Change is Hard
While the brain of the person living with dementia is changing, we healthy brain supporters need to change too. Adaptation is key to a successful dementia journey. We are called to look more closely at ourselves as well as gain a better understanding of the person we are supporting in order to create the best outcome possible.
For my loyal readers, please accept my apology for not addressing this topic, immediately following my July 1st post about adapting to brain change. Thank you for your patience as we pick up the conversation here.
Quick Recap
In my July 1st post (Adapting to Support a Person Living with Brain Change), we explored how dementia physically and chemically alters the brain, affecting memory, attention, and decision-making. We introduced the idea that these changes aren’t the person’s fault—they’re neurologically driven—and highlighted why adapting our approach can sustain connection and dignity. It’s on us—those of us with intact cognitive function—to learn, shift, and accommodate. When we adapt thoughtfully, we create moments of calm, confidence, and joy for the person living with dementia.
Five Ways We Can Adapt
1. Adapting Our Personal Approach
Verbal: Speak slowly, choose simple words, and pause to allow the person with brain change to process the information. Believe it or not, it can take up to 30 seconds for them to respond appropriately. It isn’t always a lack of understanding.
Tone & Mood: Match their emotional state – demonstrating that you understand what they are experiencing and reassure them that you are on their team. What you bring into the room will likely dictate the outcome of your experience. A person with dementia can sense your mood and understand your tone of voice even when they do not understand your words.
Energy Levels: Mirror their pace when they’re low-energy stay calm and soothing. When they are more alert, you can use your higher energy approaches.
Facial Expressions: What does a facial expression imply? The look on your face, the light or darkness behind your eyes speak volumes and the person living with dementia can sense that too.
Intentions: Are you wearing your agenda on your sleeve? Let your first intention be that of connection, genuine interest in the person that is in front of you. Check in with them to see how they are doing. Offer a kind word or compliment. We want someone with dementia to trust us, so we need to present ourselves as trustworthy and sincere, genuinely interested in who they are as a person – not a project. We don’t want to make a person feel like they are another item on a checklist, but instead a collaborator, part of a team.
2. Adapting the Environment
Safe & Functional: There is a long list of home modifications and simple strategies for how to modify the layout of a home to make it dementia friendly. There is another list that is just as long, if not longer, identifying ways to organize, arrange or remove items to promote safety. In essence, we look at the changing brain and consider what might be a safety risk due to decreased balance, decreased vision, confusion regarding appropriate use of dangerous items, monitoring, reducing risk of wandering, increasing access to emergency response systems.
Comfort: The changing brain does not experience the world the way a healthy brain does. Sounds, sights, touch, taste and smell can affect them differently. A person living with dementia might see shadows or be fearful of mirrors, certain scents can be soothing or alarming. Water from a shower can feel like little pin pricks and thresholds can look like they are stepping over the edge of a cliff. A lot of noise can create chaos and be overstimulating at times or it can be energizing and uplifting at other times. Keeping this in mind, we need to create an environment that is comfortable so that our person with dementia can thrive.
Friendly: In addition to comfortable, we want to create an environment that is friendly and familiar – this creates joy, a sense of belonging, reinforces identity and security. This is especially important for someone who no longer lives in their home. We can display personal items, keepsakes or photo albums that promote happy reminiscing. We can create soft cozy lighting, access to music, TV. It’s also critical to make socialization easily accessible.
3. Adapting How Tasks Are Accomplished
Simplify Steps: Break a multistep task into single actions—“First, pick up your toothbrush. Now, squirt toothpaste.”
Minimize Distractions: Reduce noise during focused tasks. This might be TV, radio or voices in the background. It can be difficult for people at middle to later stages to concentrate on a task and hold a conversation at the same time. We may need to reduce our cues as they can be a distraction rather than a help at times. (Remember previously mentioned delay in processing).
Rest Breaks: Build pauses between activities to reduce fatigue. Someone with dementia will not have the same endurance for a task that they used to. What was once an automatic activity may now require physical and cognitive energy. Sometimes we can’t see the cognitive fatigue until it gets to a breaking point that we could have avoided with a built in rest period. Rest does not imply sleep. Just some time to rejuvenate. What helps us to restore our energy is very personal and individual. We need to learn this about the person we are supporting.
Timing: Circadian rhythms vary for everyone as well. Some people are night owls, others are early birds. With dementia, we see changes – an early bird who no longer want to get out of bed in the morning, the early to bed person who now stays awake until midnight. Someone who never napped, needing one every day or maybe twice a day. We want to tune in to the energy levels and time our activities accordingly. We also want to consider personal preferences. See below:
4. Adapting Our Timing
Honor Old Routines: If they always showered at night, consider reinstating evening showers.
Let Go of Our Preferences: If they prefer breakfast at 10 AM instead of 7 AM, adapt your schedule to reduce their resistance.
