Caring for Someone With Alzheimer’s: What Actually Helps (And What Doesn’t)

Your dad just asked where his mother is. She’s been gone for 20 years.

Your mother introduced you to the neighbor as “a nice young woman”—you’re her daughter.

Your spouse keeps trying to leave the house to “go to work” at a job they retired from a decade ago.

Caring for someone with Alzheimer’s is heartbreaking. You watch someone you love disappear piece by piece — their memories, their personality, their ability to recognize your face.

And unlike caring for someone with a physical illness, Alzheimer’s doesn’t follow a predictable script. One day, they’re lucid and engaged. Next, they don’t know who you are.

More than 6.9 million Americans are living with Alzheimer’s disease — and that number is expected to double by 2050. Behind each one of those statistics is a family struggling to provide care, navigate confusion, and preserve dignity while grieving someone who’s still alive.

This article won’t sugarcoat the challenges. But it will give you practical, evidence-based strategies that make daily caregiving easier — for both you and your loved one.

Understanding What You’re Up Against

Alzheimer’s disease is a progressive, degenerative brain disorder that destroys memory, thinking skills, and eventually the ability to carry out the simplest tasks.

It’s not just memory loss. Alzheimer’s changes personality, disrupts sleep, causes anxiety and paranoia, and gradually strips away the ability to communicate, eat, walk, and recognize loved ones.

The Stages of Alzheimer’s (What to Expect)

Early Stage (Mild Alzheimer’s)

• Misplaces items frequently
• Struggles to find the right words
• Forgets recent conversations or events
• Has trouble planning or organizing
• Gets lost in familiar places
• Withdraws from social activities

What this means for caregivers: Your loved one can still function independently in many areas, but needs help with complex tasks (managing finances, medications, appointments).

Middle Stage (Moderate Alzheimer’s)

This is the longest and most demanding stage for caregivers.

• Cannot remember their own address or phone number
• Gets confused about where they are or what day/year it is
• Needs help choosing appropriate clothing
• Has trouble controlling bladder or bowels
• Changes in sleep patterns (sleeping during the day, wandering at night)
• Personality and behavioral changes (suspicion, delusions, repetitive behaviors)
• Wandering and getting lost

What this means for caregivers: Full-time supervision becomes necessary. Your loved one needs help with daily activities but may resist assistance.

Late Stage (Severe Alzheimer’s)

• Cannot communicate coherently
• Needs help with all personal care (eating, dressing, bathing, toileting)
• Loses awareness of surroundings
• Experiences significant physical decline (difficulty walking, sitting, swallowing)
• Becomes vulnerable to infections, especially pneumonia

What this means for caregivers: Round-the-clock care is essential. The focus shifts from maintaining independence to ensuring comfort and dignity.

The Emotional Toll on Caregivers (You’re Not Weak If This Is Hard)

Caring for someone with Alzheimer’s is among the most stressful caregiving experiences because:

You’re grieving while they’re still alive. The person you knew is disappearing, but you can’t fully mourn because they’re still physically present.

Nothing you do is “enough.” No amount of care will stop the disease’s progression.

They may not recognize your sacrifice. In fact, they might accuse you of stealing, lash out at you, or forget who you are entirely.

There’s no break. Alzheimer’s doesn’t pause. The needs are constant and escalating.

You lose your own identity. You become “the caregiver” rather than a spouse, child, or friend.

Common emotions caregivers experience:

• Profound sadness and grief
• Frustration and anger (at the disease, at the situation, sometimes at the person)
• Guilt (for feeling angry, for considering placement, for not being “enough”)
• Loneliness and isolation
• Anxiety about the future
• Physical and emotional exhaustion

This is all normal. And it’s why caregiver support, respite care, and eventually professional help aren’t luxuries — they’re necessities.

12 Evidence-Based Strategies That Actually Help

1. Simplify Communication (They’re Not Being Difficult — Their Brain Is Damaged)

Alzheimer’s damages the brain’s language centers. Your loved one struggles to:

• Find the right words
• Follow complex sentences
• Process multiple pieces of information at once
• Understand abstract concepts or jokes

What doesn’t work:

• “Do you remember when we went to Hawaii?”
• “What do you want for lunch?”
• “Did you take your medication this morning?”

What does work:

✓ Use simple, concrete language:

• “Here is your coffee” (not “here it is”)
• “Let’s put on your blue sweater” (not “do you want to get dressed?”)
• “The bathroom is here” (not “do you need to use the bathroom?”)

✓ Ask yes/no questions instead of open-ended ones:

• “Would you like eggs?” (not “what do you want for breakfast?”)
• “Are you cold?” (not “how do you feel?”)

