Caring for someone with Alzheimer’s or another dementia can sometimes leave you wondering:
Why does everything turn into a struggle?
You may simply be trying to help Mom get dressed, remind Dad to take his medicine, or get your spouse into the shower.
But suddenly they are saying no.
They may become angry, push you away, accuse you of something, or refuse to move.
It is easy to think:
Why are they being so difficult?
But there is something very important I want every dementia caregiver to understand:
Sometimes the problem isn’t the task. It is how the person with dementia is experiencing the approach to the task.
Learning how to approach someone with dementia can make everyday care feel calmer and may help reduce fear, confusion, and resistance.
When dementia changes the brain, we have to change our approach.
And sometimes a very small change in what we do can make a very big difference in what happens next.
Prefer to watch? In this video, I explain why changing your approach can make dementia care calmer and easier for both of you.
Dementia Changes How They Experience You
Dementia is much more than memory loss.
It can affect reasoning, judgment, language, vision, emotions, attention, and the brain’s ability to process information.
That means your loved one may not understand a situation as quickly as they once did.
Imagine someone walking toward you saying:
“Come on. We need to get you changed. We’re already running late.”
You understand exactly what that means.
But a brain affected by dementia may be trying to figure out:
Who is this person?
Why are they coming toward me?
What do they want me to do?
Where are they taking me?
Why are they touching me?
Am I safe?
By the time you are thinking, I’m just trying to help you get dressed, their brain may already be telling them:
Something is wrong. Protect yourself.
That’s when you may see resistance, yelling, pushing, grabbing, walking away, or simply refusing to cooperate.
We often call these behaviors.
But sometimes what we are really seeing is a person responding to a world they no longer completely understand.
Your Approach Starts Before You Say a Word
This is one of the most important things I teach caregivers.
Your approach begins before you ever open your mouth.
Your loved one may notice:
- how quickly you walk toward them
- your facial expression
- your body language
- how close you are standing
- whether you seem rushed
- whether you are looking down at them
- whether you suddenly reach for them
They may not understand everything you say, but they can often sense when you are frustrated, rushed, angry, or tense.
Think about how different these two situations feel.
Someone walks quickly into the room, stands over you and says:
“Come on, we have to get you dressed.”
Now imagine someone walking slowly into the room, smiling, getting near your eye level and saying:
“Good morning, Mom. It’s good to see you.”
Same caregiver.
Same person.
Same task.
Completely different approach.
And you may get a completely different response.
The Six Keys to the Alzheimer’s Approach
I have taught this approach to caregivers and healthcare workers for many years.
The steps are simple.
But don’t let their simplicity fool you.
When the brain is struggling to understand the world, these little things can help your loved one feel safer.
1. Approach Slowly and From the Front
Try not to suddenly appear beside or behind your loved one.
Walk toward them slowly and give them time to notice you.
Remember, their brain may need extra time to figure out what they are seeing.
If you appear suddenly or reach for them before they understand who you are, you may frighten them.
Slow down and let their brain catch up.
2. Give Them Some Personal Space
Try not to walk directly into their space.
Stop for a moment.
Let them see you.
Watch their reaction.
Standing slightly to the side rather than directly over them may feel less threatening.
This is especially important if your loved one is sitting or lying down.
Think about how you would feel if someone you didn’t recognize suddenly stood over you.
That may be exactly how the situation feels to them.
3. Get to Their Eye Level
If your loved one is sitting, try to sit beside them or get closer to their eye level.
Standing over someone can make them feel powerless or threatened.
Sitting beside them changes the message.
Instead of:
“I’m in charge.”
Your body language says:
“I’m here with you.”
That small difference matters.
4. Use a Calm, Friendly Voice
Your tone can be more important than your words.
Speak slowly.
Use short sentences.
Give one direction at a time.
And then wait.
One of the easiest mistakes caregivers make is talking too much because their loved one isn’t responding.
We ask the question again.
