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Dementia changes every aspect of a person's life, including long-term relationships with a spouse or partner, family, and friends.

If you are living with dementia, one of the many aspects of your life that is sure to change is your relationships with other people. If you have a relationship with someone who has dementia, that relationship is sure to change. Everybody experiences dementia a little differently, but relationships can continue to be mutually caring and mutually beneficial.

Problems with memory

People who have been recently diagnosed with dementia can expect problems with memory. There may be things that you have always done for the people you care about that you simply forget to do or forget how to do. Maybe you'll forget birthdays and anniversaries. Maybe you'll forget important family stories or why you have certain things or what objects in your daily life mean to people who care about you.

One way to deal with inevitable memory losses is reminiscence therapy. Don't sell things or throw things out. Keep familiar objects around you. (This doesn't mean you need to become a hoarder, just that you need to have a stable physical environment.) Talk about the past with the people with whom you shared it. The more you do this the longer your memories will last and the easier it will be for people to relate.

Another way to deal with waning powers of recollection is to rely on memory aids. Low-tech aids like post-it notes and signs can be useful. Just don't let them clutter your living space and keep them up to date (by dating a post-it note when you put it up). Higher-tech aids like pill dispensers and smart phones can be extremely useful if you already know how to use them.

Problems with role reversals

Another issue for people living with dementia is the transition from being the person who cares for others to the person who is cared for by others. What can you do to adjust to being dependent on the people who once were dependent on you?

There are types of dementia, frontotemporal dementia, for example, in which you simply won't care about questions like this. But if you are still aware of your dependence on others, take time to say "thank you". Let people know you appreciate their help. Do everything for yourself that you can, but accept help with as little fuss as possible. 

And avoid co-dependencies. While you still have power over your own affairs, steer away from well-intentioned (and not-so-well-intentioned) caregivers who need to be needed, or who express martyrdom over the time they spend with you. Usually these aren't the people who really help, anyway. 

How do healthy people deal with changes in relationships with loved ones living with dementia?

Dementia care is enormously time-consuming. During the early stages of dementia, family caregivers usually have to spend about 10 hours a week helping out. As the condition progresses, dementia care can become a full-time job even if the loved one is in a professional nursing facility. There isn't a lot of time for purely philosophical discussions. But there are ways to make relationships with a person living with dementia easier from the beginning to the end.

  • Cultivate calm communication. It's a lot easier to communicate with someone when the TV isn't blaring, the kids aren't running around the house, nobody is arguing with anyone else, and all of life's little emergencies have been dealt with. That isn't to say you can never have hubbub around the house. But make a habit of creating a calm, focused environment when you are speaking with your loved on living with dementia.
  • Learn as much as you can about your loved one's particular form of dementia. Alzheimer's disease is the most common form of dementia, but it's not the only form of dementia. There are rare cases of dementia that are reversible. There are forms of dementia that never take away memory, or that leave personality intact to the very end. Learn what you can expect, for better or worse, so you don't have to deal with unnecessary fears or false hopes.
  • Take advantage of all the help you can get. Find respite care for your loved one that allows you to take a day off. Let other family members do what they can to take care of cooking, cleaning, and recreational time. If there is an activity of daily living you just can't do, for instance, changing adult diapers, giving injections, or dealing with your loved one's old and new friends, don't take out your need for distance on your elder. Find someone else to take care of tasks you just can't handle.
  • Maintain boundaries. Don't need to be needed. Do as much as you can, and then take care of yourself. No good deed, according to an old saying, goes unpunished. But you don't have to dwell on dementia to the exclusion of your own health and wellbeing.

  • Evans D, Lee E. Impact of dementia on marriage: a qualitative systematic review. Dementia (London). 2014 May. 13(3):330-49. doi: 10.1177/1471301212473882. Epub 2013 Jan 25.
  • Sommerlad A, Ruegger J, Singh-Manoux A, Lewis G, Livingston G. Marriage and risk of dementia: systematic review and meta-analysis of observational studies. J Neurol Neurosurg Psychiatry. 2018 Mar. 89(3):231-238. doi: 10.1136/jnnp-2017-316274. Epub 2017 Nov 28. PMID: 29183957. [No authors listed] Dementia and marriage.Nurs Older People. 2016 Mar.28(2):13. doi: 10.7748/nop.28.2.13.s17.
  • Photo courtesy of SteadyHealth

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