What Should Dementia Patients Avoid? A Comprehensive Guide for Caregivers

According to the CDC, approximately 80% of people with dementia are cared for by family members at home. For these caregivers, understanding what to avoid is crucial for ensuring the patient's safety, comfort, and well-being. This guide details what a dementia patient should avoid, covering communication, environmental factors, diet, and more.

Quick Summary

This guide provides essential information for caregivers on what to avoid with dementia patients, including harmful communication tactics, environmental hazards, specific medications, and dietary pitfalls. It offers practical advice to help manage symptoms, reduce agitation, and create a safer, more supportive environment.

Key Points

• Communication: Avoid arguing, correcting, or testing the memory of a person with dementia; use simple sentences and a calm, patient tone instead.

• Home Safety: Remove potential hazards like clutter, rugs, and sharp objects; use safety features like stove shut-offs and water temperature regulators.

• Dietary Restrictions: Limit consumption of fried, processed, and sugary foods, and avoid excessive alcohol, as these can negatively impact brain health.

• Medications: Be cautious with anticholinergics, benzodiazepines, and other potentially inappropriate medications that can worsen cognitive function or cause harmful side effects.

• Routines and Pace: Avoid rushing or overwhelming individuals with dementia, and instead, allow them to complete tasks at a gentle, unhurried pace.

• Social Isolation: Encourage social engagement and avoid isolating the patient, as interaction is crucial for emotional well-being and cognitive function.

• Emotional Triggers: Never dismiss their feelings, even if they seem irrational; validate their emotions and respond with reassurance and comfort.

Avoiding Communication Triggers That Cause Agitation

Effective communication is vital when caring for a person with dementia, but certain approaches can cause confusion, distress, and agitation. Knowing what not to say or do is just as important as knowing what is helpful.

Verbal communication pitfalls

• Don't argue or confront: Attempting to reason or win an argument with a person who has cognitive impairment is counterproductive. Instead of telling them they are wrong, validate their feelings and gently redirect the conversation.
• Avoid asking complex questions: Open-ended questions or those requiring recent memory recall can be overwhelming. Instead of asking, "Do you remember what you did today?" offer a simple choice, such as, "Would you like to wear the blue shirt or the green one?".
• Refrain from correcting their memory: Forcing a patient to confront a forgotten detail can lead to embarrassment and distress. If they mention a deceased loved one as if they are still alive, go along with it rather than causing them fresh grief by reminding them of the loss.
• Use simple, short sentences: Dementia can affect a person's ability to process complex information. Break down requests into simple, one-step instructions. For example, instead of saying, "First, get your coat and put on your shoes, and then we'll go for a walk," say, "Let's put on your coat" and then, "Now, let's put on your shoes".
• Never use condescending or infantilizing language: "Elderspeak"—using a high-pitched voice or pet names like "deary" or "honey"—can be patronizing and insulting. Always maintain a respectful, adult-to-adult tone.

Non-verbal communication and actions

• Don't assume they don't understand: Even individuals with advanced dementia may still pick up on emotions and nonverbal cues. Never talk about them in their presence as if they aren't there.
• Avoid rushing them: People with dementia need more time to process information. Rushing them or setting arbitrary deadlines can lead to anxiety and agitation. Allow them to move at their own pace.

Environmental Hazards to Remove or Modify

Creating a safe and calm home environment is essential for a person with dementia, as their perception of their surroundings can become distorted.

• Remove clutter and trip hazards: Clear pathways of furniture, rugs, and electrical cords to prevent falls. Install sturdy handrails on stairways.
• Ensure safety in the kitchen: Store knives, cleaning supplies, and flammable materials in locked cabinets. Install an automatic shut-off switch for the stove and remove any inedible, food-shaped items, such as magnets or artificial fruit.
• Address bathroom dangers: Set the water heater to 120°F to prevent scalding. Place non-skid mats or strips in the tub and shower. Lock up toiletries that might be mistaken for food.
• Adjust lighting and patterns: Install motion-activated lights and nightlights to prevent disorientation. Avoid busy patterns on floors, walls, and furniture, which can cause confusion.
• Limit or remove mirrors: Reflections in mirrors can be confusing or frightening for a person with dementia. Consider removing some or placing covers over them.

Harmful Dietary Choices and Habits

While there is no single special diet for dementia, certain foods and eating habits should be avoided or limited to support brain health and prevent complications.

