Elder Care Advisor: Expert Advice for Dementia Caregivers

The Caring Generation®—Episode 255, October 7, 2026.  Elder care advisor Pamela D. Wilson offers basic caregiving tips and advice for caregivers of loved ones with dementia. Wilson shares how family caregivers can learn how to slow down, be present, and shift from fact-based conversations to emotional and daily support for spouses and aging parents with advancing memory loss.

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Dementia Care Basics: Expert Advice for Family Caregivers

Dementia care basics are concepts for caregivers of aging parents and spouses with dementia that make daily care activities easier. Shifting from fact-based, logical conversations to actions that offer comfort, emotional support, and validation can smooth out the rough edges and learning curve of dementia care.

In this article, podcast, and video presentation, family caregivers will learn four tips and reminders from caregiving expert and elder care advisor Pamela D. Wilson.

The Slow-Paced World of Dementia

Today’s world is fast-paced and logic-driven, focused on reasoning, judgment, arguments, and opinions. Convincing others or motivating them to take a certain action may be the focus in the workplace.

However, in the world of dementia, none of these skills work. Dementia care is routine, methodical, and slow-paced.

This means that caregivers for spouses, aging parents, grandparents, and others must learn new ways to care for and communicate when stress and anxiety feel overwhelming.

Shifting away from logic, being right, and speaking in few words can be challenging for outspoken, enthusiastic people who express themselves through emotions and words.

A patient, calm, and non-rushed approach can deliver more positive experiences when caring for an anxious loved one with dementia.

Decisions Drive Logical Actions

Wilson confirms that caregivers and families struggle to decide the right time and next steps to care for a parent with dementia. These decisions may include when to hire in-home caregivers, when a parent should move to a community, or when to obtain a formal dementia diagnosis.

According to elder care advisor Pamela D. Wilson, caregivers in her 1:1 virtual eldercare consultations often ask, “What should I be telling my parent? How should I explain XYZ?”

Part of the answer depends on what information a parent can understand and mentally process. When diagnosed early, parents can actively participate in decisions about their future care.

Early diagnosis allows parents to complete estate planning and legal documents that describe every wish to guide the actions of the power of attorney agent, trustee, or personal representative. Yet, an early diagnosis does not always happen.

As memory loss progresses, a husband, wife, mom, or dad may be only able to process limited information. Many family members wonder why simple things become difficult for loved ones with dementia.

So how do you talk to a parent, spouse, grandparent, or friend with advanced dementia?

Wilson’s response is always, “with a calm and kind tone of voice, and in the simplest and fewest words possible.”

Short and Sweet Conversations Can Be Challenging

For people who love to talk, explain, or debate the facts, a short sentence and waiting for a response may be difficult. Patience is important.

As dementia advances, multiple words and lengthy explanations frustrate, confuse, and agitate a person with dementia. Mom or dad may understand the first couple of words said, and the rest of the sentence is lost.

Here are four basic tips dementia caregivers can consider using in everyday interactions with loved ones with dementia.

1 Shifting focus from facts to growing emotional intelligence

Forget about what you believe to be true, the need for lengthy explanations, negotiating, or the use of logic.

Work on gaining emotional intelligence so that you can empathize and respond appropriately by managing your emotions as you notice and understand your loved one’s dementia-related actions and emotional state.

If you need support making this mental and verbal shift, a consultation with an elder care advisor can offer solutions.

There’s Nothing Wrong With My Clothes

Here’s an example of a difference of fact.

Dad believes he just showered and changed clothes when, much to your frustration, it’s been days. He is wearing dirty clothes.

• While you want to take Dad out of the house to run errands or for an activity, you’re embarrassed to take him anywhere.
• You also worry that anyone visiting will question your ability to properly care for your parent.
• You’ve tried every explanation and used reasoning; you’ve pleaded, and still there’s no action or agreement.
• Nothing you do is working.

Hiring a Caregiver

If your Mom or Dad still live alone, a complicating factor might be that you’re not with your parent when they go to bed and change into pajamas, or you’re not there when your parent gets up in the morning.

Sometimes hiring a caregiver helps with care refusals and navigating the logistics of changing clothes, bathing, and eating. In-home caregiver costs can vary. Make sure to do your homework. 

One suggestion is to lay out night clothes on the bed and lay out new clothes for the morning. This might require that you or another person, perhaps a paid caregiver, is in the home in the morning or evening. During the change of clothes, remove the worn clothing and lay out clean clothing for the next day or bedtime.

Test it out and see if it works. If so, and one parent is the caregiver, ask Mom or Dad to follow the process you tested, or assign this task to a paid in-home caregiver.

Simplifying Daily Routines

Simplifying and creating daily routines benefit loved ones with memory loss and can reduce care refusals. 

If your parent likes wearing the same clothes, buy duplicates of the same color or style to make clothing changes easy and non-confrontational.

Reduce clutter in closets, dressers, and everywhere else. The fewer choices, the better. Clutter equals more confusion and frustration.