Then we explain it.
Then we say it another way.
Meanwhile, their brain may still be working on the first sentence.
Give them a few extra seconds.
Silence doesn’t always mean they didn’t understand.
Sometimes their brain simply needs more time.
5. Use Their Name and Introduce Yourself When Needed
Don’t assume your loved one always knows who you are.
You may be their daughter, husband, son, or caregiver—but dementia can affect recognition.
Instead of asking:
“Don’t you know who I am?”
Try giving them the answer.
“Hi, Mom. It’s Larea.”
Now they don’t have to struggle to remember.
You have removed one more confusing piece from the situation.
Even when they do recognize you, hearing their own name can help get their attention before you begin speaking.
6. Offer Your Hand Instead of Giving a Command
Whenever possible, invite rather than demand.
Instead of saying:
“Get up. We have to go.”
Try smiling, offering your hand and saying:
“Come with me.”
Then wait.
This gives your loved one a visual cue along with the words.
Sometimes the brain has trouble understanding spoken directions, but seeing your hand may help them understand what you want them to do.
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Connection Before the Task
Caregivers have a lot to accomplish.
Bathing.
Dressing.
Meals.
Medications.
Bathroom trips.
Appointments.
Laundry.
Housework.
And everything else that comes with caring for someone.
It is very easy to become focused on the next thing that needs to be done.
But your loved one doesn’t have your to-do list in their head.
You may walk into the room thinking:
We have a doctor’s appointment in 45 minutes. I need to get Mom dressed.
Mom may simply be sitting in her chair watching television.
Suddenly someone comes in, turns off the television and starts telling her she needs to change her clothes.
She says:
“No.”
So you explain why.
She still says no.
You explain again.
Now she is angry.
And you’re frustrated because you’re going to be late.
This is where the Alzheimer’s Approach can change the whole interaction.
Instead of starting with the task, start with the person.
Sit down for a moment.
Smile.
Talk about something familiar.
Make a connection.
Then move toward the task.
It may feel like you don’t have time for that extra minute.
But that one minute of connection may save you 20 minutes of arguing.
Connection first. Task second.
Task-Centered Care vs. Person-Centered Care
There is a big difference between getting a job done and caring for a person.
Task-centered care says:
“It’s bath day. We need to get your bath done.”
Person-centered care asks:
“How can I help this person feel comfortable enough to let me help them?”
That may mean changing the time of day.
It may mean changing your words.
It may mean playing favorite music.
It may mean letting them wash part of their own body.
It may even mean skipping the shower today and trying again tomorrow.
The goal isn’t to win.
The goal is to provide the care they need while helping them keep as much dignity, independence, and control as possible.
When They Say No, Don’t Push Harder
This one can be difficult.
You know something needs to happen.
Your loved one needs a shower.
They need to change their clothes.
They need to eat.
But they say:
“NO!”
Our natural reaction is to explain why they need to do it.
When that doesn’t work, we explain more.
Then we may become firmer.
But dementia can affect the brain’s ability to reason.
More logic doesn’t necessarily create more understanding.
Sometimes it creates more pressure.
And more pressure creates more resistance.
Instead, ask yourself:
Why might they be saying no?
Are they afraid?
Are they cold?
Are they tired?
Are they in pain?
Do they understand what you are asking?
Do they recognize you?
Are there too many people around?
Are you moving too quickly?
Could they need a few minutes?
Sometimes the best response to “no” is:
“Okay.”
Step away.
Change the subject.
Give them time to settle.
Then try again later with a different approach.
A no right now doesn’t always mean no all day.
Use Fewer Words
As dementia progresses, long explanations can become harder to follow.
Instead of:
“Mom, I need you to get your shoes on because we have a doctor’s appointment at 10:30, and if we don’t leave soon we’re going to be late.”
Try:
“Mom, let’s put on your shoes.”
Pause.
Then give the next step.
“Now let’s get your coat.”
