Why “reminders” backfire in dementia care

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“So, mom, remember what you need to do after you eat breakfast?” Nancy asked her mother. 

“Um…I need to…eat lunch,” the older woman grinned, knowing it was the wrong answer, and looking at me for a quick wink of the eye.

“No, mom,” Nancy sighed, not enjoying the joke. “You need to brush your teeth.”

“…after breakfast,” Corrine nodded.

“Right!” Nancy smiled, happy that her mom “understood” the plan.

Corrine didn’t actually retain any information, but her daughter felt like she did. Corrine actually only repeated the information soon after she heard it, which doesn’t mean that she learned anything new—she was just repeating. 

I used to have a resident in one of my communities whose son was really great and devoted to her care. Still, he didn’t understand why all the notes he’d stationed around her room weren’t working. He had notes for everything: in the bathroom, there was a note that signaled her to “brush her hair,” near the clock a note that signaled her to note the time and head down to meals, on the bedroom wall, a note that suggested she should pick out socks from the sock drawer. 

My resident ignored every single note. Really, she didn’t see the notes, and, even if she did, the information was too complicated. 

This is one of the reasons that you won’t often see emergency call buttons in dementia care communities: the residents don’t know to use them in an emergency. While it can make family members feel better to see an emergency call button in a residents’ bathroom, the fact is, they just don’t understand how to use them.

These types of “reminders,” although they make families feel better, often don’t accomplish anything. People with dementia have trouble reading something and then translating into action.

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Rachael Wonderlin is an internationally-recognized dementia care expert and consultant. She has a Master’s in Gerontology and is the author of three published books with Johns Hopkins University Press. Rachael owns Dementia By Day, a dementia care consulting and education company.

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