Dementia changes the rules
Caring for someone with dementia at home is different from almost any other kind of caregiving. The person you love is still there, but the way they experience the world — time, memory, language, reasoning — is shifting. What worked yesterday might not work today.
There's no single playbook. But there are principles that most families find helpful.
Create a predictable routine
Routine is one of the most powerful tools in dementia care. When memory is unreliable, familiarity provides security.
- Keep mealtimes, bedtimes, and activity times consistent
- Follow the same sequence each morning (bathroom, get dressed, breakfast)
- Minimise surprises — if plans change, explain gently and simply
- Use visual cues: labels on doors, clocks with day and date, a visible daily schedule
Communication strategies
As dementia progresses, communication becomes harder. These approaches help:
- Keep sentences short and simple. One idea at a time.
- Use names instead of pronouns. "John is coming for tea" is clearer than "He's coming over."
- Offer choices, not open questions. "Would you like tea or coffee?" rather than "What would you like to drink?"
- Don't correct or argue. If they think it's 1985, joining their reality causes less distress than correcting it.
- Watch body language. As words fail, emotions remain. Tone of voice, facial expression, and touch communicate more than words.
Make the home safe
- Remove trip hazards (loose rugs, trailing cables, clutter)
- Install locks on medicine cabinets and cleaning product cupboards
- Consider stove guards or automatic gas shut-off devices
- Use night lights in hallways and bathrooms
- Secure external doors if wandering is a risk — but don't make the person feel imprisoned
- Remove or lock away car keys if driving is no longer safe
Managing difficult behaviours
Agitation, repetitive questions, sundowning (increased confusion in the evening), and resistance to personal care are common. They're not deliberate — they're symptoms of the condition.
- Look for the cause. Is the person in pain, hungry, tired, overstimulated, or needing the toilet?
- Distract, don't confront. If they're upset, redirect attention to something comforting — music, a photo album, a walk.
- Reduce stimulation in the evening. Dim lights, turn off the TV, play gentle music.
- Don't take it personally. Aggression and hurtful words are the disease talking, not the person you love.
Look after yourself
Dementia caregiving is a marathon, not a sprint. It can last years, and it intensifies over time. You cannot sustain it alone.
- Accept help — from family, from paid carers, from your community
- Use respite services so you can rest
- Join a dementia carers' support group — people who understand
- Keep your own GP informed about how you're coping
The Alzheimer's Society helpline (0333 150 3456) offers advice and emotional support for anyone affected by dementia.