Tips for Families Visiting Dementia Residents

My Grandma Lily lived for several years in a nursing home, and toward the end of her life she became quite confused. While this was disturbing to me and the rest of the family, I found when I changed my approach and expectations of our time together, our visits were more successful. Between that experience, my training as a psychologist, and my work in nursing homes, I’d like to offer some suggestions of what might be helpful to others in their visits with residents with dementia. If you have additional tips that have worked for you, please add them to the comments section.

Post family photographs, with labels that indicate the names and relationships of those pictured. It will serve as a reminder for your family member, and enable the nursing home staff to reinforce connections. I filled an inexpensive multi-photo frame with pictures, wrote the names on the mat between the photos, and hung it in a spot my grandmother could see from her bed.

Put a calendar on the wall and log your visits to help your loved one remember when you were last there, and when you’re planning to return.

Create a sign in book for guests, so your relative can review it after you’ve left. Add details (“Shared a pizza.” “Talked about the time we went to the circus.”) to refresh memories and to allow other callers to pick up the thread of conversations.

Leave other visible reminders of your visit — flowers, balloons, cards, photos, etc.

Turn off the TV, close the door, and minimize background noises during your time together.

Sit in chairs and on the bed so that you’re at the eye level of your seated relative. One family I know brought in small folding chairs, labeled them, and tucked them in a corner when not in use.

Use visual cues such as photo albums and small keepsakes during conversations.

Sing songs, listen to music, and dance, if possible. I used to exercise with one lady in the nursing home, running an individualized stretch class with her following along. She was very good at it, and I believe it helped her stay on her feet longer than she might have otherwise.

Go outside and share the sunshine, the breeze, and the respite from bells and buzzers.

Ask questions you know your loved one can answer, and don’t ask those your relative cannot. The goal is to provide a “success experience.” Not being able to respond correctly to a question once easily answered can be frustrating and/or embarrassing for someone with dementia, and upsetting for those visiting.

Redirect, rather than contradict, if your relative insists that something is true when you know it’s not. For example, I once woke Grandma Lily up from a nap and she said, “Eleanor, what are you doing here in the middle of the night?”
“But Grandma, it’s the middle of the afternoon,” I told her as I opened her window curtains. “See, it’s still light outside.”
“Oh, it’s always like that this time of year!” she told me.
Seeing I wouldn’t win that argument, I shifted the discussion to another topic, and I’ve savored the humor of that moment for years.

Let go of expectations. While Grandma Lily wasn’t the same person she used to be, she still had a lot of the same general characteristics (for instance, all visits had to include food), and she was glad to see me, even if she didn’t always know who I was.

14 thoughts on “Tips for Families Visiting Dementia Residents”

  1. All your suggestions are great, I would just like to emphasize the importance of asking questions a person can answer. I have witnessed families drilling their relative on seemingly pointless facts which they were obviously unable, and disturbed at being unable, to answer. Also, it is generally not a good idea to approach somebody with dementia with "Do you remember…"

  2. Sue, I've heard those conversations too. It can be painful for family members to realize their loved one no longer recalls important people and events, and hard to let go of the urge to "help" them remember. Rather than discussing mutually shared past experiences, it's more effective when families focus on the feelings and encounters in the present moment.

  3. Thank you so much. As my eyes water thinking of my mother who is in assisted living, your blog inspired me. I will share with family and friends. She is thankfully chipper most of the time, yet batty and confused too and after a year more settled in her new residence.

    What do you know about bladder control medications helping to facilitate dementia? My brother read about it and we think that is the source of mothers decline. An avid walker, reader with a voracious appetite for fruits and veggies she tanked at about 86 but kept walking uptown until she went to assisted care.

    I've bookmarked your blog. Thanks again.

    India Watkins

  4. Thanks, India, for your comments, and for sharing my blog. If you're mother is able to, going for walks with her sounds like a great idea.

    Regarding the medication issue, that's a question best answered by her medical doctor. It might be helpful to give him or her a copy of the article your brother read, if the doctor is the kind of person who seems receptive to that type of approach. Families are an important part of the care team, providing crucial information such as, "Mother was fine until she started that bladder control medication." The assisted living or nursing home staff don't know what your parent was like before she arrived, so it's easy for us to assume that the level of dementia she's presenting with now has been an ongoing situation.

  5. Thank you for this timely post. My Mother-in-law did not know us at all on our last visit, so these are suggestions that we can use right away. I'll let you know how they worked for us, next visit.


  6. Mary, please do let us know how your visit is with your Mother-in-law. I hope some of the suggestions prove helpful.

  7. Any tips for when you don't know if the dementia is temporary or permanent? My father recently experienced urinary sepsis and acute kidney failure due to an enlarged prostate. He has been in a skilled nursing facility for almost a month. In the beginning, he seemed to be getting better, but now he seems to be getting more confused and also paranoid. He doesn't remember people who've visited, thinks there are trip wires on the floor, etc. He really wants to come home, but my mother works full-time, so he needs to be able to stay home alone during the day. It's just difficult at this point to figure out whether being in the facility is helping or hurting.

  8. AOS, as a family member, you're a very important member of the treatment team and can provide information needed to make the best decisions for your father. For example, if your father never exhibited confusion and paranoia prior to entry into the nursing home, or if his symptoms appear much worse, the staff need your observations because they don't know what he was like before he arrived at the nursing home. I would start by telling the daytime charge nurse on his floor. The social worker is also likely to be a good resource because you're wondering about discharge planning issues. Your questions are good: Is this temporary or permanent dementia? Why do they think this is happening? Is there anything they can do to address the symptoms? Do they think your father can manage at home? If so, what assistance can be provided for him? If needed, you can request a team meeting to discuss all these concerns.

  9. Hi Dr. El!

    We found out that my mom has been sick. We're not sure if it is dementia or Alzheimer's because we haven't visited her. Today, she's now staying in one of the retirement communities, Pennsylvania-based. We'd only knew her condition yesterday, when my cousin phoned us. I felt guilty inside because for almost 2 years I haven't visited our home. Jodi told us that we shouldn't worry much because most retirement communities in PA have skilled nurses who give proper care for patients like my mom. I hope my mom still recognizes me when I visit her tomorrow. I'll try to follow your tips, I hope it will work.

  10. Thanks for visiting, Doris. Care plan meetings, when members from many departments of the nursing home get together to discuss the care of the resident, is the single most important time for a family member to be at the nursing home. Family members can ask questions and provide essential information, and decisions about how to progress are written into the care plan. Once decisions about care are written down, they are far more likely to be followed than when decisions are made via a discussion with one staff member at the nursing station.


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