How do you tell a person with dementia that they are moving? A compassionate guide

According to the Alzheimer's Association, over 6 million Americans are living with Alzheimer's dementia, and family caregivers often face monumental decisions regarding living arrangements. When the time comes, knowing how do you tell a person with dementia that they are moving is crucial for their emotional well-being and a smoother transition.

Quick Summary

Telling a person with dementia about a move requires careful planning, empathy, and consistent communication, often by focusing on feelings of safety rather than logical explanations. Frame the move positively and involve them in comforting choices to ease anxiety and manage the emotional turbulence of transition.

Key Points

• Timing is Critical: Announce the move closer to the date for mid-to-late stage dementia to avoid prolonged anxiety, or discuss it gradually for early stages [1, 3].

• Frame it Positively: Focus on feelings of safety and reassurance rather than rationalizing the need for the move, which can be confusing and distressing [1, 3].

• Use Consistent Messaging: All family members should use simple, consistent language to avoid confusing your loved one with conflicting information [1, 3, 5].

• Create Familiarity: Personalize the new space with beloved photos, furniture, and objects to provide a sense of security and continuity [1, 3].

• Validate Feelings and Redirect: Acknowledge your loved one's anxieties and fears, then gently redirect their attention to calming activities rather than arguing or correcting them [1, 5].

• Prioritize Self-Care: Caregivers must be patient with themselves and their loved one, seeking support from others to manage the emotional demands of the transition [1, 3].

Approaching the Conversation with Empathy and Planning

For a person with dementia, change can be incredibly disorienting and frightening. The familiar environment is a source of security, and the prospect of a move can trigger anxiety, confusion, and resistance [1]. Therefore, the approach is more important than the words themselves. Careful planning and a strategy rooted in compassion can make a profound difference in the outcome of this difficult conversation [3].

Timing the Announcement

The optimal timing for informing a loved one about a move varies depending on the stage of their dementia [3]. Giving too much notice to someone with mid-to-late stage dementia can cause prolonged anxiety [1]. Many experts suggest informing them closer to the move date, perhaps just a day or two before, when their ability to process and retain information is significantly impaired [1]. For individuals in the earlier stages who can still understand and remember, a more gradual conversation about the reasons for the move, framed positively, might be appropriate, though repetition and managing anxiety will still be necessary [3].

Crafting the Right Message

When discussing the move, the message should be tailored to the individual's cognitive abilities [3]. Avoid detailed, complex explanations that can be overwhelming [1, 4]. Instead, focus on simple, positive, and reassuring statements [1].

• Use clear, calm language [1, 5].
• Maintain gentle eye contact and a warm, reassuring tone [5].
• If they become agitated, pause and revisit the conversation later [1, 5].

Practical Communication Strategies

Non-verbal communication and visual aids can significantly help in communicating with someone with dementia about a move [4].

Use Visual Aids and Familiarity

Visual tools can help make the abstract concept of moving more understandable and less frightening [3, 4].

• Photo Collages: Create collages featuring the new space and familiar items that will be present [3].
• Memory Books: These can include pictures of the new community and family, serving as a comforting tool [3].
• Video Tours: If possible, show them a video of the new location [3].

The Power of Compassionate Deception

Sometimes, a gentle, compassionate deception may be the kindest approach, particularly for those in late-stage dementia who cannot process difficult truths without significant distress [1, 2].

• Instead of explaining they can no longer live at home, you might say you are going on a trip or a short stay at a new place [1].
• If they ask to go home, redirect them to a happy memory or a calming activity [1].

The Dos and Don'ts of Discussing the Move

Do	Don't
Emphasize Feelings of Safety [1]	Use Blame or Accusations [1]
Frame it as a Positive Change [3]	Focus on Logical Reasons [1]
Use Simple, Short Phrases [1, 5]	Provide Overwhelming Detail [1]
Validate Their Feelings [1]	Contradict or Argue with Them [1]
Involve Them in Simple Choices [1]	Give Them Complex Choices [1]
Use Familiar Items for Comfort [1, 3]	Introduce Too Many New Things at Once [1]

Preparing the Environment for a Smooth Transition

Preparation involves making the new space feel as familiar and comfortable as possible to minimize disorientation [1, 3].

1. Pack Intentionally: Pack essentials first, prioritizing familiar items like bedding, photos, and furniture to help the new space feel recognizable [1, 3].
2. Move the Big Items Early: Having major furniture like their bed and favorite chair in place before they arrive helps create instant familiarity [3].
3. Decorate with Familiarity: Arrange the room similarly to their old one and include personal touches like family photos [1, 3].
4. Create a Sensory Connection: Bring items that appeal to their senses, such as a favorite scent or music [3].

Managing the Emotional Aftermath

Adjustment to a new environment can be challenging for individuals with dementia, often involving confusion and anxiety [1, 2]. Caregiver support is vital during this period.

Be a Constant, Reassuring Presence

Your presence is a powerful source of comfort and reassurance [1].

• Maintain regular visits and communication [1].
• Use gentle touch for comfort [1].

Practice Redirection

Redirection is an effective strategy when your loved one becomes distressed or agitated [1].

• Shift their focus to a pleasant activity or simple task [1].
• Avoid dwelling on the source of their anxiety [1].

Patience and Self-Care

The moving process is stressful for everyone involved [1, 3]. Be patient with yourself and your loved one, and seek support for your own emotional well-being [1]. Remember the move was made for their safety and care [1, 3]. For more information and resources on supporting a loved one with dementia through major changes, visit the Alzheimer's Association.

Conclusion: A Journey of Compassion and Care

Informing a person with dementia about a move is a deeply personal and challenging process with no single perfect approach [1, 3]. The key is to prioritize compassion, minimize distress, and tailor your communication and preparation to the individual's needs and stage of dementia [1, 3]. Focusing on reassurance, using simple language, and creating a familiar new environment can help ease this significant transition for both your loved one and your family [1, 3, 5].

Frequently Asked Questions

When is the best time of day to have this conversation?

The best time is often in the morning or early afternoon when the person is typically most alert and before the potential onset of 'sundowning,' a period of increased confusion and anxiety common in late afternoons and evenings [1].

How do you tell a person with dementia that they are moving if they are resistant?

If they are resistant, avoid arguing or reasoning with them. Acknowledge their feelings ('I understand this is hard') and gently pivot the conversation or activity. Depending on the stage, you may need to use compassionate deception, framing the move as a short trip or a new opportunity [1, 2].

Should we involve them in the packing process?

For most people with dementia, especially in mid-to-late stages, involvement in packing can cause overwhelming stress. It's often best to handle most packing discreetly, focusing instead on having them choose a few favorite items to bring along [1].

What if they keep asking to go home after the move?

Repeatedly asking to go home is common. Respond with reassurance and redirect their attention. Avoid stating that this is their new permanent home, as this can cause more distress. Instead, say something reassuring like, 'You are safe here,' or 'Let's have some tea.' [1]

How can familiar items help with the transition?

Familiar items, such as photos, a favorite blanket, or furniture, provide a crucial link to their past and offer a sense of security and comfort in an unfamiliar place. They can reduce disorientation and provide a positive focal point [1, 3].

Is it better to move the person when they are not present?

In many cases, especially for those with later-stage dementia, moving the person when they are not present can reduce the stress and chaos of the moving process. The new, pre-arranged environment can feel more calming upon arrival [3].

What is Relocation Stress Syndrome?

Relocation Stress Syndrome (RSS) is a cluster of symptoms, including confusion, anxiety, and depression, that can occur when a person with dementia moves to a new environment. A compassionate, prepared move can help mitigate this [1, 2].