Rethinking Dementia: Focusing on What Still Works

A person with dementia wants the same things that you and I want: a reason to get out of bed in the morning, quality social connections, opportunities to do things they enjoy, privacy and independence, and a sense of accomplishment.

- Evan Shelton, Chief Innovation Officer, Center for Applied Research in Dementia

When you first hear the word dementia, it can feel like a door closing — bringing uncertainty, fear, and sadness all at once.

But dementia is not the end of the story. It’s the beginning of a different chapter, one that can still include purpose, connection, and joy. Understanding what remains possible, and what we as caregivers can influence, is the first step toward helping a person live well with dementia.

If you are currently on the caregiving journey, you’ve probably already encountered plenty of biomedical information about dementia — plaques and tangles, disease stages, and cellular changes.

We’re not going to discuss that here. Why? Because while that information explains what dementia is, it doesn’t always tell us what to do about it. The medical lens, while important, can be narrow and often leaves care partners feeling helpless or hopeless about the road ahead.

Instead, let’s look at the practical, human side of dementia care. When we zoom out from the cellular level to the human level, we find many factors we can influence—factors that enable a person living with dementia to stay active, maintain independence, and live well.

Dementia Is More Than Memory Loss, But Not the Loss of a Person

Dementia is a term that describes changes in how the brain processes information — including memory, planning, and communication. Yet while some abilities change, others remain deeply intact.

People living with dementia often retain:

• Long-term memories from earlier in life (music, familiar routines, emotional memories)
• Procedural memories from a lifetime of practice (playing an instrument, folding clothing, writing with a pen, pouring water)
• Cognitive skills like reading signs, sorting and matching objects, and mimicking actions
• Social conventions like waving, shaking hands, and holding a simple conversation, which fulfill the need for connection
• Sensory abilities and the power to connect them to long-term memories and emotions (personalized music, familiar smells, old photos)
• The ability to learn, especially through repetition, hands-on experiences, and visual cues
• The capacity for joy and pride when they contribute to daily life and feel useful

Images showing Ju’s grandfather sharing vivid stories with his great-grandchild, learning to play a new activity with his great-grandchildren, and taking pride in his garden. 

When caregivers focus on what still works, they create an environment where a person’s strengths shine—and their challenges become easier to manage.

Using Remaining Strengths

So, remaining strengths exist — but how do we use them?

First, we must establish a goal: What does a person with dementia want? This isn’t a trick question. A person with dementia wants the same things that you and I want: a reason to get out of bed in the morning, quality social connections, opportunities to do things they enjoy, privacy and independence, and a sense of accomplishment.

If we think creatively, we can leverage a person’s remaining strengths to help them fulfill these needs. Let’s look at two key examples:

1. The Prepared Environment

Earlier, I referred to dementia as a cognitive disability. Let’s extend that idea here.

For someone with a physical disability, a prepared environment is essential. A few steps at a doorway might be an insurmountable barrier for a person in a wheelchair. But with a physical ramp, that person gains access and independence.

For a person with a cognitive disability, the barrier is not steps, but thinking and memory. So how can we help them overcome this barrier?

Just as a physical ramp uses a person's remaining ability (to use a wheelchair), we can create "cognitive ramps" that use their remaining strengths. These ramps are simple environmental cues—such as imagery, visual contrast, or large-font words—that provide the person with information. Written signs are especially effective because reading is a highly practiced and long-lasting skill for most people. Most people learn to read at a very young age and continue to read every day; reading is a skill that becomes highly automatic.

Images illustrating how physical ramps can facilitate independent access for individuals in wheelchairs.

Images illustrating how cognitive ramps, like kitchen labels and signage, can bring clarity to everyday life and support independent item retrieval and placement.

Imagine entering a new restaurant with no environmental cues — no “Please wait to be seated” sign, no menu, no name tags, no bathroom signs. It would be confusing, right? These everyday cues are all cognitive ramps we rely on, whether we have dementia or not.

For people living with dementia, environments that lack such cues can be just as confusing. Fortunately, we can do something about this. Here are several ways to use cognitive ramps at home:

- Labeling drawers and cupboards so a person can find and put away items independently

- Posting simple instructions or invitational sign for a TV remote, or a favorite hobby

- Using reminders for important information (e.g., "Turn off oven," "No metal in microwave oven")

- Creating daily schedules or task lists (e.g., take medication, water plants, sweep floor, wipe counters)

These cognitive ramps provide guidance, restore autonomy, and reduce frustration — for both the person and the care partner.

2. Personal Care

While at a senior living community in Virginia Beach, I started a session by telling attendees, “To get a sense of what it’s like to receive care, we are going to break into pairs and take turns brushing each other’s teeth. I’ve got some disposable toothbrushes in my bag…”

I faked a move to my bag and nervous glances shot around the room. “Okay, I’m just kidding.” There was a collective sign of relief. “However, I would like you to remember the feeling you just felt. The feeling of relying on someone else for your most personal daily tasks is highly uncomfortable, and that feeling does not magically disappear when you get dementia.”

Many caregivers, with the best intentions, end up helping too much. When a person can still do something for themselves, allowing them to do so preserves not only their skills but also their dignity. Over-helping doesn’t just create dependence—it unintentionally communicates that the person is incapable of helping themselves.

Supporting independence requires intention and patience. Here are five ways to do that:

- Break the task down. Instead of “Would you help me set the table?” try, “Would you put a placemat at each setting?” And then, “Would you put a plate on each placemat?”

- Slow down! Allow the person time to process and respond. Practice patience. It may take longer, but our focus should be on engagement and independence, not efficiency.

- Mime the action. Sometimes verbal instructions are too difficult. Instead, try demonstrating the action (brushing teeth, folding a shirt, taking a bite). Often, they will be able to copy you.

- Go with the flow. If the person says “no,” don’t push it. They will often match your persistence, making the task more difficult. Approach with a friendly invitation, not a command.

- Build trust with the person. People living with dementia learn associations through repetition. If you are constantly the person who says “No,” “Stop that,” or “You have to,” they can learn to associate you with negative feelings. The opposite is also true. Repeated positive experiences will create a positive association, making cooperation easier.

Shifting Focus From Weakness to Strengths

When we focus on what remains—the abilities, memories, and motivations that endure—dementia care shifts from focusing on weakness to celebrating strengths.

Dementia may change a person’s experience of the world, but it does not erase their need to belong, contribute, and feel capable. And that is something we can do something about. This philosophy is the reason Aegeliss exists. Focusing on remaining strengths and building upon them is the key to unlocking a better quality of life.

The "cognitive ramps" and supportive, prepared environments described are the very principles we use to design our products. From our Room Signs and Home & Routine Labels that provide visual support for independence, to our dementia-friendly puzzles that serve as a "cognitive ramp" to joy and connection, our tools are designed to celebrate ability, support independence, and bring families back together.

We invite you to explore these tools and join us in shifting the story of dementia from one of loss to one of possibility.