Working with Dementia
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.
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.
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.
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?
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.
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.
