges and care needs. 

Early Stage 

Dementia symptoms are mild and may not be immediately noticeable. This is when patients begin to experience slight memory lapses, such as forgetting recent events or names. They can still function independently but may need reminders. This stage can last several years. 

Middle Stage 

Memory loss worsens, and patients may struggle with daily tasks like dressing, cooking or managing finances. They might become confused about time, places or events and begin to show aggression or depression. This stage of dementia can last from two to ten years. 

Late Stage 

Patients require full-time care as they lose the ability to communicate, stop recognizing loved ones and forget how to perform basic daily tasks like eating or bathing. This stage can last from several months to a few years. 

Caring for Someone With Dementia 

Caring for a person who has dementia requires a multifaceted approach that addresses physical, emotional and psychological needs. Here are some strategies to help caregivers manage the challenges: 

Create a Safe Environment 

Safety is a top priority when providing care for someone with dementia. As cognitive and physical abilities decline, the risk of accidents rises. 

• Remove hazards. Move items that might cause a fall (e.g., loose rugs, electrical cords or clutter). Install grab bars in bathrooms and ensure that walkways are well lit. 
• Use locks and alarms. It’s common for dementia patients to wander as they become more confused. Consider installing locks on doors and windows. Alarms can also alert caregivers if a door is opened unexpectedly. 
• Simplify your home. Reduce confusion by labeling drawers, cabinets and rooms. Keep frequently used items in easily accessible places. 

Establish a Routine 

A consistent daily routine can provide structure and reduce anxiety for dementia patients, and helps those who provide care for them as well. Daily routines help dementia patients know what to expect and can improve their overall well-being. 

• Stick to a schedule. Consistency helps reinforce memory and reduces confusion. Schedule meals, medication, exercise and rest at the same time each day. 
• Create practical tools. Dr. Schindler recommends using a whiteboard to clearly post days, events and other reminders. 
• Enjoy life. Help the patient continue favorite activities like listening to music, gardening and simple craft projects. This can stimulate the patient’s mind and provide a sense of accomplishment. 

Manage Behavioral Changes 

Behavioral changes, such as agitation, aggression or depression, are common in dementia patients. Understanding the triggers and managing these behaviors can improve the quality of life, not only for the patient, but for the caregiver as well. 

• Identify triggers. Pay attention to what precedes behavioral changes. Hunger, discomfort and overstimulation are common triggers. 
• Use calming techniques. Deep breathing, gentle massage or playing soothing music can help calm an agitated patient. Redirecting attention to a different activity can also be effective. 
• Ask for help. Consult a healthcare provider if behavioral changes become unmanageable. In many cases, medication and therapies can help. 

Support Caregiver Well-being 

Providing care for someone with dementia can be physically and emotionally draining. Caregivers must also take care of themselves. 

• Take a break. Schedule time to recharge. It’s OK to ask a family member, friend or professional caregiver to take over for a few hours or a few days. 
• Prioritize self-care. Maintain your health by eating well, exercising and getting enough sleep. Consider speaking with a counselor or therapist to manage stress and prevent burnout. 
• Build a network. Connecting with other caregivers can provide emotional support, practical advice and a sense of community. 

Additional Resources for Dementia Caregivers and Patients  

Dr. Schindler also recommends keeping up with medical appointments and having open, honest conversations with trusted healthcare providers. “I always value seeing the patient – and at times, the caregiver without the patient – to talk about strategies and resources,” Dr. Schindler says. 

Caregivers can also tap into local support networks for loved ones of dementia patients. 

• Connect. The Alzheimer’s Association – Tennessee Chapter and Alzheimer’s Tennessee offer support groups where family members can share experiences, gain support and learn from others facing similar challenges. 
• Learn. Caring and Coping Caregiver Workshops presented by Alzheimer’s Tennessee offer valuable information and support for caregivers, including strategies for managing daily challenges and coping with stress. Instructional videos are also available. 
• Get help. In Knoxville, the Community Action Committee Office on Aging provides information about places that offer daytime caregiving services, some of which care for Alzheimer’s patients. Check with your local community resources for support. “There’s no need for family to bear all the stress of what this condition brings,” Dr. Schindler says. 

Perspective matters. When an adult child cares for a parent who has dementia, it’s a role reversal. When a spouse is the caregiver, the balance of a decades-long partnership changes forever. 

In every case, caring for a dementia patient can deepen the bond between the patient and caregiver. Dr. Schindler says looking for the joy and humor that happens when memory loss occurs and worsens helps lighten the emotional load. 

“Remember, there are resources for support, respite and advice,” he says. “Use them early and fully.” With the right care, the patient and the caregiver can both experience quality of life as they live in the moment together – one day and one memory at a time.