Flexibility Over Rigidity: Recognize that what works today may need tweaking tomorrow. Nothing is permanent – dementia is ever changing. As I tell all of my clients – always expect the unexpected and we will work through it!
5. Adapting Through Education and Skill-Building
Dementia-Specific Workshops: Enroll in local caregiver classes or online modules. Dementia-specific training helps you build relevant skills. I offer several of these classes – ask me about them.
Professional Support: As a dementia care consultant – this is my jam! I love teaching caregivers about brain change and how they can adapt to it. We make their caregiving journey less stressful. It’s so exciting to see the frustration leave their faces and the hope rise in their eyes when our strategies work. If you or someone you know has a friend or a loved one with dementia, please share my information with them. I can support people near and far with the amazing option of video conferencing. No one needs to walk this journey alone. If anyone would like support form someone local to them, I can also explore my network of like minded professionals to find someone closer to you.
Role-Play Scenarios: Try role-playing tough moments to refine your ability to react with less frustration. This can be done with a friend or also as part of a workshop or consulting session.
Peer Support: Learn from others in support groups—share what works and what doesn’t.
Real Life Examples
(All names have been changed to protect privacy)
“Betty” Battles Showers
Betty was crying, yelling, even becoming aggressive when it was time to shower. Her daughter (my client) was at her wit’s end, concerned that Betty’s hygiene was being neglected. Betty used to love showers and her daughter was concerned by the changes and could not understand what was causing them. With a little detective work, discovered a few key truths: Betty had always preferred showers at night, she had visual difficulties that made the white shower appear like a giant hole, she hated being cold and the feeling of the water on her was painful.
So we adapted. We returned to evening showers, placed dark towels on the shower seat for contrast and comfort, warmed the bathroom, and added her favorite calming music. We made sure the water was at a comfortable temperature and we assured her that if anything was uncomfortable we would stop. We placed a medium sized towel over Betty to reduce the water pressure on her skin and we did not put any water over her head. Betty was given choices: whether to sit or stand, how to begin and what to wash first. Betty was in control of the shower hose and Betty’s daughter used a calm voice, simple words, and always asked permission before touching.
At first, my client said it felt like extra work – but the calmer, safer experience was worth every step. Betty wasn’t just clean – she felt respected and she enjoyed the shower.
“Joe” and the Towels
Joe’s wife was frustrated that he kept using their good bath towels for cleaning his bottom instead of toilet paper. She said she had verbally corrected him over and over and it “wasn’t sticking”. She was really struggling to understand why he was doing this. When I asked her to describe the bathroom setup I was able to quickly identify the problem: the location of the toilet paper and the location of the towels.
Joe, dealing with memory impairment, reduced peripheral vision and reduced inclination to scan his environment, naturally reached for what he saw first. While seated on the toilet, the towels were in front of him – centered in his visual field and the toilet paper was off to the side on the wall. The wipes which were also preferred, were located on the toilet tank behind him. So we moved the toilet paper and wipes into clear view. She placed them on a small stool in front of him and problem solved.
This change didn’t just help in the bathroom; we applied the same logic to his kitchen setup, placing favorite snacks and dishes where he could easily find them. Education about brain change and stepping into Joe’s reality created an opportunity for my client to make several adaptations that maintained Joe’s independence and reduced her frustration!
Last-Minute “Lucy”
Lucy, a delightful woman with Alzheimer’s disease takes great pride in her appearance. She has not yet experienced a fear of showers like Betty (above) but instead loves showers so much, that she is often noted to shower several times a day. For Lucy, she struggles with the concept of time and also with memory so one shower is easily forgotten and on to the next one she goes. She may put one outfit on and then another over it. Lucy is also fiercely determined to be independent and does not want help from anyone, including the caregivers that have been designated to assist with her morning routines.
Lucy’s daughter “Jennifer” is finding that her mom’s attention to hygiene while wonderful on one hand is impacting her ability to be ready for appointments on time. Jennifer has made several, very appropriate adjustments – calls to offer reminders, verbally breaks tasks down into steps, etc – but EVERY time she shows up, her mother is only partly ready. The fear of being late for the appointment creates stress and inevitably gets everyone started off on the wrong foot.
Solution: adding in buffer time. Everyone needs more time – more time for errors, more time for processing, more time for stepping back and taking a deep breath. Expecting that Lucy is going to be partly ready despite everyone’s best efforts and with the added buffer, Jennifer can approach the situation with greater ease and forgiveness. At the end of the day….she recognizes that Lucy is doing the best she can, as her brain continues to change.
Start Small, Stay Curious
Every small change you make opens doors to more peaceful, connected days. Pick one strategy to try this week—maybe soft evening showers or extra time for dressing—and notice the difference. When we adapt with intention, we’re not just making tasks easier; we’re honoring a whole person who is navigating an unfamiliar world. Let’s keep learning, adjusting, and celebrating each small win, together.
Senior Moments Consulting 