BY THE OPTIMIST DAILY EDITORIAL TEAM

Dementia is something that touches more and more families every year. Globally, someone develops dementia every three seconds. In the U.S. alone, more than 6 million people live with some form of the condition, and that number is expected to double by 2060. Even if you haven’t yet supported someone through dementia, chances are high that you will at some point.

But beyond the memory challenges or difficulty completing daily tasks, dementia can feel especially painful because of something less visible: the gradual erosion of identity. Social stigma often paints people with dementia as incapable or “no longer themselves.” These assumptions can leave those living with dementia feeling isolated and unseen.

The good news is that everyday interactions can make a profound difference. As researcher R. Amanda Cooper, who studies family caregiving and communication, explains, “Supporting self-worth for people who have dementia is often done through daily conversations.” And with intention, those conversations can preserve dignity, confidence, and connection.

Understanding dementia beyond the symptoms

Dementia is not one single disease but an umbrella term for conditions that affect memory, thinking, communication, and daily functioning. Alzheimer’s is the most widely known form, but there are others that present differently. Many forms are progressive, meaning symptoms shift over time.

In the early stages, a person may still engage in their hobbies, relationships, and routines. As dementia progresses, they may need help with daily tasks, and communication may become more difficult. In later stages, verbal communication may fade, but connection does not.

Importantly, research shows that even when spoken language becomes limited, people with dementia continue to pick up on tone of voice, facial expressions, and touch. Gestures, warmth, and presence still reach them.

Centering care around the person, not the condition

In the 1990s, psychologist Tom Kitwood introduced the concept of personhood in dementia care, which is the idea that each person has unique worth, identity, and emotional needs that must be honored, regardless of their cognitive changes.

Kitwood identified five elements that support personhood:

Comfort: 

Comfort goes beyond managing physical symptoms. It includes creating an environment where your loved one feels safe, soothed, and emotionally supported. This might mean adjusting lighting or noise, offering gentle reassurance, practicing patience during moments of confusion, and ensuring that pain or discomfort is acknowledged rather than overlooked.

Attachment: 

Meaningful relationships are central to every human life, and dementia does not change that. Maintaining strong, loving bonds can ground your loved one and help them feel protected. Familiar faces, consistent caregivers, shared jokes, and routines all reinforce a sense of belonging, reminding them that they are held and valued.

Inclusion: 

Inclusion means more than simply being nearby. It’s ensuring that the person remains part of social life and daily activities rather than being spoken over, spoken for, or left out. Inviting them to join conversations, family gatherings, or small shared moments preserves dignity and combats isolation.

Occupation: 

Occupation refers to engaging in activities that feel meaningful and familiar. These do not need to be complex. Think folding laundry, listening to favorite music, gardening, arranging flowers, coloring, singing, or helping prepare a meal. These all provide purpose and rhythm. Meaningful engagement maintains a sense of usefulness and autonomy.

Identity: 

Identity acknowledges the person behind the diagnosis; their history, values, accomplishments, personality, preferences, and dreams. Continuously recognizing who they are (and have been) helps sustain self-worth, even when memory fades. Calling them by name, reminiscing together, displaying cherished photos, and honoring their routines all reinforce their enduring identity.

Cooper notes that communication is at the heart of all five. The way we talk to and about someone shapes how valued they feel.

Communication strategies that support dignity and connection

Research has identified several helpful practices for supporting personhood in daily interactions:

Create a supportive communication environment.

• Sit close and at eye level.
• Keep the environment as calm as possible.
• Use gentle gestures and eye contact.

Honor their history and identity.

• Use their name.
• Invite shared reminiscing about meaningful life moments.
• Acknowledge strengths, accomplishments, and personality traits.

Validate emotions rather than correcting facts.

• If something said isn’t accurate, avoid directly challenging it.
• Instead, respond to the emotion underneath.

Include them in decisions whenever possible.

• Offer simple choices (“Would you like tea or water?”).
• Ask permission before offering physical help.

Use prompts to support conversation, not control it.

• Rephrase questions.
• Give plenty of time to respond.
• Offer gentle cues if needed.

Keep connection at the center.

• Hug, hold hands, smile.
• Share music, art, or simple games.
• Laugh together whenever you can.

Small changes can nurture deep emotional safety.

Adapting communication as the disease progresses

One of Cooper’s studies found that communication needs shift over time. For example, asking “Do you remember?” may feel affirming in early stages, but later on, it can feel like an unwanted test. Conversely, offering word prompts may feel helpful later on, but patronizing earlier.

The key is to adjust your approach as your loved one’s abilities change. Too much assistance can cause frustration. Too little can create confusion.

Think of it as finding the communication sweet spot, or meeting your loved one exactly where they are today.

Connection remains, even when words fade

Our instinct may be to focus on what dementia takes away. But what remains is just as important. People living with dementia continue to experience love, joy, humor, and meaning.

The most supportive thing you can do is continue seeing and treating your loved one as the person they have always been.

Your presence, patience, and warmth matter more than perfect phrasing.

Meaningful connection is still possible. And every shared moment of dignity strengthens it.