Understanding their reality

As a person’s cognitive ability starts to decline, the reality they perceive can be very different from ours. Dementias like Alzheimer’s disease can cause more than just memory loss. The disease can impact our speech, logic, emotions, behavior, and affect our brain in other ways.

People with Alzheimer’s may not have the ability or trust to tell you that something is making them uncomfortable. As a result, you may have to look for nonverbal signs and other clues to better understand what they are experiencing or feeling. Perhaps they are wearing multiple layers of clothing in the house. Consider that perhaps the environment is too cold and that they would benefit from the heater being turned on to warm them up. Even though your loved one has not communicated to you that they may be cold, you can observe by the many layers of clothing, their attempt to keep warm.

Trying to place yourself in a situation through your loved one’s perspective before they experience it can be a useful exercise to identify areas you can address to improve their experience.  One regular activity many face is trying to get a loved one to shower or bathing them. Let’s break this down and enter their world as a compassionate care partner.

Consider the size when entering the bathroom. Is it big and spacious or small and confined?  A small bathroom can be intimidating. Your loved one may think “what is this confined small space that this person wants me to enter?” You can reassure them by walking in first and saying it can fit multiple people.


Is there a bathmat on the floor? This can be helpful so your loved one doesn’t have to touch cold tile. The color of the bathmat can also be an important consideration. Perhaps you observe your loved one deliberately stepping over the dark bathmat. If their vision and logic is impaired, they could be perceiving the dark bathmat as a hole in the ground. It’s best to use light color accessories that are easily visible.

When your loved one steps in the shower be mindful of what they may be experiencing. Their senses aren’t the same as ours. They could be perceiving the water to be too hot or too cold than it actually is. The water pelting from the shower head high above them could be a strange and scary feeling to them. It might be best to use a handheld showerhead that is more visible to them.

Whether it’s showering, eating or doctor visits, make an effort to analyze what’s involved with the activity, empathize with what the person may be feeling and always be reassuring. You can understand their reality more successfully by applying and following the IDEA model.

Idea model

  • Identify the problem
    • Be a detective and look for clues
  • Describe the problem
    • This will allow you to empathize with your loved one
  • Explore why it may be occurring
    • Triggers and unmet needs
  • Adjust your approach and/or the environment
    • Reassure, comfort or distract your loved one appropriately

Here are some tips for effective communication when trying to step into their world and understand their reality.


  • Repeat
  • Accept blame
  • Leave the room
  • Agree
  • Use distraction


  • Reason
  • Argue/Confront
  • Remind
  • Question recent memory
  • Take it personally

Click here to view some examples of Do’s and Don’ts when trying to effectively communicate with your loved one.

So what can you do to enter your loved one’s reality? Leave your assumptions, emotions, and preconceived thoughts at the door. Applying these suggestions can improve the quality of life for the person you’re caring for and help you step into their reality.

To learn more about how Alzheimer’s Orange County can help you and your family, call our Helpline at 844-373-4400 to speak to one of our dementia care experts.

Additional reading

Six Strategies for Developing Resiliency

Follow these six steps to see how you can become more equipped to navigate the challenges of caregiving. Read more here.

Free Educational Classes

Check out classes that will teach you important care strategies and help improve your caregiving skills. Read more here.

Five Things First-Time Care Partners Should Know

Learn what you should know if you’re new to caregiving. Read more here.