Personal care may seem like a small part of dementia care—but it shapes a person’s entire day.

Clean clothes.
Brushed teeth.
Hair gently combed.
Hands washed.
A clean brief.

These are not cosmetic details. For a person living with dementia, personal care is about dignity, comfort, and being treated as someone who still matters.

Yet in long-term care and memory care settings, personal care is one of the most commonly rushed, delayed, or missed aspects of care.

Not always because caregivers don’t care – but often because the system is stretched thin.

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Why Dignified Personal Care Is So Important in Dementia Care

In many long-term care communities, staff are responsible for too many residents with too little time. When this happens, care becomes task-focused instead of person-centered.

Harmful assumptions can also creep in:

• “They don’t notice anymore.”
• “They don’t care how they look.”
• “They’ll just resist.”

But here is the truth we cannot ignore:

People with dementia are often more aware than we think.
Even when words fade, emotional awareness remains.

Think about how you feel when you leave the house not looking or feeling your best. That discomfort does not disappear with dementia. In many cases, it intensifies – because the person may feel something is wrong without being able to explain it.

Personal care communicates something powerful:
You are worth care. You are worth time. You are worthy of dignity.

It is also directly tied to health outcomes:

• Clean skin reduces infections and skin breakdown
• Oral care lowers the risk of pain, aspiration, and pneumonia
• Clean clothing and briefs reduce UTIs and irritation
• Grooming supports comfort, confidence, and calmer behavior

When dignity is protected, health improves.

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Why People With Dementia Need Help With Personal Care

One of the most misunderstood parts of dementia care is why personal care becomes difficult.

Dementia changes the brain in ways that affect planning, sequencing, and initiation – even for tasks someone did independently for decades.

As dementia progresses:

• The brain may no longer remember that personal care needs to happen
• The person may forget when it should happen
• Sequencing steps (turning on water, picking up a toothbrush, knowing what comes next) becomes difficult
• Multiple steps can feel overwhelming
• Sensations like discomfort or uncleanliness may not register the same way

This is not stubbornness.
It is not refusal.
It is the disease affecting the brain.

Without guidance and hands-on support, personal care can quietly disappear – not because it isn’t needed, but because the brain can no longer manage it alone.

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What Dignified Personal Care Should Include

Personal care is not optional. It is essential care.

At a minimum, dignified dementia care should include:

• Clean, weather-appropriate clothing changed daily
• Teeth brushed or dentures cleaned morning and night
• Hair gently brushed or styled in a familiar way
• Hands washed regularly, especially before meals
• Clean, dry briefs or undergarments checked frequently
• Face washed and skin cared for
• Privacy, modesty, and respect at every step

These details directly affect how a person feels in their body – and in the world.

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Dementia Personal Care at Home: What Families Can Do

Caring for someone with dementia at home can make personal care one of the hardest parts of the day. Resistance is common – not because the person doesn’t need care, but because the experience can feel confusing or overwhelming.

The environment matters more than many realize.

Before personal care begins, ask:

• Is the room warm enough?
• Is the lighting soft and calming?
• Is the space quiet and unrushed?

A cold room, harsh lights, or hurried tone can trigger anxiety before care even starts.

Helpful strategies include:

• Keeping routines consistent
• Preparing the space ahead of time
• Using warm towels and comfortable water temperatures
• Offering choices instead of commands
• Explaining steps gently, even if repeated
• Focusing on comfort rather than perfection
• Being mindful of past trauma
• Asking for help before burnout sets in

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Personal Care in Memory Care and Long-Term Care Communities

Families often assume that once a loved one moves into a care community, dignified personal care is guaranteed. Unfortunately, that is not always the case.

In busy environments, care can become task-driven instead of person-centered.

Families can and should:

• Ask how often personal care is provided and documented
• Clarify expectations for grooming, oral care, and clothing changes
• Share lifelong routines, preferences, and sensitivities
• Request care plan meetings when concerns arise
• Speak up when care is missed or rushed

Advocacy is not being difficult.
It is protecting dignity.

