"Give to them what you would want for yourself if one day you are walking the same path.

Marc Agronin (@MarcAgronin) is a geriatric psychiatrist at Miami Jewish Health and the author of “The End of Old Age: Living a Longer, More Purposeful Life" and "The Dementia Caregiver: A Guide to Caring for Someone with Alzheimer’s Disease and Other Neurocognitive Disorders.” Nevertheless, he writes at The Wall Street Journal,

It’s natural to feel uncertain, afraid, and even turned off when first trying to interact with someone with dementia--especially when you have an emotional tie. Fortunately, there are several approaches to overcome these reactions.

To start, be an empathic friend by imagining yourself in the shoes of the affected person. They often feel deep frustration, sadness and embarrassment as their cognitive impairment makes it increasingly difficult to manage previous expectations and roles. As a result, they may begin withdrawing from activities and relationships. You can turn your empathy into action by initiating contact without waiting for them to ask. When together, put aside your past expectations and assumptions and simply listen to them and observe what has changed. Your presence in the moment is key.

As you get a better sense for their limitations, avoid posing open-ended questions (e.g., “What would you like to do?”) or suggesting tasks or activities that might be too challenging. Instead, offer several choices that tap into their ongoing interests and abilities (e.g., “I bet you would love to do this with me.”). If they are unsure of something or unaware of who you are, gently and simply reorient them without feeling obligated to explain the unexplainable.

Another strategy is to focus on a person’s strengths that persist even when there is significant cognitive impairment. These include the senses, past memories, physical skills and routines. You can translate these strengths into meaningful activities involving music, arts, nature, pets, storytelling, exercises and religious or other related rit"uals.

There are innumerable examples: Take a walk around the neighborhood or at a local park or mall; look through photo albums or watch movies that may trigger fond memories; sing songs; attend religious services together; or if the person's native language is not English, and you both speak it, try having a conversation.

When considering several activities, ask yourself the following questions ahead of time: Can they easily participate in it? Does it bring stimulation, joy or meaning in the moment? Does it need to be adapted in some way to make it more accessible and comfortable for them?

Going to a show or concert is a great idea, for instance, but may be but too taxing for some. Instead, host a small gathering in their home to watch a recording of the same or a similar show on a large screen. Eating at a restaurant may work well for some people with mild dementia, but a festive meal at home with familiar foods and friends may be easier when they have more advanced symptoms. Plan ahead so that the environment both meets their needs and elevates their abilities.

Remember that these individuals are living with dementia, surviving the challenges and still retaining value as a person and the ability to find joy and meaning in life. Give to them what you would want for yourself if one day you are walking the same path.

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