Alzheimer’s Caregiving: When to Step In and When to Step Back

If someone you love has Alzheimer’s disease, it can be an automatic response to step in and take over a task in the belief that it is safer or easier or that you are helping to avoid a potential embarrassment for the person. However, taking over tasks that they are actually capable of completing on their own can reduce their feelings of independence and self-worth. In this tip sheet, we are addressing tasks related to daily living.

Tips and Insight on How to Help While Promoting Independence
  • Focus on doing things “with” rather than “for” the person.
  • Observe and assess actual needs through interaction and observation, rather than what is believed the person needs. Assessing the situation can help you to identify and resolve problems and understand what is happening from the care recipient’s perspective. When observing, consider the following:
    • Are there visual or audible distractions that are causing confusion or agitation?
    • Are the mechanics of the task proving too difficult? What part of the task?
    • What is the emotional climate in the room?
    • Is the light too low or too bright?
    • Are there too many choices?
    • Is taste or smell an issue?
  • Do not assume that the person cannot complete the task. Gauge their actual abilities first and be patient. If it takes longer or is more complicated than if you were to do it, what does that matter? Time to complete a task should not be a requirement.
  • Sometimes you may just need to help get the task started, and then they can take it over on their own or you can help with a small part of the task. And, if they forget mid-stream what they are doing, use visual clues to get back on track (calmly and lovingly).
  • Break up a larger task such as preparing a meal or getting dressed into smaller, more manageable tasks that the person can accomplish with your verbal prompts. Even though the large task of making the meal or putting on all of the clothing may seem unmanageable, the person may be capable of doing individual tasks, step by step, and oftentimes with gentle prompting, not rushing the process.
  • If the person seems confused about what to do, use “body memories” which are sensory prompts to help them start or complete an activity. Handing the person a fork at mealtime may prompt them to begin eating. Giving them a toothbrush with toothpaste on it in front of the sink may prompt them to brush their teeth. Putting a hairbrush in their hand and guiding their hand may prompt them to brush their hair.
  • Non-verbal communication is very important. Use a “watch me” technique where you demonstrate the activity first and then let the person try it. If, at any time in any task there is agitation, step away from it and finish it later.
  • Adaptation is a regular, recurring part of living with someone who has Alzheimer’s. Adapt activities to fit within a framework of the person’s abilities, finding a way that allows the person to do the activity without feeling like they are a child who can’t be trusted. There is a respectful balance between promoting independence and ensuring well-being.
  • It can be frustrating watching something being done slowly when you could do it quicker and easier yourself. But even if the person is struggling with a task, be patient, and avoid the temptation to take over. If you do, they may lose confidence and withdraw from engaging. Take breaks if necessary. Get away from the care responsibilities if patience is being tested and wearing thin.
  • Speak in a way that you would find helpful if you were in their position, and above all, do not forget to offer praise, reassurance, tender touch and encouragement for attempting or completing a task.

Reminding yourself regularly to assess whether you can “take a step back” when caring for a loved one with dementia may be difficult at times, but is essential to maximize the person’s independence for as long as possible. To learn more about the best techniques for caring for a loved one with dementia, contact CareWorks Health Services. Our caregivers are professionally trained in providing compassionate care for persons with dementia and essential support for family caregivers who need time to care for themselves.

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