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A Message to Memory Care and Long-Term Care Directors

Dignified personal care starts with leadership.

As leaders, we are entrusted with the lives and daily care of some of the most vulnerable people in our society. That entrustment is profound – and it must be taken soberly. Families are not just choosing a building or a program; they are placing their loved ones, and their trust, in our hands.

Staff take their cues from what is taught, modeled, and enforced. It begins with us.

Education matters

• Teach that personal care directly affects health, comfort, and behavior
• Reinforce that emotional awareness often remains long after memory fades
• Help staff understand that rushing or skipping care communicates something powerful

Expectations must be clear

• Define what daily personal care includes
• Set standards for grooming, oral care, clothing, and toileting
• Ensure expectations are written, taught, and reinforced
• Enforce no–cell phone policies during resident care time
• Acknowledge that time spent on personal devices is time taken away from residents who rely entirely on staff for care and dignity

Personal care requires presence. Phones divide attention from residents who need eye contact, patience, and human connection.

Inspiration sustains culture

• Share resident stories and life histories
• Remind staff these are someone’s parent, spouse, or grandparent
• Recognize staff who consistently provide compassionate care

Accountability requires courage

• Address patterns of missed or rushed care
• Coach first, but do not look away
• Understand that accountability is protective, not punitive

Ignoring poor care does not protect staff.
It harms residents.

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A Truth We Must Hold Together

Personal care is one of the clearest reflections of how we value another human being.

When it is rushed or overlooked, something deeper is lost. When it is done with patience and presence, dignity is preserved.

Even in an industry overwhelmed by staffing shortages, regulations, and challenges that can feel insurmountable, we cannot look away from this. The pressures are real – but so is the person standing in front of us, depending on others for care.

People living with dementia are still here. They are still feeling. They are still deserving of care that honors who they are.

The details may seem small – but to someone who depends on others for everything, they are everything.

I was in a memory care community some time ago, doing a sing-along with a group of residents. The piano keys rang out as I played an old familiar waltz — one of those songs that stirs something deep, something that memory loss can’t erase. A woman, maybe in her mid 70s, rose from her seat with a radiant smile and began to sway to the music. Her movements were gentle, full of grace. But within moments, a staff member called out sharply:

“Sit down! You know you’re not supposed to get up like that.”

She wasn’t a significant fall risk. She wasn’t unsafe. She was simply dancing. I watched the smile leave her face. She began to walk around, confused.

A few minutes later, she noticed another resident whose blanket had slipped to the floor. Tenderly, she smiled, picked it up, and began to tuck it around the woman’s shoulders. Again, staff intervened:

“I told you — leave her alone! That’s not your job.”

When she wandered over to the piano with childlike curiosity and joy, eager to be part of the music, she was met with another correction:

“That’s not for you. I told you — go sit down!”

Then came the heartbreak. Her face flushed. She grew agitated. Distressed. Tried to leave the community altogether, setting off the door alarm. The staff labeled it a “behavior.” But I saw something else that broke my heart:
A spirit being chipped away, one “no” at a time.

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What We Hear All the Time — and Why It Hurts

I wish this had been a rare occurrence. Sadly, it isn’t. These kinds of harsh corrections happen every day in memory care communities. You’ve probably heard them too:

• “Stop that!” when a resident tries to push another’s wheelchair out of a desire to help.
  
• “Sit down!” barked at someone who, due to memory loss, doesn’t remember they can no longer walk unassisted.
  
• “Don’t touch that!” when a resident reaches for something that sparks interest or familiarity.
  
• “That’s not yours!” when someone picks up a purse or sweater — because in their mind, it may truly be theirs.
  
• “You already ate!” when someone asks when lunch is — for the third time.
  
• “You live here now, remember?” said to a resident asking to go home.
  

These reactions are often born out of frustration — and sometimes fear — especially when staff feel overwhelmed or unsupported. But they leave behind lasting damage. These aren’t just “corrections.” They are often the cause of distress, agitation, and emotional pain.

