The 10 Commandments: Caring for Someone with Memory Loss

Caring for a loved one with memory loss can be a challenging journey, but it can also be filled with moments of profound connection and love. Paula Harder, Vice President of Resident Programs, recommends following what she calls "The 10 Commandments for Caring for Someone with Memory Loss." Throughout her many years of helping families navigate this difficult situation, she's found these strategies and reminders consistently help alleviate many of the unpredictable challenges caregivers experience.

1. Expressions (Behaviors) are communication. Frequent or repetitive expressions, or behaviors, may indicate an individual with memory loss is trying to tell us something or solve a problem on their own. These actions could be a sign of an unmet need. For example, constant pacing or wandering might mean the individual is searching for a restroom. If you are noticing a frequent or recurring expression, we recommend identifying if there are any unmet needs such as hunger, pain, thirst, or exhaustion.
2. Situational awareness is your superhero 6th sense. When caring for someone with memory loss, it is crucial to prioritize self-awareness for your own safety. You must keep an eye on the individual and work around them, so you remain safe during interactions. Additionally, be mindful of the entire space around you and the person you are caring for, so you don't mistakenly put them in harms way. For example, if you ask the individual to sit down, be sure the seat is available at that moment. Also, be sure the space is free of potential hazards such as glass objects, makeup, and cleaning products.
3. Your loved one is perfectly normal, we are not. It is important to remind yourself that the person you are caring for is reacting normally to the situation at hand, and you must adjust accordingly. For example, assisting individuals with showering can be uncomfortable, even for someone with memory loss. Try to imagine how the situation would feel for a person without memory loss.
4. We cause 90% of expressions in memory loss. Caregivers play a crucial role in an individual's life, as they are the ones who are closest to them. It's important to acknowledge that our actions and interactions can greatly influence their reactions and behaviors. For example, when someone with memory loss experiences a sense of withdrawal, it may be because they no longer have access to the things and activities that used to bring them joy. By carefully observing their needs and desires, we can better understand what they may be missing and provide the necessary support.
5. No means no, and no is not an option. If the person you are caring for says no, it is important to respect their decision. Take the time to understand their reasons for resistance and try again later. Conversely, caregivers should avoid saying no. Instead of saying "no" to a request to walk along a busy road, offer some alternatives to do first. For instance, you can suggest taking a break to enjoy some refreshing tea. Use this opportunity to introduce additional items or activities that can redirect their thoughts, but still align with their desires. This approach allows you to find a creative solution that meets their needs without outright denying their requests.
6. Stop, challenge, and choose. Caring for someone with memory loss entails significant responsibility that rests entirely on the caregiver's shoulders. It is crucial to adapt your responses accordingly. When faced with a challenging situation, take a moment to reflect: What is happening? How can I best address it? By asking these questions, you can better understand the individual's needs and provide the best possible solution.
7. Mind the Dementia Box. Similar to the concept of "thinking outside the box," the dementia box refers to the conventional or easiest approaches to managing expressions. Thinking inside the dementia box involves immediately resorting to medical interventions for something as simple as pacing. It is important to keep an open mind and consider a wide range of solutions through trial and error. This flexibility and willingness to explore alternatives could make a huge difference in supporting someone with memory loss.
8. One face, one voice. A single voice keeps conversations with someone with memory loss more accessible. Ensure there is only one person speaking and interacting with them. If you need assistance with helping a person with memory loss, have the second person stand behind you. This way, the individual with memory loss can focus on one face, making it easier for them to engage and communicate if needed.
9. If youve met one person with memory loss, youve met one person with memory loss. There are no "one size fits all" solutions for mediating expressions in someone with memory loss. When advising other caregivers on dealing with challenging expressions, it is crucial to emphasize this key point. This underscores the importance of adopting a personalized approach and finding the most effective response for each specific situation.
10. Attitude and language are EVERYTHING. When interacting with someone who has memory loss, it is important to be aware of our own emotions in the moment. Instead of trying to manage their reaction to negativity, it's much easier to adjust our attitude beforehand. Take a deep breath and give yourself a break before interacting with them if necessary. Clear and compassionate communication is highly valuable. Use direct and simple instructions, always opting for positive language.

When taking care of someone with memory loss, there will be challenging moments. Memory care is an ongoing journey, so as a caregiver, it is crucial to stay flexible while providing consistent emotional support. Even though it may be tough at times, there are also moments of joy and fun to be shared. Download our 10 Commandments for Caring for Someone with Memory loss here.

If you are struggling to care for your loved one with memory loss on your own, take a look at these signs your loved one may need additional support or click the button below to take our free, anonymous assessment. We've partnered with a research firm to help families determine the appropriate level of support for their loved ones. The answer to this may look different for everyone, but our hope is that this assessment and guidance will be helpful for families to find the right fit for them. 

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