One step.
One sentence.
One task at a time.
This reduces the amount of information their brain has to process.
Show Them What You Want Them to Do
Words aren’t always enough.
Visual cues can be very helpful.
If you want your loved one to sit down, point to the chair.
If you want them to brush their teeth, hand them the toothbrush.
If you want them to come with you, offer your hand and begin walking with them.
If they are struggling to use an object, demonstrate what to do.
Instead of adding more words, sometimes it is better to show them.
Use Softer Words for Difficult Tasks
Some care tasks can feel very personal or frightening.
Bathing and toileting are good examples.
Imagine having someone tell you:
“You need a bath.”
Now imagine not understanding why that person thinks they have the right to undress you.
Instead of focusing on the task, try gentler language.
Instead of:
“It’s time for your shower.”
Try:
“Let’s freshen up.”
Instead of:
“You need to use the bathroom.”
Try:
“Let’s stop in here before lunch.”
Instead of:
“You need to change your clothes.”
Try:
“I found your blue shirt. I think this would look nice today.”
You’re still accomplishing the same goal.
You’re simply changing how you get there.
Watch Their Body Language
Your loved one may not always be able to tell you:
“I’m getting overwhelmed.”
Their body may tell you first.
Watch for:
- pulling away
- frowning
- becoming very quiet
- clenching their hands
- pacing
- pushing your hands away
- raising their voice
- turning away
- repeating “no”
- looking frightened
These can be early warning signs.
Don’t wait until the situation becomes a full-blown struggle.
Slow down.
Lower your voice.
Give them some space.
You may even need to stop the task.
Their behavior is giving you information.
What Fight, Flight, or Freeze May Look Like in Dementia
When someone becomes frightened or overwhelmed, the brain may move into a survival response.
You may see fight, flight, or freeze.
Fight
They may yell, hit, kick, push, grab, or resist your help.
Flight
They may walk away, try to leave the room, or attempt to get away from you.
Freeze
They may stop moving, hold tightly onto furniture, refuse to take another step, or appear unable to respond.
Instead of immediately thinking:
“They’re being difficult.”
Try thinking:
“Something about this situation may feel unsafe to them.”
Then look at what happened right before the reaction.
What did they see?
What did they hear?
What were you asking them to do?
Were they startled?
Were they confused?
Were they hurting?
Were you rushing?
That is where you may find your answer.
Change Your Approach Before Trying to Change Their Behavior
This is one of the biggest lessons I want caregivers to take from this article.
When a behavior happens, our first thought is often:
How do I get them to stop doing this?
Try changing the question.
Ask:
What can I change about my approach?
Maybe you need to slow down.
Maybe you need fewer words.
Maybe you need to stop correcting.
Maybe they need more time.
Maybe the room is too noisy.
Maybe they don’t understand what you’re asking.
Maybe they’re frightened.
Maybe this simply isn’t the right time.
You cannot control everything dementia does.
But you can control how you enter the situation.
And sometimes changing your approach changes everything that happens next.
A Simple Example: Bath Time
Let’s put all of this together.
Dad hasn’t showered in several days.
You say:
“Dad, you need a shower. You haven’t taken one all week.”
Dad says:
“I took one this morning!”
You know he didn’t.
You say:
“No, you didn’t. I’ve been here all morning.”
Dad gets angry.
“Don’t tell me what I did!”
Now you’re arguing over something his brain may not be capable of remembering accurately.
Try another approach.
Walk in calmly.
Sit near him.
Talk for a minute.
Then say:
“Dad, I’m going to freshen up. Come help me get things ready.”
Offer your hand.
Walk toward the bathroom together.
Once you’re there, take things one step at a time.
Did you prove that Dad was wrong?
No.
Did it matter?
No.
The goal was never to prove when he last showered.
The goal was to help him get clean while protecting his dignity and keeping the situation calm.
That’s the Alzheimer’s Approach.