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Why Correction Doesn’t Work

Alzheimer’s and other forms of dementia damage the parts of the brain responsible for short-term memory, logic, decision-making, and impulse control. This means:

• They may not remember the “rules” you just told them.
  
• They may not understand your tone or reasoning.
  
• They may not grasp why you’re upset — only that you are.
  

What may look like “noncompliance” or someone “being difficult” is often simply confusion or an unmet need. What appears to be “wandering” might be a search for safety, belonging, or purpose. What we label “attention-seeking” is often a deep desire for connection — to feel seen, useful, and loved.

When we correct, scold, or lecture, we’re not helping them remember.
We’re only making them feel wrong, small, ashamed, and unwanted.

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Stop Correcting. Start Connecting.

Think about how you feel when someone corrects you harshly. Embarrassed? Defensive? It certainly doesn’t create a connection with the person doing the correcting.

We must stop treating people living with dementia like children who need to be managed. They are adults with a lifetime of experience — worthy of honor, dignity, and grace.

Here’s what works instead:

• Take “no” out of your vocabulary. Redirect with kindness. If she wants to dance, let her. If safety is a concern, say, “Let’s do this together.”
  
• Validate first. If he thinks he needs to go to work, don’t say, “You’re retired, remember?” Say, “You’ve always been such a hard worker. They were lucky to have you. Want to tell me about your job?” Then find something meaningful for him to do.
  
• Don’t call it a “behavior” unless it truly is. Getting up, helping others, asking questions — these are human expressions, not problems.
  
• See the need behind the action. Every “behavior” communicates something: loneliness, boredom, pain, fear, or love. Ask yourself: What is this person trying to tell me?
  
• Let go of rigid expectations. Stop demanding that people with dementia sit still, stay quiet, and follow every “rule” we’ve subconsciously created. Life doesn’t end with a diagnosis — why should joy and purpose?

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It Starts With Us

I often think of the signs we hang as decor in our own living rooms — “In our home we are kind, we have fun…”

We need to decide that in our memory care homes, we create a culture of dignity — without exception.

Just because someone has worked in memory care for years doesn’t mean they get to carry forward poor habits. As leaders, we MUST set the standard: This is how we do things here.

Culture change begins with leadership and accountability. It begins when caregivers and staff agree:
In our home, we treat each person as we would want to be treated.

That means:

• A reminder to staff: residents are not children. Even if their abilities regress, they are still adults. 
• .An understanding that the memory care community is their home — not ours. Our role is not to correct, fix, scold, or impose unnecessary restrictions. Our role is to gently guide.
• Acknowledging that correction is stressful — for both the resident and the caregiver. Validation creates a far more peaceful environment.
• Setting — or resetting — expectations. Caregivers must be engaged with the residents during their shift, not scrolling phones while the residents are “parked” in front of the television.
• Modeling dignity and respect for every team member to follow. Remove “no,” “stop that,” and “don’t you remember?” from our vocabulary.
• Speaking up when we witness interactions that aren’t honoring. Mistreatment – including raised voices – is never acceptable.
• Teaching caregivers that there is a better and more dignified way. Instead of “Stop that,” try, “Thank you for your help. I appreciate you.” Then gently redirect.
• Being willing to acknowledge when a caregiver is not a good fit for dementia care, and is unwilling to change poor habits.

As leaders in dementia care we MUST lead the way in creating and maintaining a culture of dignity and honor in our communities. We are entrusted with the precious lives of people who cannot speak up for themselves – and they are depending on us to be their voice. As family members, we must speak, act, and advocate for our loved ones until dignity is the standard, not the exception. Anything less is unacceptable.

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We all want the same thing: a safe, loving, joyful environment where people with dementia are truly living — not just existing.

So let’s start here:

In our home, every person is valued.
In our home, we treat others as we would wish to be treated.
In our home, we don’t say “no” when we could say “yes.”
In our home, we dance.
In our home, we honor.
In our home, our words are kind, never harsh.
In our home, we care with love.

