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The Seven Common Senses of Dementia Care - Engagement



This blog post focuses on how people with dementia and their caregivers can stay engaged mentally, physically and socially. It is the fifth installment of a seven-part series on common sense caregiving for people with dementia. The series features seven principles that can improve quality of life for caregivers and their loved ones. R-E-S-P-E-C-T is a helpful mnemonic (memory device) for remembering these tried and true tips:

The Seven Common Senses of Dementia Care

  1. Respect
  2. Enlist help
  3. Safety
  4. Preparation
  5. Engagement
  6. Consistency
  7. Tolerance

The previous installment of this series focused on how to prepare a loved one with dementia for the journey of each day—and beyond. Now it’s time to get up and go. 


People with dementia become less socially, mentally and physically active over the course of their disease. Social withdrawal may occur due to a number of reasons, including apathy, depression and/or loss of abilities. Some people with mild dementia may become socially isolated due to fear or anxiety over how they will be perceived. Let’s look at a couple of examples involving a hypothetical woman named Betty who has Alzheimer’s disease: Scenario #1: Betty develops difficulty keeping track of the cards played during her weekly bridge club and quits going to avoid embarrassment. Scenario #2: Betty and her family tell her bridge partners about her diagnosis and reassure them that she is under medical care. Her friends express gratitude as they had noted some problems but were afraid to say anything. Betty and her family ask her friends to step in if they see her struggling, as stress and frustration are bad for the brain. Her friends find they do have to help her play her hand once in a while. Over the course of a few years, Betty continues to play bridge with gradually increasing assistance from her friends. When Betty develops difficulty driving, a friend arranges to pick her up and drive her to and from the bridge club. In the second scenario, open communication and incremental assistance allow Betty to keep playing bridge, maintaining an important mental and social activity in her life. Similar approaches can be applied to many different activities. Communicating the diagnosis of dementia to close friends and family means they can offer help, understanding and support. It also may allay fears they have about a loved one’s memory loss or other symptoms, as well as reassuring them that their loved one is getting appropriate treatment and medical attention. As dementia progresses, an individual’s needs and abilities change. But change is hard, especially for people with dementia. So those around them should be flexible. Modify activities, increase assistance and provide supervision as needed, letting a person with dementia’s interests and abilities lead the way. Enlist help and delegate responsibility, playing to the strengths of others, in order to reduce caregiver stress. Consider brain therapy (adult day programs) and similar groups for additional support. 

Encouraging a Special Type of Engagement

Physical activity, particularly aerobic exercise, reduces the risk of developing dementia and slows the progression of memory loss in dementia. Moreover, people with dementia and their caregivers have high rates of depression, and exercise is a wonderful anti-depressant. Exercise also involves mental engagement and can be social, too. So exercise is a very special type of engagement for people with dementia and their caregivers. Treat it like any other important appointment: Put it in the calendar. And show up.     

By Anne M. Lipton, M.D., Ph.D. Neurologist and Author of The Common Sense Guide to Dementia For more information on the Seven Common Senses, see Dr. Lipton’s book, The Common Sense Guide to Dementia for Clinicians and Caregivers.

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