Some individuals with dementia have hoarding tendencies, or their home becomes cluttered because of the loss of organizational skills.

You might see clutter everywhere: on the kitchen table, in a spare bedroom, on the clothes dresser, or on the stove.

Rather than believing that a loved one with dementia is being purposefully difficult when they refuse to change clothes, take medications, eat, or remove clutter, understand that the environment matters.

In some cases, decluttering a home can require taking the parent out of the home to complete the cleanout. Having them stay for the process can result in high levels of anxiety.

People and Environmental Factors

Persons with dementia cannot rationalize refusals as purposeful. They’re more likely reacting to outside influences. For example,

• The demeanor of the person trying to get them to do a task, including their facial expressions, tone of voice, or emotional expression.
• Background noise, too many people, and too many distractions can result in sensory overload.
• Feeling rushed or pressured can result in anxious outbursts.

The average person lives in a world where there’s never enough time. Thoughts run a mile a minute. With a dementia diagnosis, the brain needs more time to process information.

Rushing or pressuring a person with dementia is certain to result in an emotional reaction or outburst. So it’s best for caregivers to make a short request and wait 30 to 60 seconds for a response. If that doesn’t work, wait 10 minutes and try again.

If you’re rushing a person with dementia, your time frame and personal approach may be the problem.

If you disagree or force them, your reality and expectations are the problem. Their reality is that life moves at their own pace. Caregivers must accept this as fact and adjust accordingly. Caring for an anxious elderly mother can be highly stressful for a son or daughter.

Additionally, if they think their mom or dad is alive or dead, this is their fact. Do not correct them.

There’s no point in being right. You don’t win this one; they do. You cannot change their reality.

2 Be Comforting Instead of Confrontational

If your loved one knows they have memory loss, they may become increasingly afraid or paranoid, especially at night. These feelings are normal for a person who feels they are losing control of their life.

They may frequently lose or misplace items. Tell a parent that you’ll help them find the wallet or purse they lost.

Look in places where you know they hide things. Sometimes this might be a dresser drawer or under a pillow on their bed.

If the car is missing because you removed it, state that you will report it lost or stolen in the morning. Then change the subject.

There can also be times when a loved one with dementia is trying to communicate, and you have absolutely no idea what they saying. This type of communication is called word salad.

Encourage Participation

On the prior topic of encouraging a parent to participate in an activity, rather than saying it’s time to bathe, eat, or take medications, lead into the action and encourage participation.

If medication refusals or managing medications is difficult, request permission from the doctor to crush meds. Mix them in a cup of pudding or applesauce. Use a medication organizer.

Hand them the cup of pudding and place a spoon in their hand. Sit and eat with them so they don’t feel like they’re doing the activity alone.

It’s the same for a walk. Take their hand. Say, “Time for a walk,” and lead them out the door.

Make simple comments like, “It’s a beautiful day, look at the birds, I enjoy walking with you.” Encourage and express appreciation for their participation.

Walking is good for everyone. It can reduce stress and anxiety, slow time, and keep the mind focused on the present moment.

A walk, when done as an activity for a loved one with dementia, can maintain physical abilities and prevent weakness or balance issues.

3 Let a Person with Dementia Be Happy in Their Place and Time

Aging parents and spouses with advancing dementia mentally live in a different place and time. Pamela D. Wilson, elder care advisor, recommends responding positively to repetitive actions. For example:

• Does your spouse or parent spend every morning rearranging the clothing in their closet and dresser every day?
• Do they pack and unpack a suitcase because they’re going on a trip?
• Does Dad tell you he has to get up and go to work?
• Are they worried about getting home from school to have dinner with Mom and Dad?

Instead of correcting a spouse or parent, or arguing, acknowledge what they’re saying.

If rearranging clothing, say, “Thank you for putting away your clothes. I appreciate your help.” Give them a hug.

Or, say, “Let’s have breakfast before your trip or before you go to work.” Reassure them that they will be home in time for dinner with Mom and Dad.

You can also redirect them by asking what they liked about work, asking them to share a favorite travel location, or describing a favorite dish Mom cooked.

Offering a daily routine with regular activities helps manage anxiety, boredom, or frustration.

A calming routine is especially important in the late afternoon when sundowning and an increase in behaviors or anxiety happen. Less light can result in heightened anxiety, pacing, verbal repetition, or other behaviors that indicate discomfort or fear.

If your parent with dementia doesn’t have a hobby or a daily activity, help them find one.

Maybe it’s a simple coloring book for mom. Give dad a woodworking or mechanical project to tinker with. Showing them how to play simple games or listen to music on a tablet can be a positive experience that can last for hours.

I Don’t Have Dementia

Taking a step back. Early on, if your parent says, “I don’t have Alzheimer’s or I don’t have dementia,” there’s no point in arguing.

If there is a medical diagnosis of dementia, there is a diagnosis. The challenge of a parent accepting the diagnosis can vary. Yet getting a dementia diagnosis is critical. 