If you’re ready to shift from correcting to truly connecting, we’re here to help you make it happen. Our free staff training, Connecting Instead of Correcting, is designed to equip your team with practical, compassionate strategies that create a calmer, happier, more dignified environment for everyone.

Email mary@dementialife.care for more information.

Shadow Boxes

A shadow box is more than just a collection of items—it’s a window into a person’s most cherished memories. Filled with meaningful keepsakes, photographs, and mementos, it tells the story of a life well-lived and can encourage them to keep going.

For those experiencing memory loss, a shadow box can be a powerful tool. It not only serves as a visual reminder of their past but also enhances their overall well-being and supports meaningful interactions with caregivers and loved ones. Whether your loved one resides in a senior living community or at home, a memory shadow box can make a significant impact in their daily life.

I’ve had the privilege of creating many shadow boxes for Memory Care residents, and I’d love to share what I’ve learned to help you create one for someone special.

Step 1: Gather Information

Before you start, take time to learn about the individual’s life. Using a social profile, life story questionnaire, or personal interviews, gather details about their interests, hobbies, career, favorite places, and important life moments. This will guide you in choosing the most meaningful items to include.

Step 2: Choose a Style

There are two primary approaches to designing a shadow box:

Themed Shadow Box – Center the design around a specific aspect of their life, such as their career, a favorite sports team, a beloved hobby, or a passion they held dear. This creates a cohesive and visually appealing display.

Collage-Style Shadow Box – Incorporate a mix of items from different parts of their life, creating a rich, varied representation of their experiences. This approach highlights multiple parts of their personality and journey.

Step 3: Select Items for the Shadow Box

Once you’ve decided on a style, start gathering meaningful items. Consider including:

Their name (large and visible)

Photographs of family, friends, and significant life moments

Small mementos that hold sentimental value (ticket stubs, medals, fabric swatches, keychains, etc.)

If you’re looking for more items to fit the theme, don’t hesitate to shop for extra pieces that may complement the collection. I’ve found many of the items pictured below at Dollar Tree, Hobby Lobby, and Walmart.

Step 4: Choose the Right Size and Location

The size of the shadow box will depend on where you plan to display it and what you plan to put in it. If your loved one lives in a senior community, check for any guidelines about hanging shadow boxes. The ideal placement is just outside their door—it serves as a helpful visual cue to identify their space and creates an opportunity for engagement with caregivers and visitors.

Shadow boxes can be found online or at craft stores. While you’re there, grab some scrapbooking paper for the background!

Step 5: Assemble the Shadow Box

Now comes the fun part—bringing it all together! Use a hot glue gun or strong adhesive to securely attach each item to the scrapbook paper while keeping everything visible and easy to appreciate. Arrange the pieces thoughtfully, making sure they tell a clear and meaningful story.

In Conclusion

What I love most about creating shadow boxes is the reminder that behind every collection of items is a remarkable person—a person who has lived, loved, and made countless memories. These moments deserve to be honored and remembered, and through shadow boxes, we can help bring those memories to life.

If you’d like a custom shadow box created for your loved one, I’m available to craft a personalized memory box that tells their unique story. Feel free to contact me for more details and pricing information at RachelMattSheehan@gmail.com.

Engaging individuals with dementia is one of my favorite topics to discuss. I’ll never forget my first visit to a memory care facility and the profound impact it had on me. Residents were either sleeping in wheelchairs, slumped at tables with their heads resting on their arms, or staring at blank walls. I remember thinking, “There has to be a better way.”

And there is!

Simply placing an individual in front of a television is not real engagement. While it may seem like the easier option, in the long run, it can make caregiving more difficult.

Engagement—helping someone experience a meaningful and purposeful day—is vital for individuals with dementia. There are many reasons why this is so important:

1. Engagement helps maintain function.
Studies show that engagement in activities can help individuals maintain both cognitive and physical abilities for longer periods. The longer someone with dementia can maintain their abilities, the better it is for both them and their caregivers.

