Living With a Loved One With Dementia – Encounter, Presence and Communication

When a loved one has dementia, interaction often changes before the relationship itself disappears. The person may no longer share the same sense of time, place or continuity, but they may still be deeply present in their own inner world. Meeting them requires more than correction, instruction or factual reminders. It requires the ability to enter their experiential reality for a moment, to listen to what still carries meaning, and to build connection before trying to restore order.

Meeting a Person With Dementia Means Building a Shared Reality

For many years, I have developed a way of speaking with people who have dementia. I do not mean a technique in the mechanical sense of the word, but rather an attitude, a way of observing and a logic of interaction that in many ways resembles what happens in good therapy and mental coaching. The essential point is the creation of connection: that the other person can feel safe, seen and accepted within their own world of experience.

In encounters with a person with dementia, the difficulty often arises when the healthy person treats their own reality as the only correct one and starts guiding the conversation back to it. That is where friction begins. The person speaking with the memory-impaired individual starts correcting, reminding, instructing and putting things right. They mention dates, deaths, places and family relationships, as if the task of the conversation were to bring the other person back to the shared agreement we call reality.

Often, however, the result is not calm, but restlessness, confusion or withdrawal.

The mental state of a person with dementia calls for a different starting point. The conversation partner must try to reach, almost to see, the kind of inner landscape in which the other person is living. What is reality like for someone who no longer has our usual understanding of time? But even that question takes us further: what is time, after all? In everyday life we take it for granted, although in reality it is an agreement, a way of structuring experience, a practical fiction through which we organize what we live through.

The world of a person with dementia makes visible what the healthy mind usually conceals: that human life is not only a linear movement from the past toward the future, but layers, fragments and worlds that may be present at the same time.

For this reason, a person with dementia should not be hurried back into our order of things. If she says that she must arrange her mother's funeral, it is not wise to answer that her mother died decades ago and that the funeral took place long ago. Such an answer may be factually correct but interactionally wrong. It does not build connection. It breaks it. It is much more fruitful to follow the reality that is true for the other person at that moment.

What was your mother like? What kind of funeral do you have in mind? Who will be there? What will be sung? In this way, the conversation partner does not impose their own frame on the other person, but allows the other person to lead the conversation, as is often done in good therapy.

This is not about lying or reinforcing a delusion, but about preserving connection. The value of the conversation does not then arise from placing things in the correct chronology, but from allowing the person to remain for a moment in their own inner reality without tearing it apart. Often, within that very reality, there is still a feeling, a relationship, a longing, a love or an unfinished task. It is possible to join with those.

I sometimes think that the way a person with dementia lives in the world resembles certain older cultures in which place and events were not structured linearly in the same way as we structure them. One did not start from a single central point and move toward a coherent map, but rather lived among fragments, meaningful places. People might go to a great tree to share news. There, a shared image of what had happened would form, and then everyone would go their own way again.

In such a way of thinking, what matters is not the exact order of the fragments, but that they are recognized and shared. This is useful in meeting a person with dementia. One must be interested in the fragments, not in their chronological correctness.

The same applies to place. A person with dementia may lose the sense of where they are from our point of view. From the window of a care home, we may see the brick wall of the building opposite, while they see a summer cottage shore, the sea and the church tower on the far side. Here, too, it is easy to make the mistake of correcting: there is no sea there, no church, this is a care home.

But why should that be done? It is much more constructive to ask: did you often go to that church? Did you travel by boat? Did you swim there? Did you set fishing nets? What was the sauna like? Were there stones or sand on the shore? In this way, the conversation moves away from proof and toward life. The issue is no longer a struggle over what can be seen from the window, but an attempt to reach the world in which the other person is moving at that moment.

A good question in such a situation is not an interrogation but an opening that creates space. Its purpose is not to test memory, but to invite experience to appear. When the question succeeds, the person's expression often changes: tension softens, the voice gains nuance, gestures find rhythm. The person may not remember the date or recognize the room, but they can still be fully present in the landscape into which the question leads them.

The situation also becomes difficult when the person with dementia no longer recognizes the person speaking with them. For a loved one, this is often a painful moment. It may feel as if the relationship has been erased. But even then it can help to look at the situation somewhat differently. Healthy people encounter similar situations all the time. We see familiar faces but cannot remember the context in which we know them. Still, we usually do not panic or make a great issue of it. We continue politely.

We do not demand perfect recognition from the other person before interaction is allowed to begin.

With a person with dementia, the same kind of subtle social intelligence is needed, but in an even more pronounced form. If they do not recognize me, I do not need to demand recognition as a condition for the relationship. I can still be safe, calm and familiar to them in that moment, even if my name, role or family relationship is not available to them. A human relationship does not disappear simply because its title disappears.

What may remain is an atmosphere, a tone, a bodily recognition, an experience that it feels good to be with this person.

The same applies to repetition. A person with dementia may say the same thing many times because the previous time no longer exists for them. The healthy person, meanwhile, becomes burdened because they carry the memory of all the previous times. Frustration easily arises between these two realities. But if repetition is understood in a new way, the situation changes. All small talk is partly based on the same phenomenon.

When someone asks how we are, we usually do not answer with our entire life story, nor do we assume that the person asking wants a complete report. We exchange a few recognizable expressions, keep the connection open and strengthen the social bond. With a person with dementia, a particular kind of small talk is needed: not the exchange of information, but the maintenance of connection.

Then the same sentences do not need to be treated as errors, but as invitations to repeat the same ritual. The answer may be almost the same as a moment ago, but tone of voice, facial expression and presence make it new. What matters is not content as new information, but the form of interaction. There is something deeply human in repetition. Many everyday conversations, greetings, memories and family expressions live precisely through repetition. In dementia, this structure merely becomes more visible than usual.

Learning this way of meeting the other person also eases our own anxiety. Being with a person with dementia can easily evoke feelings of inadequacy, helplessness and grief over changing roles. The person who once supported others now needs support. The person who once remembered everything no longer remembers what was said a moment ago. This touches loved ones deeply, because their own sense of continuity, memory and shared history is also shaken.

That is why a practical way of being in the situation is needed. Not grand principles or sentimental phrases, but a functional model of interaction.

Its core is simple but demanding: do not rush to correct the other person's reality. Create connection first. Calm your own mind. Observe the world in which the other person is living right now. Step into it as far as you can. Ask questions that open experience rather than close it down. Stay for a while with what the other person brings forward, and do not rush ahead. Be interested in the fragments, even if you cannot build a complete whole from them. Often, that is precisely when the best possible encounter emerges.

Speaking with a person with dementia is therefore not primarily about managing memory errors. It is the skill of moving along the boundary between realities without violently declaring either one to be the only correct one. When this is learned, many difficult situations soften. Unnecessary argument disappears from the conversation. Something steadier takes its place: the ability to be with another human being even when shared time, place and history no longer remain within the same frame.

I offer conversational support for family members, loved ones, friends and, when appropriate, also for the person with dementia. During the conversation, I can show in practice how interaction can be built and what kinds of questions can help the situation move forward. The purpose is not to bind anyone to a long process, but to help find functional ways of dealing with difficult situations.