• Perhaps memory loss has progressed to the point where they will disagree with any information they don’t want to hear.
• One of Wilson’s clients had a mother who reacted badly to anything she believed to be bad news.
• Alternatively, a parent or spouse may have no way of realizing they are forgetful because this realization requires logical thought—a skill the brain can no longer perform.

As time passes, a loved one with memory loss lives life one minute and eventually one second at a time. This can be a blessing if there is something you want them to forget.

Care Advice for the Elderly and Their Caregivers | Pamela D Wilson Elder Care Advisor

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4 If You Are the Guardian or POA, Stop Agonizing Over Difficult Decisions

If your parent completed an estate plan before a dementia diagnosis or early in the process, you have a guiding document for their wishes. If not, and you are the guardian or conservator, then you can follow the principle of substituted judgment.

Elder care advisor and caregiving expert Pamela D. Wilson confirms that “while family members accept legal roles, many do not understand the responsibilities that come with these roles. I most often see this when families engage in litigation.”

For example

• If you are a durable medical or financial power of attorney, as long as your parent has decision-making capacity, you do not have legal power to take over their life and start making decisions for them.
• At the time there is suspicion that a person with dementia has more difficulty with memory, executive function, or completing organizational tasks, a geriatric, neurological, or neuropsychological examination can confirm the degree of memory loss through testing.
• Once a physician, neurologist, or neuropsychologist confirms that decision-making power and comprehension are seriously impaired, the power of attorney agent can begin making decisions, if the power of attorney document includes this direction.

Not all power of attorney documents include provisions for incapacity, prevailing power of attorney, guardianship, or conservatorship.

Taking the Car Away

One common example that caregivers or a power of attorney agent struggle with is taking the car away when Mom or Dad is no longer safe to drive.

Maybe Dad has had accidents and become lost – multiple times. You’re worried he will injure himself, or worse, harm another driver, a child playing in the street, or a person in a crosswalk.

At this point, it’s not about trying to get mom or dad to understand that they are dangerous behind the wheel of a car. A parent with dementia driving a vehicle is a risk to themselves and others. End of story.

Remove or disable the car.

Tell dad it’s been sold or the insurance company won’t issue a policy.

Choose the story that makes you feel the most comfortable and is least upsetting to your parent.

Not making difficult decisions also carries risks.

In the case of taking away the car, if you, as the power of attorney agent, know that your parent has dementia and there are medical tests and a diagnosis in their medical records, you have a duty to end driving privileges.

If dad continues to drive and others are injured or property is damaged, your parent can be sued, and you, as the legally responsible party, can become a party to the lawsuit.

Allowing your parent to do something you know is risky, with a medical diagnosis of dementia, can result in a claim of failing to use reasonable care that caused harm to someone else. Power of attorney agents have a fiduciary duty of care to the person that appointed them.

Time to Move

If living at home isn’t practical anymore, then it may be time to move Mom or Dad to a memory care community or a nursing home. If they can’t understand, don’t ask them. Don’t tell them. Make it happen.

For example, say “let’s go for a ride.” When you arrive, have lunch and go to their room. Say, “This is your new home. You’ll be staying here.”

Have all of their clothes and personal belongings set up before this visit. Add familiar items like family photos.

Most of all, be prepared for Mom or Dad to tell you they want to go home with you. This is common.

How many of you remember the first day at kindergarten?  This is similar, except many years later and under different circumstances.

While many caregivers don’t like the idea of not providing detailed explanations or rationale, or involving a parent in decisions in the hope they understand, sometimes that isn’t possible.

If a loved one can understand, offer the information and then wait for them to ask questions. Beyond a single mention, don’t repeat information that may frustrate or frighten them.

Document Your Actions

If you are concerned that other people, family members, or others will question your decision-making, then make daily notes about conversations, what was discussed, etc. Record conversations with permission if that makes you feel better and safer.

Wilson relates her experience as a care manager, fiduciary, and elder care advisor:

“When I was a care manager, guardian, conservator, and trustee, I documented every phone call, email, and meeting. For transparency and accountability, I submitted all records of the activities my staff or I performed. When I was the legal appointee, notes were submitted with invoices and court reports.”

If you are a power of attorney, guardian, conservator, or trustee, keep detailed records for transparency.

Not all family members make the effort. Sometimes keeping records is not an issue. Other times it is.

Lack of documentation can be a major problem when another family member files a lawsuit, claiming that a person is not fulfilling their power of attorney, guardian, conservator, or trustee duties.

Wilson’s experience as an elder care advisor confirms, “There’s no need to put yourself in an uncomfortable or stressful legal situation. Gain an understanding of the legal role, responsibilities, and obligations of acting within the scope of the position. Record keeping is the best way to document what happened and protect yourself when questioned.”

Return to the Basics

By considering these four basic dementia care tips and suggestions, caregivers can shift from focusing on facts, expectations, reasoning, logic, and being right to helping a loved one live a comfortable, happy, and well-cared-for life.

If you’re looking for dementia care support, eldercare advice, or information about family care meetings, schedule a 1:1 or family virtual consultation with Pamela D Wilson, elder care advisor and caregiving expert.

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