2. Engagement reduces challenging behaviors.
Participating in activities can significantly reduce anxiety and stress, which in turn helps manage challenging behaviors. A person with dementia who is engaged in enjoyable and purposeful activities will be less likely to express difficult behaviors. Coupled with a structured routine and a dementia-aware environment, life becomes much easier for everyone involved.

3. Engagement encourages better rest at night.
When someone is engaged and active throughout the day, they are more likely to have a restful night. The body and mind need the stimulation of meaningful activities during the day to encourage quality sleep.

4. Engagement boosts self-esteem.
When someone is involved in activities they enjoy or feel successful doing, they experience a strong sense of accomplishment and well-being. This can help improve their overall mood and self-esteem.

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Types of Activities to Try

1. Physical Exercise
Exercise should be a daily part of life for someone with dementia, and many activities can be adapted for those in wheelchairs. Here are a few ideas:

• Going for a walk
• Chair exercises (YouTube is a great resource)
• Chair dancing or standing dance
• Chair yoga
• Stretching exercises
• Stationary bike (consult a physician)

2. Cognitive Activities
Just as we work our bodies, we should also exercise our brains. Consider these cognitive activities for your loved one:

• Large-print word search
• Simplified crossword puzzles
• Reading the daily newspaper
• Playing checkers or dominoes
• Playing Uno or “War” with large-print cards
• Reading a book or reading aloud together
• Identifying states on a map
• Playing matching games
• Playing “Finish the Phrase”
• Saying prayers or reading the Bible together

3. Outdoor Activities
Being outside can be very stimulating and enjoyable. Try these:

• Gardening or planting flowers
• Going to a park
• Feeding birds
• Raking leaves
• Watching dogs at a dog park
• Sipping a beverage on the porch
• Tossing a ball or playing cornhole/horseshoes

4. Music and Art
Don’t be afraid to try new activities. A daughter once said, “My dad will never paint – he’s not into that.” But I watched as he created a beautiful sunset painting, completely absorbed in the colors. Here are some other ideas:

• Listening to music
• Playing “Name That Tune”
• Attending a virtual music event together
• Singing
• Painting or coloring
• Taking photos together
• Knitting, crocheting, or rolling yarn
• Creating collage art or making cards
• Making jewelry with large beads

5. Sensory and Personal Care
Engaging the senses can be calming and soothing. Here are a few activities to try:

• Smelling essential oils
• Giving hand massages with lotion
• Doing a “mini-makeover”
• Brushing hair or giving a manicure
• Creating a “rummage box” filled with safe items to explore

6. Purposeful Activities
Involving someone in everyday tasks can make them feel useful and needed. Some activities include:

• Baking or cooking together
• Snapping beans or shucking corn
• Setting the table
• Washing or drying dishes
• Folding laundry
• Sorting socks or buttons
• Shelving books
• Clipping coupons

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Best Practices for Engagement

• Use invitations carefully. Instead of asking “Do you want to?” say “It’s time to…” This can make it easier for someone with dementia to understand and participate, rather than defaulting to “no” because they are unsure. Sometimes, simply starting an activity and inviting them to join can be effective.
• Focus on the experience, not perfection. The goal of any activity is not to do something perfectly, but to have a positive experience. Encourage your loved one to try and praise their efforts, never redoing their work in front of them.
• Keep it short. Limit activities to 20-30 minutes, as this is often the ideal length for someone with dementia.
• Be flexible. If an activity doesn’t work, try something else or try again later. What doesn’t work today might work tomorrow.
• Prioritize safety. Know your loved one’s safety needs. For example, someone who puts non-food items in their mouth should not engage in jewelry making or use modeling clay unsupervised.
• Adapt activities to their abilities. Almost any activity can be modified to suit a person’s abilities. For example, when baking cookies:
  • Early stage: Help set out supplies, read the recipe, or measure ingredients.
  • Middle stage: Pour, stir, or roll dough.
  • Late/end stage: Engage the senses by allowing them to smell, touch, or taste the ingredients.

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By incorporating these activities and strategies into daily life, you can provide individuals with dementia a more engaged, meaningful, and fulfilling experience.