Foods and beverages to limit

• Fried and processed foods: A diet high in saturated fats and processed foods is linked to a higher risk of cognitive decline. These foods contain advanced glycation end products (AGEs) that can speed up cell aging.
• Excessive sugar: Soda and sugary beverages are linked to diabetes, a risk factor for vascular dementia. Limiting sweets can help maintain stable blood sugar levels.
• Processed meats and cheeses: Nitrosamines in processed meats can cause the liver to produce fats that are toxic to brain cells. Processed cheese also contains these compounds.
• High alcohol consumption: Excessive drinking increases the risk of dementia by leading to high blood pressure and brain injuries.

Eating habits to avoid

• Distractions during meals: Eating in a noisy or cluttered environment can overwhelm a person with dementia. Serve meals in a quiet, calm setting.
• Overwhelming food choices: Presenting too many food options at once can cause confusion. Serve one food at a time to keep the decision-making simple.

Medications and Healthcare to Approach with Caution

Certain medications and medical practices can worsen dementia symptoms or cause harmful side effects.

• Anticholinergics and benzodiazepines: Medications with anticholinergic properties and benzodiazepines, such as some antihistamines and sedatives, can have a strong negative effect on cognitive function.
• Unnecessary medication: Review all medications regularly with a doctor to eliminate any that are no longer necessary or may be causing adverse side effects like confusion or agitation.
• Ignoring side effects: Some common dementia medications can cause side effects like dizziness, nausea, or sleep problems. If side effects are concerning, consult a doctor before stopping the medication.

Lifestyle and Behavioral Factors

• Isolation: Disengaging from social activities can lead to loneliness and depression, which can worsen dementia symptoms.
• Physical inactivity: A lack of physical activity is a risk factor for cognitive decline. Regular, gentle exercise is beneficial for brain and overall health.

Comparison Table: What to Avoid vs. What to Embrace

Area of Care	What to AVOID	What to EMBRACE
Communication	Arguments, complex sentences, memory tests	Validation, simple phrases, statements of shared memories
Environment	Clutter, mirrors, harsh lighting, loud noise	Clear pathways, non-reflective surfaces, nightlights, calm atmosphere
Diet	Processed foods, excessive sugar, fried foods, alcohol	Fruits, vegetables, whole grains, lean protein, healthy fats
Medication	Anticholinergics, benzodiazepines, unreviewed prescriptions	Regular medication review with a doctor, adherence to treatment plan
Activities	Rushing, isolation, overwhelming tasks	Gentle pace, social engagement, simplified enjoyable activities

Conclusion

Understanding what dementia patients should avoid is fundamental for anyone providing care. By consciously steering clear of specific communication patterns, environmental hazards, certain foods, and particular medications, caregivers can significantly improve the patient's quality of life. Embracing patience, simplicity, and a supportive, safe environment helps manage challenging behaviors and allows the individual to retain dignity and a sense of calm. Proactive and informed caregiving is the best strategy for navigating the complexities of dementia, ensuring both the patient and caregiver experience less stress and more peace.

For more expert advice on communicating with a person with dementia, refer to the Alzheimer's Society blog.

Frequently Asked Questions

Why should you not correct a dementia patient?

You should not correct a dementia patient because arguing or confronting them about inaccuracies is counterproductive and can cause frustration, agitation, and embarrassment. It is more effective to validate their feelings and gently redirect the conversation.

What foods should be avoided for a person with dementia?

Foods to avoid or limit include processed meats, sugary drinks, fried foods, and other ultra-processed options. These can negatively impact brain health and contribute to conditions like diabetes, which is a risk factor for dementia.

Why should caregivers avoid 'elderspeak'?

Caregivers should avoid 'elderspeak'—using a high-pitched voice or pet names—because it can sound condescending, infantilizing, and disrespectful. It is important to maintain a normal, respectful tone when communicating to preserve the individual's dignity.

Are there any medications that dementia patients should avoid?

Yes, certain medications, such as some anticholinergics, benzodiazepines, and older-generation antihistamines, should be used with caution or avoided. They can have adverse cognitive effects and worsen dementia symptoms.

How can you prevent a dementia patient from wandering off?

To prevent wandering, consider home safety modifications like installing motion-activated door alarms or monitoring systems. Ensure identification is carried, and create a safe, engaging environment to reduce restlessness and the impulse to wander.

Why is a calming environment important for dementia patients?

A calming environment helps reduce confusion and agitation. Removing clutter, minimizing noise, and ensuring adequate, non-harsh lighting can help a person with dementia feel more secure and focused.

How should a caregiver handle a dementia patient's repetitive questions?

When a dementia patient asks repetitive questions, avoid reminding them that they just asked. Instead, answer the question calmly and patiently each time, or try to distract them by changing the subject. Remember that they have genuinely forgotten.