Why "Because They Have Dementia" Is Never the Real Answer
A Guide to Understanding (and Answering) Unmet Needs
When a loved one is living with dementia, we’re often told that challenging or "responsive" behaviors are just a part of the disease. It’s easy to feel helpless, or to assume that nothing can be done.
This is simply untrue.
As our friend and dementia educator, Dr. Evan Shelton says, there is one important rule we must follow: "Because they have dementia" is never the real answer.
Behavior is not random. It’s communication.
When a person shows an unusual behavior, it almost always points to an underlying, unmet need. This could be a basic need (like pain, hunger, or thirst) or a more complex emotional need (like the need for purpose, friendship, control, or privacy).
While we can’t change the disease, we can absolutely change their environment and the way we interact to support these core needs.
Meeting the Real Human Needs
It’s easy to focus on the physical side of caregiving—medical needs, safety, and security. But to truly support our loved ones, we must also honor their core psychological and social needs. When we do, we often see those "responsive behaviors" fade away.
Let’s look at these fundamental human needs and some real-world examples of how we can help.
1. The Need for Purpose & Contribution
In many care settings, “activities” can sometimes feel like simple recreation or diversion—something to fill the day. But true engagement runs much deeper.
Purposeful activities draw on our loved one's creativity, their desire to contribute, and their sense of responsibility. They allow a person to participate in life—to care for a plant, assist with setting the table, or share wisdom from their lived experience.
A Real-World Example: A woman with dementia moved into a memory care community and quickly became depressed and self-isolated. A staff member learned she had worked for years in a secretarial position and asked if she would like to volunteer at the concierge desk. She agreed.
Over time, she was given a basic script in large font to answer the phone: “Thanks for calling [community name], please hold.” She began forming relationships and getting more involved. She became so invested in her "job" that she started waking up early to do her makeup for “work” and even asked her family to bring her work clothes from home.
Check out how Denny's role in checking rooms for new rehab residents gives him a sense of purpose and pride. (Video by Ecumen North Branch)
2. The Need for Belonging & Community
We all need to feel part of something larger than ourselves. Too often, people in care communities spend the day alone, watching others.
But belonging comes through doing with others—not being done for. Group cooking, folding laundry side-by-side, or simply sharing morning coffee can turn simple routines into shared rituals of community.
A Real-World Example: In many Montessori-trained memory care communities, residents plan how to welcome a new person. By bringing them a welcome basket, saving them a seat at the table, or giving them a tour, the current residents feel good about helping, and the new resident feels an immediate sense of warmth and belonging, easing their anxiety.
3. The Need for Independence & Choice
Independence does not disappear with a diagnosis—it simply needs support.
When the environment is thoughtfully prepared, people can continue to make choices and care for themselves. Clear signage, uncluttered spaces, and familiar objects within reach all send a powerful message: You can do this. The smallest act—pouring their own glass of water, finding their own coat—can restore confidence and dignity.
A Real-World Example: A beverage dispenser is a common feature in senior living. Often, they are under-utilized. By adding a simple sign that says, “Help Yourself,” residents are encouraged to drink more water independently. This simple change supports hydration (preventing UTIs) and gives residents a feeling of control.
4. The Need for Dignity & Pride
Too often, caregiving focuses on efficiency rather than experience. But dignity lives in the doing—in being able to help, contribute, and make a difference.
When we celebrate effort instead of perfection, we affirm the person’s value. Letting someone help, even when it takes longer or looks different, isn’t indulgent—it’s essential. Pride is found not in compliance, but in contribution.
A Real-World Example: At one community, a retired football coach with a big, booming voice does the morning announcements every day. His vision has worsened, and he is no longer able to read. To enable him, a staff person sits next to him and reads each item, one by one, so he can repeat it into the microphone. This takes extra time, but more important than efficiency is the pride and dignity this role affords the resident each day.
5. The Need for Relationships & Closeness
Human beings are wired for connection. When we are touched, listened to, asked our opinion, or included in a conversation, we are satisfying that human need for connection.
Real connection happens in the small, authentic moments—a shared laugh, a gentle hand, a look of recognition.
A quick tip: Always build engagement around remaining strengths, like long-term memories and hands-on skills. Avoid quizzing or testing a person with dementia ("Do you remember my name?"). This can be incredibly frustrating for them.
A Real-World Example: We've learned that behavior is a form of communication. In care communities, a common challenge is a resident who repeatedly presses their call bell. When a caregiver checks, the person doesn't need anything specific. This often stems from loneliness. The person learns that pressing the button brings someone to talk to. The solution isn't to re-educate them on the button; the solution is to meet their need for socialization.
Check out how Project Love Meter breaks down the wall of isolation and how connection restores dignity, joy, and meaning to daily life. (Video by TaleGate4Joy)
6. The Need for Focused Engagement (Finding "Flow")
We all thrive when we are deeply absorbed in what we’re doing—when an activity captures our attention, challenges us just enough, and offers a sense of accomplishment. Psychologists call this a state of "flow."
For people living with dementia, these moments are just as possible and just as powerful.
When activities align with a person’s interests and abilities, they invite concentration, pride, and peace. Folding linens, arranging flowers, sorting photographs, or sanding a piece of wood can all become immersive experiences that restore a sense of identity. Think of engagement as medicine. We don’t need to keep a person busy all day, but we do need to find the right number of "doses" of engagement to keep them in a good mood.
"Help those who are in search of activity and cannot find it." - Maria Montessori
From "Managing" to "Connecting"
When we begin to see our loved ones as capable, curious, and deserving of autonomy, everything changes.
The work of caregiving transforms from "managing symptoms" to nurturing relationships; from "filling time" to creating meaning. We start to see behaviors not as symptoms of a disease, but as real human expressions of an unmet need.
By proactively creating an environment and routine that meets these core needs, we empower our loved ones to continue living well. This allows us, as care partners, to spend less time reacting and more time finding those precious moments of connection and bliss.
Our Mission: Building Tools for These Needs
This philosophy is the heart of our mission at Aegeliss. That's why every product we create is thoughtfully designed to be a bridge—not just an "activity," but an invitation to connect, an opportunity for independence, and a way to find purpose. We are dedicated to creating a "thoughtfully prepared environment" so you and your loved ones can focus on what truly matters.
Tools to Support Your Journey:
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To Support Independence & Choice: Our Home & Routine Labels are the perfect example of preparing the environment. Using clear, high-contrast text and simple graphics, they help reduce confusion and empower your loved one to navigate their day with more confidence and less frustration.
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- To Create Focused Engagement & Pride: Our 2-in-1 Jigsaw Puzzles are designed to invite that feeling of "flow." With thick, easy-to-grasp pieces, beautiful barrier-free "book" packaging, and engaging themes, they are built to provide a sense of accomplishment.
