When Logic Stops Working: Responding Differently to Dementia

Caring for someone living with dementia can feel like navigating a world in which the rules keep changing.

A response that worked yesterday may not work today. A simple request to get dressed, take medication or have a shower can suddenly result in refusal, anger or distress. The same question may be asked repeatedly and attempts to explain or correct the situation can make everyone more upset.

As both a carer and a coach, I have learned that we cannot always change the situation, but we can change the way we respond to it.

My mother lived with vascular dementia, and my father is now living with mixed dementia. This means I understand these challenges professionally and personally. I know how difficult it can be to remain calm when you are tired, worried and repeating yourself for what feels like the hundredth time.

There is no perfect script for dementia care. Every person, diagnosis and day can be different. However, there are alternative ways of responding that may help reduce distress and protect the dignity of everyone involved.

Look beyond the behaviour

When someone refuses help or becomes angry, it is easy to see only the behaviour.

But behaviour is often a form of communication.

The person may be frightened, confused, embarrassed, uncomfortable or in pain. They may not understand what is being asked of them or recognise the person trying to help.

Instead of asking, “Why are they being difficult?”, we can ask:

“What might they be trying to communicate?”

That small change encourages us to become curious rather than confrontational.

As a coach, one of my skills is helping people pause, step back and consider a situation from another perspective. In dementia care, that pause can prevent a difficult moment from escalating.

When someone refuses personal care

If a person refuses to wash, shower or change their clothes, repeatedly insisting may make them feel threatened.

Imagine not fully understanding where you are, why someone is asking you to undress or why they are entering your personal space. Resistance suddenly becomes understandable.

An alternative response might be to stop, offer reassurance and try again later. You could offer a choice:

“Would you like to wash before or after breakfast?”

“Would you prefer the blue towel or the yellow one?”

Choices should be simple. Too many options can become overwhelming, but two familiar alternatives can restore a sense of control.

Sometimes changing the person providing the care, warming the room, playing familiar music or breaking the task into smaller stages can also help.

When the same question is repeated

Repeated questions can be exhausting for carers. However, the person asking may have no memory of receiving the answer.

Correcting them or saying, “I’ve already told you,” may cause embarrassment without preventing the question from being asked again.

It can help to listen for the emotion beneath the words.

“Where are we going?” might really mean, “Am I safe?”

“When are you coming back?” may mean, “I’m frightened of being left alone.”

A reassuring response could be:

“You’re safe. I’m here with you.”

A written note, clock, calendar or familiar routine may help, depending on the individual. Sometimes distraction with a drink, favourite song, photograph or simple activity can gently move the moment forward.

When someone wants to “go home”

A person living with dementia may ask to go home even when they are already there.

Explaining this repeatedly can lead to an argument because their experience feels completely real to them.

“Home” may represent safety, family or an earlier time in their life.

Instead of correcting them, we might respond to the feeling:

“You’re missing home. Tell me what you loved about it.”

“What would help you feel more comfortable?”

This is not about being dishonest. It is about entering their emotional reality and helping them feel heard.

When emotions are running high

When someone is distressed, long explanations and logical arguments may be difficult for them to process.

A calm tone, fewer words and gentle reassurance may be more effective.

But carers have emotions too.

If you feel yourself becoming overwhelmed, and the person is safe, it is acceptable to step away briefly. Take a breath, have a drink of water and begin again.

One difficult interaction does not make you a bad carer. It makes you human.

Coaching is not about telling carers that they must always remain calm or positive. It is about helping them recognise triggers, explore different responses and find practical approaches that work for their family.

Planning can also reduce future distress

Dementia support is not only about responding to today’s crisis. It is also about preparing for the future.

While someone has the relevant mental capacity, conversations can take place about their wishes, care preferences, finances and the people they trust to help them.

Lasting Powers of Attorney for Property and Financial Affairs and for Health and Welfare can provide clarity if decisions later need to be made on their behalf.

A dementia diagnosis does not automatically mean that someone lacks capacity. Capacity is specific to the particular decision and the time it needs to be made. However, planning early gives the person a voice and can reduce uncertainty and family conflict later.

My experience as a coach, carer and estate planner allows me to look at the whole picture: the emotional pressures, the practical challenges and the importance of planning ahead.

Sometimes families do not need another person telling them what they are doing wrong.

They need someone who listens without judgement, understands how exhausting caring can be and helps them discover another way forward.

Because changing our response may not change dementia, but it can change the moment.

This article provides general information for England and Wales. It is not personalised legal, financial, medical or care advice. Appropriate arrangements depend on individual circumstances and should be reviewed as those circumstances change.