✓ Give one instruction at a time:

• “Please sit down.” [wait] “Now put your arms in the sleeves.” [wait] “Good, now I’ll button it.”

✓ Use gestures along with words:

• Point to the object you’re talking about
• Demonstrate what you want them to do
• Use a gentle touch to guide them

✓ Avoid negatives (don’t, can’t, won’t):

• “Walk slowly” (not “don’t walk so fast”)
• “Sit here” (not “don’t sit there”)

✓ Eliminate slang and idioms:

• “Let’s get started” (not “let’s hop to it”)
• “We’re almost done” (not “let’s wrap it up”)

2. Stop Correcting Their Reality (Enter Their World Instead)

Your loved one thinks their deceased mother is coming to visit. Do you:

A) Remind them she died 15 years ago
B) Say, “Tell me about your mother.”

The answer is B.

Here’s why correcting them is cruel:

• They’ll forget the correction within minutes
• You’ll have to break the devastating news over and over
• It causes confusion, distress, and sometimes agitation
• It damages the trust between you

“Therapeutic lying” or “validation therapy” is more compassionate:

They say: “I need to go pick up the kids from school.”
You say: “Tell me about your children. What are they like?”

They say: “Where’s my mother? She’s supposed to be here.”
You say: “You must miss her. What was she like?”

They say: “I have to go to work.”
You say: “You worked so hard. Tell me about your job.”

You’re not lying to manipulate them. You’re meeting them in their current reality — which is just as real to them as yours is to you.

3. Create Structured Routines (Predictability Reduces Anxiety)

Alzheimer’s patients feel constantly disoriented. Everything is confusing and unfamiliar. Routines create islands of predictability in a sea of chaos.

Establish consistent daily patterns:

• Wake up at the same time
• Meals at the same time
• Bathing at the same time
• Activities at the same time
• Bedtime at the same time

Why this works:

• Reduces anxiety (“I don’t know what’s happening”)
• Decreases resistance (the routine becomes familiar even when memory fails)
• Helps maintain remaining skills longer
• Makes caregiving more manageable (you know what to expect)

Sample daily routine:

4. Plan Meaningful Activities (Not Busy Work)

Alzheimer’s patients still need purpose, engagement, and the feeling of contribution. Sitting in front of the TV all day accelerates decline and increases depression.

Choose activities based on:

• What they enjoyed in the past
• What they can still do successfully
• What provides a sense of accomplishment

Good activities for early/middle-stage Alzheimer’s:

✓ Music — Singing, listening to favorite songs, playing simple instruments (music memory lasts longest)

✓ Looking at photo albums — Especially photos from their youth (long-term memories remain intact longer)

✓ Folding laundry or sorting items — Provides a sense of helping and accomplishment

✓ Simple cooking tasks — Washing vegetables, stirring, tearing lettuce (with supervision)

✓ Gardening — Watering plants, pulling weeds, digging in soil (calming, sensory)

✓ Walking — Daily walks reduce agitation, improve sleep, and maintain mobility

✓ Art projects — Coloring, painting, clay (process matters more than outcome)

✓ Pet interaction — Petting a dog or cat provides comfort and connection

Avoid:

• Quizzing or testing (“Do you remember this?”)
• Activities that highlight losses (“You used to be so good at this”)
• Overly complex tasks that cause frustration

5. Manage Mealtimes (Nutrition Becomes Surprisingly Difficult)

Alzheimer’s patients often:

• Forget they’re hungry
• Forget they already ate (and ask for food constantly)
• Lose interest in food
• Struggle to use utensils
• Get overwhelmed by choices
• Become distracted during meals
• Develop strong preferences for sweets (taste buds change)

Strategies that help:

✓ Serve meals at the same time every day (routine reduces confusion)

✓ Eliminate distractions — Turn off TV, remove clutter from the table, minimize noise

✓ Offer finger foods if utensils become difficult — Chicken strips, cheese cubes, carrot sticks, sandwiches cut into quarters

✓ Use contrasting colors — White food on a white plate is hard to see. Use colored plates.

✓ Simplify the table — One item at a time. Too many dishes confuse.

✓ Serve one course at a time — Salad, then main dish, then dessert (not all at once)

✓ Accommodate sweet preferences with nutritious options:

• Smoothies with fruit and Greek yogurt
• Sweet potatoes or yams
• Oatmeal with cinnamon and bananas
• Yogurt with honey

✓ Offer high-calorie, nutrient-dense foods if appetite is poor — Avocado, nut butters, full-fat dairy, protein shakes

✓ Prompt eating gently:

• “Take a bite of chicken” (while pointing)
• Demonstrate by eating with them
• Guide hand to mouth if needed

6. Minimize Environmental Confusion

Alzheimer’s patients struggle to process sensory information. Too much noise, clutter, or activity overwhelms them and triggers agitation.

