Nobody told you there was more than one kind of dementia, did they? You got a diagnosis, a pamphlet, and a “good luck.” Then you tried the tips everyone swears by, and your person with dementia got more upset, not less.
So you figured you were doing it wrong. Oh, friend. You weren’t. You were handed one key and told it opens every door.
Here’s the secret nobody put in the pamphlet: dementia isn’t one disease. It’s an umbrella, and underneath it are different types that break different parts of the brain. The exact sentence that calms one type can set off another. Once you know which type you’re living with, this whole thing gets easier.
First, the move that works on all of them
Validate, empathize, redirect. Their reality is real to them, so meet them there. Name the feeling out loud. Then gently steer toward something warm, using one of the five senses and something that matters to them. Their music, not yours. That’s why one song from when they were twenty can bring a whole person back into the room.
And the three things that backfire every time: arguing, reasoning, and quizzing. We’ve all done all three, me included. It comes from love. It just doesn’t work, and it wears you both out.
Now, meet the four types.
Alzheimer’s: the save button is broken
This is the one everybody’s heard of. New memories simply don’t get saved. The old ones, from decades ago, are often still in there and doing fine. So the same question really is brand new every time, and sometimes it’s 1974 in their world and Mom should be home any minute.
What helps: less is more. Two options instead of open questions (“Soup or a sandwich?” is kinder to their brain than “What do you want for lunch?”). Live in the old years with them, that door is still wide open. And a kindlet (a small, kind untruth that protects their heart) is often the loving choice here, when the truth would only wound them on a loop.
Vascular: some rooms lost power, some are still lit
This one comes from blood flow problems in the brain, often little strokes. Picture a house where a few rooms went dark but the rest still have the lights on. Here’s the part that will break your heart: they often know. “I should know this” is a sentence you’ll hear, and they mean it.
That also means the Alzheimer’s playbook can backfire. They may catch you in a made up answer, and that costs trust. Honesty and patience are your best friends here. And that flat, won’t start anything look? That’s not laziness. Starting is the part of the brain that lost power. So you might start things together: “I could really use your help. Will you match these towels with me?”
Lewy body and Parkinson’s: the brain runs its own movie projector
With this type, they may see people and things you can’t. Calmly. Like it’s just a fact. “There are people in my closet.”
Whatever you do, resist saying “nobody’s there.” Telling them it isn’t real doesn’t remove the people. It removes you from the list of people they trust. Instead, get curious: “You see people in your closet? Are they being nice to you?” Because the real question is, is it scaring them, or is it scaring me? If she’s happily watching children play in the hallway, you get to leave it be. She has company. If it’s scary, fix it inside their world: “Let’s go tell them it’s time to go home.”
Also, give them time to answer you. Their processing speed is dial up internet, and the rest of us are on wifi. And if strange things show up suddenly, it’s worth a call to the doctor. UTIs are notorious little troublemakers.
Frontotemporal: the filter quit first
This one hits the front of the brain first, which is where the manners live. Memory can be totally fine while the filter is long gone. So you may get the blunt comment, out loud, in public, with zero apology after.
Please try not to take it personally. The part of the brain that would have softened it is gone, and it was never about you. What helps: two choices, never corrections. Make things their idea. And when you need to redirect around other people, do it privately. Dignity still lives here.
The bottom line
The same move that’s perfect for one type can blow up with another. A kindlet is fine for Alzheimer’s and backfires with Lewy body. That’s not you failing. That’s four different diseases wearing one name. Know the dementia, then choose the tool.
You won’t get it right every time. Twenty years in, I still blow it some days. But the fact that you’re here, learning, says everything about your heart.
Want the full toolbox for your person’s type?
My Art of Dementia Communication training walks through all four types with scripts and practice, and it lives inside Joanna’s Care Club, along with all 14 of my dementia trainings unlocked on day one, a live training plus Q&A with me every month, every replay, and a community of caregivers who get it.
➡️ Join Joanna’s Care Club here.
💜 Joanna
gdmaine7” gmail.com