In 2017, I recorded a video on three things to never do with someone who has dementia. Don’t correct them. Don’t argue with them. Don’t try to reason with them.
What I didn’t do a very good job of was telling you what the heck to do instead.
So that’s what this post is for: strategies you can start using today to make life more peaceful for you and your loved one. I also changed one word. These are three things to avoid now, not three things to never do, because there are exceptions to every rule. The original video is written up as three things to never do with someone with dementia.
1. Don’t Correct Someone With Dementia
We’ll start with the easiest one.
Your energy is so precious. Think about everything you have to do, manage and keep hold of. And the relationship you have with your loved one is so important. Why spend either one on a correction that isn’t necessary?
How do you know it’s unnecessary? It isn’t heading off an imminent safety risk, to them or to anybody else. If they aren’t putting themselves or someone else at risk, by all means, let them do it wrong. Let them say it wrong. That makes life easier for you, easier for them, and it protects the relationship between you two.
What to Do Instead: Let Them Do It Wrong
One of the stories I write about in my book, The Dementia Care Toolkit, started with a simple question. A Careblazer asked me for activity ideas to try with her husband.
Before you answer a question like that, you get more information. So I asked her what he enjoys doing now.
Her husband has always read The Wall Street Journal. For much of their marriage, he woke up every morning and read it. But lately, when she asked him about what he’d read, he couldn’t remember any details. He had no idea. So she took that to mean he needed to do something else.
But he was pleasantly engaged. He wasn’t distressed that he couldn’t remember anything.
It turned out her husband wasn’t the one struggling with the activity. It was Donna. Donna was grieving, watching her husband lose an ability he had always had.
She didn’t need to correct him. She didn’t need to change anything. He could keep doing the activity he enjoys, even if he isn’t doing it well, even if he doesn’t remember what he reads. It wouldn’t have mattered if he read it upside down. As long as he seems pleasantly engaged, we can let our loved ones do things wrong and say things wrong.
When You Should Correct: Safety
The only time you really want to correct and step in is when there’s a safety risk. And even then, you don’t have to do it in front of them if you can avoid it.
There’s another story in the book about a patient of mine who told me he was drinking six beers a day. His family member didn’t correct him. It turned out they were non-alcoholic beers, but she didn’t want him to know that. So she caught me in private to tell me.
She didn’t correct him.
So, Careblazer, don’t correct. Let them do it wrong. Let them say it wrong. Unless there’s an imminent safety threat, you don’t need to do much at all.
2. Don’t Argue With Someone Who Has Dementia
On the surface, this one seems obvious. Of course we don’t want to argue with our loved ones.
But take a moment and think back over the past month. Have you found yourself caught in an argument with your loved one?
Maybe they’re calling you nasty names. Accusing you of lying. Saying something about you that isn’t true. With every ounce of your being, you’re going to want to defend yourself. To correct them. To tell them, “That is rude, and that is not okay.”
You can, by all means, keep doing that. You are their primary Careblazer, and you can interact with them however you want to. But if you’re like many of the Careblazers I’ve worked with, correcting them or arguing with them in that way sometimes makes things worse.
Why Arguing Makes It Worse
First, they’re living in a different reality, with whatever they believe is true, and they don’t really see things from ours.
Second, they might not be able to remember what you said. They might not be able to process the information you’re giving them.
Sometimes we interact with people who have dementia as if they don’t have dementia. We expect the same manners and the same socially appropriate behavior we’ve expected from them most of their lives. But their brain cells are dying. Especially when someone has frontal lobe problems or executive functioning problems, it can cause them to say and do things that you and I would point-blank call rude and unacceptable.
If your loved one doesn’t have the brain ability to grasp that, reminding them of it again and again depletes your precious energy. And it puts more strain between you and them.
What to Do Instead: Do Less to De-escalate
The story that goes with this one might be hard for you to hear. I hope you’ll stay open to the message in it.
I once witnessed a powerful example of this during a live video call with members of our Care Collective. While one caregiver was on the call, her husband, who had dementia, began yelling at her from across the room. He used vulgar language and accused her of lying. His voice was angry and loud. Everyone on the call could hear it.
Most of us braced ourselves, expecting her to react or disengage.
Instead, she looked at him calmly and said, “I know, honey. I’m sorry. I’ll get better, my love.”
Then she turned back to the screen and kept participating in our conversation as if nothing had happened. It was a masterclass in responding without escalating.
Afterward, someone asked her, “How do you stay so calm?”
She answered without hesitation. “That’s not him.”
So when you find yourself pulled to defend yourself or argue with your loved one, you can do exactly what this Careblazer did. Do less to de-escalate. There’s more to this strategy, starting on page 86 of the book, if you want to take it further.
3. Don’t Reason With Someone Who Has Dementia (With One Exception)
This one is a bit more complicated, and it’s the one I’ve changed since the original video.
In 2017, I said, “Do not reason with somebody who has dementia.” Trying to reason with someone who has dementia is like trying to convince a blind person to see by looking harder. It isn’t possible.
They’re often living in a different reality, with beliefs based on what their brain has filled in, and it might not be the truth or what’s accurate. The reality you’re living in and the reality they’re living in are often two different things. That kind of logic depends on memory and insight that may no longer be available. So when we try to reason with them, it makes everything worse.
With one exception. You can reason with them from their reality.
What to Do Instead: Reason From Their Reality
Instead of trying to get them to understand your reality, the one you know to be true, you join their reality and reason with them from that point of view.
This strategy starts on page 102 of the book. Here’s the story that goes with it.
Brenda was caring for her husband, who had dementia. Before his diagnosis, he had owned a successful insurance company, which their son had since taken over. One night, Brenda woke up to find her husband convinced that a client had broken down on the side of the road and urgently needed their insurance paperwork.
No matter what she did, he would not believe her when she told him it wasn’t true. Desperate to calm him down, she called their son for advice.
Her son had an idea. Instead of trying to convince his father that the situation wasn’t real, he told him he had already delivered the insurance paperwork to the client, and everything was taken care of.
That simple explanation, one that made sense within her husband’s reality, instantly calmed him down.
Notice what nobody had to say. Nobody had to tell him, “You’re not working at the insurance company anymore. You haven’t worked there for years. You’re retired.” And there was no imminent safety danger here. He hadn’t gotten into the car to drive in the middle of the night. Brenda just needed to find a response that made sense in his world.
That’s how this one weaves back into the first. When you reason from their reality, you don’t have to correct what they believe.
When You Feel the Urge to Explain
When you find yourself wanting to reason with your loved one, wanting them to understand what you understand, use that as a little warning. A little red flag.
Wait a minute. What are they believing right now? And how can I say something that makes sense for what they believe?
If you want more replacements for these habits, I go through six of them, each with what to say instead, in what not to say to someone with dementia.
Putting These Into Practice
In the book, there are questions, prompts and exercises to help you work through each of these strategies. I’ve also put together a free PDF workbook that helps you take them and apply them to your specific situation. You can order your copy of the book, and find out how to download the free workbook, here.
Careblazer, thank you for doing what you are doing for your loved one.
That live call I told you about was with members of the Care Collective, where we work through moments like these every week: what to say when you’re accused of lying, how to answer from inside their reality, and how to cope with how it feels to let it go. You can learn more here.