Create a calm environment:

✓ Reduce noise — Turn off TV/radio during conversations or activities

✓ Declutter — Remove excess furniture, decorations, and visual chaos

✓ Improve lighting — Shadows and dim areas cause confusion and hallucinations

✓ Remove mirrors (in later stages) — They may not recognize themselves and think a stranger is in the house

✓ Simplify choices — Limit clothing options to 2-3 outfits

✓ Use labels with pictures — Label drawers, bathroom, bedroom with words AND images

7. Manage Sundowning (Late Afternoon/Evening Agitation)

“Sundowning” = increased confusion, anxiety, and agitation in late afternoon and evening.

Why does it happen:

• Fatigue from the day’s activities
• Disrupted circadian rhythms
• Hunger or thirst
• Shadows and dim lighting cause visual confusion
• Overstimulation during the day

How to reduce it:

✓ Maintain a consistent routine (especially afternoon/evening)

✓ Avoid late-day appointments or activities

✓ Ensure adequate daytime light exposure (helps regulate sleep/wake cycle)

✓ Keep evenings calm and predictable — Same dinner time, same routine

✓ Turn on lights before it gets dark (shadows trigger confusion)

✓ Offer a snack (hunger worsens agitation)

✓ Provide reassurance — Speak calmly, use gentle touch

8. Handle Repetitive Questions Without Losing Your Mind

“When is mom coming home?” (for the 50th time today)

Why do they repeat:

• They don’t remember asking
• The answer doesn’t register
• They’re anxious and seeking reassurance

What doesn’t work:

• “I just told you!”
• Answering the same way every time (it won’t satisfy them)

What does work:

✓ Address the emotion, not the question:

• “You miss her, don’t you? Tell me about her.”

✓ Redirect to an activity:

• “Let’s look at some photos together.”

✓ Write the answer down and point to it:

• “Mom will be home at 5:00” (on a note card they can see)

9. Prepare for Wandering (It’s Dangerous and Common)

60% of Alzheimer’s patients wander. They get lost, disoriented, and are at high risk of injury.

Why they wander:

• Searching for something or someone from the past
• Restless energy with no outlet
• Following old routines (“going to work”)
• Trying to “go home” (even when they’re already home)

Safety strategies:

✓ Install locks out of sight (top or bottom of door)

✓ Use door alarms (alerts when the door opens)

✓ Keep car keys hidden

✓ Ensure they wear an ID bracelet with name, “memory impaired,” and contact number

✓ Register with MedicAlert + Alzheimer’s Association Safe Return program

✓ Inform neighbors about the situation and ask them to call if they see your loved one alone

✓ Take recent photos (for search purposes if they go missing)

✓ Increase daytime activity (physical exercise reduces restlessness)

10. Don’t Take Aggression or Accusations Personally (This Is the Disease)

Your loved one may:

• Accuse you of stealing
• Insist you’re an imposter
• Hit, pinch, or scratch
• Scream or curse
• Refuse care

Why does this happen?

• Brain damage affects impulse control and emotional regulation
• They’re frightened and confused
• They feel threatened by care tasks (bathing, dressing)
• They’re in pain but can’t communicate it
• Medications cause agitation

How to respond:

✓ Don’t argue or defend yourself (they won’t remember, and it escalates conflict)

✓ Stay calm (your stress increases their stress)

✓ Step back (give them space)

✓ Identify triggers:

• Is it a specific task? (Bathing often triggers fear)
• Time of day? (sundowning)
• Caregiver? (Sometimes they respond better to different people)
• Pain or discomfort?

✓ Distract and redirect:

• Change the subject
• Offer a snack
• Move to a different room
• Try again later

✓ Consult the doctor if aggression is severe or sudden (may indicate pain, infection, or a medication issue)

11. Preserve Dignity (They’re Still a Person)

Alzheimer’s steals memory and cognitive function. Don’t let it steal dignity, too.

✓ Include them in conversations (even if they can’t fully participate)

✓ Ask permission before touching or moving them

✓ Provide privacy during personal care tasks

✓ Let them make choices when possible (even small ones like “red shirt or blue?”)