What If Your Approach Doesn’t Work?
Sometimes you can do everything right and your loved one will still say no.
That doesn’t mean you failed.
Dementia is unpredictable.
Pain, hunger, fatigue, illness, constipation, medications, noise, temperature, unfamiliar surroundings, or simply having a bad day can affect how someone responds.
If the task isn’t urgent, stop.
Give them space.
Try again later.
Try a different caregiver.
Change the room.
Put on some music.
Offer a snack.
Come back after they have rested.
And if you notice a sudden or major change in behavior, don’t automatically assume it is dementia. Sudden changes can sometimes have another cause and may need medical attention.
The Alzheimer’s Approach Is Really About Dignity
There is something important underneath all of these techniques.
Your loved one is still an adult.
Dementia may change what they remember.
It may change how they communicate.
It may change what they understand.
It may change how much help they need.
But it doesn’t take away their need for dignity, respect, comfort, and human connection.
Don’t talk down to them.
Don’t talk about them as though they aren’t there.
Don’t quiz them to see what they remember.
Don’t embarrass them when they’re wrong.
And whenever possible, give them choices and let them participate in their own care.
They may forget your words.
They may forget what happened five minutes ago.
But the feeling of being safe, respected, and cared for still matters.
Remember This: Calm, Connect, Then Care
If remembering all of these tips feels overwhelming, remember three words:
Calm. Connect. Care.
CALM
Slow yourself down before you approach.
CONNECT
Help them feel safe and comfortable with you.
CARE
Then move into whatever task needs to be done.
We often want to jump straight to care.
But with dementia, those first two steps can make all the difference.
Frequently Asked Questions About Approaching Someone With Dementia
1. Why does my loved one get angry when I’m only trying to help?
They may not understand that you are trying to help. If they don’t understand who you are, what you want, or why you’re touching them, your help may feel threatening. Slow down, explain less, reassure them, and look for what may be causing fear or confusion.
2. Should I correct my loved one when they say something that isn’t true?
Usually, correcting every mistake isn’t necessary. Ask yourself whether correcting them will actually help. Often it is better to respond to the feeling behind what they are saying and gently redirect the conversation.
3. What should I do when my loved one refuses care?
If it is safe to wait, stop and try again later. Look for pain, fear, fatigue, embarrassment, confusion, or another reason for the refusal. A different time, caregiver, wording, or approach may work better.
4. Why does explaining things sometimes make the situation worse?
Dementia can make it difficult to process language, follow several ideas, and use logic. A long explanation may add more information to a brain that is already overwhelmed. Try shorter sentences and one idea at a time.
5. What if I lose my patience?
Caregivers are human. If you feel yourself becoming frustrated and your loved one is safe, step away for a moment. Regroup and try again. Sometimes both of you need a reset.
The Heart of the Alzheimer’s Approach
The Alzheimer’s Approach isn’t about having the perfect words.
And it isn’t a magic trick that will prevent every difficult moment.
It is a different way of looking at dementia care.
Instead of asking:
“How do I make them cooperate?”
We begin asking:
“How can I help them feel safe enough to accept my help?”
That shift changes caregiving.
Slow down.
Approach from the front.
Use fewer words.
Give their brain time to process.
Connect before starting the task.
Don’t argue when you don’t need to.
Watch their body language.
And when something isn’t working, change the approach before pushing harder.
Because when dementia changes the brain, we have to change the way we care.
💜 Connection before correction. Compassion before completion.
Want to Better Understand the Brain Behind the Behavior?
The more you understand what dementia is doing to the brain, the easier it becomes to understand why your loved one responds the way they do.
In my Understanding Dementia: A Beginner’s Guide course, I walk caregivers through the changes dementia causes and practical ways to respond with more confidence.
You’ll learn not just what your loved one is doing, but why it may be happening—and what you can do differently.
Understanding dementia changes the way you see the behavior. And changing the way you see the behavior can change the way you respond.
