How can I alleviate fear in someone with dementia?

This article came to us by way of Nina Poletika, LMFT, a therapist in the San Francisco Bay Area who specializes in helping caregivers to those with dementia.  She adapted this article from Emma Hamilton’s “AgedCarer” website, which is no longer in existence.


How Can I Alleviate Fear in Someone with Dementia?
Adapted from an article by Emma Hamilton, AgedCarer, October 2010

People with dementia often live in a permanent state of anxiety and fear.  This can be very upsetting, not only for the person who has the disease but also for the people around them.  Imagine living in an unrecognizable world, where familiar items and faces gradually bring no comfort or meaning.

Many people with dementia can constantly search for a loved one that died many years ago or wander aimlessly in search of their home.  If you have visited a residential facility for those living with dementia, you would recognized the scared residents, the ones that continue to call out “help,” wander down the corridors or repeatedly ask what time their husband, wife, son or daughter are coming.

It can be difficult to know how to relate to a person with dementia.  Even if you were to explain to the person the reality of a situation, they will not be able to process this information correctly, will likely become upset, or will often forget.  A few minutes later they may ask you the same question again.

People living with dementia can have many fears including:

  • Being left alone
  • Strangers or intruders in their “home”
  • Anything new or different
  • Forgetting plans and appointments
  • Losing their independence
  • New environments and unfamiliar faces
  • Losing a loved one

Depending on the progression of the dementia, providing a person with a “reality check” about a situation is not useful.  Since a demented person’s ability to reason is impaired, telling the person that their mother died years ago will only heighten the person’s confusion and fear.  To them, it may be the first time they’ve heard the devastating news.  Clearly, honestly isn’t always the best policy.

Distracting a person without revealing the facts may be a more effective approach.  For instance, if a person believes their dead mother is coming to visit and insists on waiting for her, try going along with the scenario while suggesting that perhaps her mother may be late.  It can also be helpful to reassure the person by saying that you will make sure that the staff knows to come and get her as soon as her loved one arrives.

Remember a person’s fears are very real and not imagined.  Giving someone some acknowledgment that you know that they are upset, offering physical comfrot, and reassurance may allay their anxiety.