✓ Avoid baby talk (speak respectfully, not condescendingly)

✓ Don’t talk about them as if they’re not there

✓ Respect their emotions (if they’re sad, angry, or scared, those feelings are real)

12. Take Care of Yourself (You Can’t Pour From an Empty Cup)

Alzheimer’s caregivers have:

• Higher rates of depression and anxiety than any other type of caregiver
• Increased risk of chronic illness
• Weakened immune systems
• Higher mortality rates

You are at risk. This is not sustainable in the long term without support.

Non-negotiable self-care:

✓ Accept help — Let people bring meals, run errands, sit with your loved one

✓ Use respite care — Adult day programs, in-home caregivers, temporary facility placement

✓ Join a support group — Alzheimer’s Association hosts free groups online and in-person

✓ See a therapist — You’re experiencing anticipatory grief, exhaustion, and trauma

✓ Maintain your health — Doctor appointments, exercise, sleep

✓ Set boundaries — You don’t have to do this alone 24/7

✓ Plan for the future — Eventually, facility placement may become necessary (this is not failure)

When Professional Help Becomes Necessary

There is no shame in needing help. Alzheimer’s caregiving is a full-time job that escalates into round-the-clock nursing care.

Consider professional in-home care when:

• You’re physically or emotionally exhausted
• Your loved one needs supervision you can’t provide
• Behavioral issues are beyond your ability to manage safely
• You have work or other family obligations
• Your own health is suffering

Consider memory care facility placement when:

• Wandering creates safety risks you can’t manage
• Aggression puts you or them at risk
• Incontinence and personal care needs exceed your ability
• You’re no longer able to provide adequate supervision
• Your physical or mental health is failing

This is not abandonment. This helps ensure they receive appropriate care while preserving your health and your relationship with them.

How Professional Alzheimer’s Caregivers Help

At All Heart Home Care, our caregivers receive specialized training in dementia and Alzheimer’s care. We understand the disease, the behaviors, and the heartbreak.

What Our Alzheimer’s-Trained Caregivers Provide:

✓ Compassionate companionship — Reducing isolation and providing emotional support

✓ Structured daily routines — Creating predictability that reduces anxiety

✓ Meaningful activities — Music, reminiscence, gentle exercise, sensory engagement

✓ Assistance with personal care — Bathing, dressing, grooming, toileting (with dignity and patience)

✓ Meal preparation and feeding support — Ensuring adequate nutrition despite eating challenges

✓ Medication reminders — Monitoring compliance with prescribed treatments

✓ Safety supervision — Preventing wandering, falls, and other hazards

✓ Communication support — Using validation techniques and person-centered approaches

✓ Behavioral management — De-escalating agitation, redirecting effectively

✓ Respite for family caregivers — Giving you time to rest, work, or breathe

Most importantly, we give you your relationship back.

Instead of being the person who battles them over bathing or forces medications, you get to be the daughter, son, or spouse who sits and holds their hand.

You Don’t Have to Do This Alone

Alzheimer’s caregiving is one of the hardest things you’ll ever do. The person you love is disappearing. The responsibilities are endless. The grief is profound.

But you don’t have to carry this alone.

At All Heart Home Care, we’ve walked alongside hundreds of San Diego families through the Alzheimer’s journey. We provide the skilled, compassionate support that makes it possible to keep your loved one at home safely — while preserving your own health and wellbeing.

If you’re exhausted, overwhelmed, or need help — call us at (619) 736-4677 for a free in-home consultation.

We’ll assess your loved one’s needs, create a personalized care plan, and provide caregivers explicitly trained in Alzheimer’s and dementia care.

Because caring for someone with Alzheimer’s takes a village. Let us be part of yours.

Resources

• Alzheimer’s Association 24/7 Helpline: 800-272-3900
• Alzheimer’s San Diego: alzsd.org
• MedicAlert + Safe Return: alz.org/help-support/caregiving/stages-behaviors/wandering
• Caregiver support groups: alz.org/help-support/resources/care-training-resources

Quick Caregiver Checklist

☐ Simplify communication (concrete language, one instruction at a time)

☐ Don’t correct their reality (validate emotions, redirect)

☐ Establish daily routines (same schedule every day)

☐ Plan meaningful activities (music, walks, simple tasks)

☐ Manage mealtimes (eliminate distractions, finger foods, one course at a time)

☐ Reduce environmental confusion (calm, uncluttered, well-lit)

☐ Prepare for sundowning (structured evenings, lights on early)

☐ Safety-proof for wandering (locks, alarms, ID bracelet)

☐ Don’t take aggression personally (stay calm, identify triggers)

☐ Preserve dignity (respectful communication, maintain privacy)

☐ Take care of yourself (respite care, support groups, therapy)

☐ Ask for help (professional care isn’t failure — it’s wisdom)