6 Things Never to Do When Caring for Someone With Alzheimer’s

Jennifer Fink was driving with her mom one afternoon when her mother asked, “Does my husband know where we are going?” Fink, who was caregiving for her mom with early-onset Alzheimer’s, instinctively responded, “Yes, Mom. Dad knows where we’re going.” But her mom wasn’t satisfied.

When she asked the same question for the fourth time in less than 10 minutes, Fink wasn’t sure she wanted to continue with their outing. 

She put her mom back in the car and walked around. When her hand hit the door handle, realization struck like a lightning bolt: Fink hadn’t actually answered her mom’s question. 

This time, when her mom asked the same thing again, Fink tried something new. “Oh yeah,” she said. “I saw him at the Rotary meeting and told him what we would be doing today.” Her mom didn’t bring up the question again.

“Caregivers sometimes get so frustrated or confused by the symptoms of Alzheimer’s that they think the person is being deliberately difficult, inattentive, or moody,” says Dr. Jason Krellman, associate professor of neuropsychology at Columbia University Irving Medical Center. “Because people with Alzheimer’s can sometimes appear quite normal or do or remember some things well, we might not fully understand their deficits,” he notes. 

This is why it’s important for caregivers to understand what not to do as much as to learn what to do to better support their loved ones.  Here are six key things to avoid when caring for someone with Alzheimer’s.

Don’t Rush Through Communication

People with Alzheimer’s often have difficulty processing conversations and forming responses due to impaired working memory and language difficulties. “Rushing can make them feel inadequate or dismissed,” says Michelle Mintz, CCC-SLP, a California-based speech pathologist. So, avoid interrupting or finishing their sentences. 

Instead, speak slowly using simple words. And give them the time and space to respond in their own way, Mintz suggests. Repeat information calmly when necessary to help them feel less overwhelmed. 

Don’t Overstimulate Their Environment

“A cluttered or noisy environment can be overwhelming and confusing for someone with Alzheimer’s,” says Mintz. This means no loud music, crowded spaces, scattered stuff, or too many simultaneous conversations. 

Instead, Mintz suggests simplifying their surroundings to create a calm, predictable environment that reduces stress and promotes focus. It’s also important to keep a consistent schedule as much as possible.

Don’t Ignore Their Emotional Needs

People with Alzheimer’s still experience emotions, even if they can’t always express them. “Dismissing their feelings or neglecting to provide comfort can lead to loneliness and distress,” says Mintz. 

So, always acknowledge their emotions, even if their words don’t make sense. Reassure them with phrases like “I’m here to help” to build trust, suggests Mintz. Also, try to engage them in conversations and activities that bring them joy. 

Don’t Try To “Fix” Their Memory

While it can be tempting to try and jog their memory, prompting or quizzing them about things they can’t recall can be a frustrating and, in some cases, painful experience.

Similarly, if they get some details wrong, arguing or contradicting them can be counterproductive. In fact, “it’s very likely that people with more advanced disease will forget the argument even happened within a short time,” says Dr. Krellman. 

Focus on the present moment instead and meet them where they are. Gently remind them only what’s helpful for them to know rather than every detail. “Your goal isn’t to win an argument or force them into our reality—it’s to reduce their anxiety and help them feel secure,” says Nancy Treaster, certified caregiving consultant and co-host of The Caregiver’s Journey podcast. 

Don’t Take Their Behavior Personally

In addition to thinking and memory problems, Alzheimer’s may cause behavioral changes like irritability, aggression, or withdrawal that can be difficult for caregivers. “It’s crucial to remember that these behaviors are symptoms of the disease, not intentional actions against you,” says Mintz.

To help de-escalate the situation, avoid arguing and try not to show frustration. Mintz suggests gently redirecting their attention elsewhere by bringing up a story or an activity they find comforting. 

Don’t Talk About Them Where They Might Overhear

Never talk about them within earshot as if they’re not there. “Even when it seems they’re not following the conversation, they may be understanding more than we realize,” says Treaster. 

It’s best to save sensitive conversations about their care or condition for another time and place, she suggests. 

Effective Communication Strategies

Alzheimer’s affects different people differently, so it’s essential to choose communication techniques that are right for your loved one. Here are a few tips that may help: 

• Keep it simple: Mintz suggests using short, clear sentences, focusing on one idea at a time. Ask yes-or-no or either-or questions, like “Would you like tea or water?” instead of open-ended questions like “What do you want?”
• Use non-verbal cues: “People with dementia often mirror the facial expressions they see. A warm, happy approach usually leads to a warm, happy response,” says Treaster. She suggests speaking warmly, getting at their eye level to maintain eye contact, and wearing a reassuring smile. 
• Approach from the front: Avoid sudden movements and approaching from behind as it may startle them. Also, identify yourself if needed, suggests Fink.
• Add visuals: Support your words with gestures or pictures if verbal instructions are unclear, says Mintz. For example, if asking them to get dressed, gently pat the clothes and say, “Let’s put these clothes on.” Treaster suggests using visual prompts like sticky notes if it’s early in their journey. For example, “I would leave a sticky note on the refrigerator letting my husband know his lunch was in there. These prompts helped him maintain his independence and feel accomplished,” she shares.
• Use positive reinforcement: “Even something as simple as brushing teeth deserves enthusiastic praise,” says Treaster. If they seem confused, use positive reinforcement to gently guide them and appreciate their effort. For example, instead of saying, “Why aren’t you using the soap?” say, “Excellent job using the soap!” This creates a positive, less scary environment, adds Treaster.
• Match their words: It also helps to answer the same question with the exact same worded response. “If you ask me what I did today, and I told you I went to the gym, then you asked again, and I told you I went to the Rotary meeting, you might be confused for a second until you piece together that I did one then the other. People with cognitive diseases can’t do that. I learned that one too late,” Fink shares.

The key is to constantly observe and adjust your communication style accordingly. What works today might not tomorrow, says Treaster. 

Bottom Line

Caregiving is tough, sometimes even overwhelming. By using mindful communication techniques and avoiding common missteps, caregivers can create a safe and supportive environment that reduces frustration and eases the journey for everyone involved.