Dementia expert urges families to rethink daily routines

Families in Davidson County caring for a parent with dementia may find that standard routines no longer work. Teepa Snow, a nationally recognized dementia care educator and founder of Positive Approach to Care, recently appeared on the program Aging Untold to explain how caregivers can adapt their daily interactions. Snow, an occupational therapist, emphasized that dementia involves a shift in abilities rather than a simple loss of function.

Snow uses the term "brain change" to describe this process. She noted that while some skills fade, others transform. For instance, individuals who never used strong language might begin to swear, or those who rarely asked strangers for help might suddenly approach someone to say they need to get home. Snow explained that neuroplasticity, the brain's ability to reorganize, continues regardless of whether a person has dementia. "So let's use what we have and let's use what they have," Snow said.

When a person with dementia refuses a basic task like showering, Snow advised against forcing the issue. She told gerontologist Sam Cradduck that she would not try to make a parent take a shower. Instead, she suggested asking for help with a much smaller task. In her example, she might point to a smudge on a cheek and ask the person to go to the bathroom, look in the mirror, and try to wipe it off with a washcloth. Another option is asking them to wash their hands before cooking dinner. If the person refuses these smaller steps, a full shower is unlikely to happen at that moment.

Snow also addressed the common use of written reminders, such as sticky notes. She explained that following a written sequence requires the hippocampus, the brain's learning and memory center, to process the information. The front of the brain is responsible for sequencing actions, and both areas are affected by dementia. Because of this, families should recognize that the person likely needs more direct support to complete tasks rather than relying on visual cues.

Snow stressed that both the person with dementia and the caregiver are doing the best they can. She told families that if they want a specific outcome, one of them must change their approach. Since the person with dementia is already experiencing brain change, the caregiver must build new skills and awareness. Snow added that not every family member is suited for hands-on care. "You can be great at organizing care because not every family member is built for this," she said. "I mean, it's hard work."

The educator's advice centers on adjusting expectations and interactions to match the current state of the person's brain. Caregivers are encouraged to look for what is blocking the interaction rather than pushing through resistance. This approach aims to reduce friction in daily life for families managing dementia at home.