April 28th, 2025

Prairie Doc Perspective Week of April 27th, 2025 
“The Golden Rules of Dementia”
By Jill Kruse, DO
Dementia is a progressive condition that results in decline in cognitive function.  People with dementia have increasing difficulties with short term memory, thinking, and reasoning.  For family members it can be hard to watch the decline in a loved one who is struggling with dementia.  Interacting when someone has dementia can be difficult.  Following these three Golden Rules can help.  
Rule number 1: Do not ask direct questions.  Asking someone with dementia if they remember your name or remember what they had for breakfast can be distressing.  Someone with dementia may not be able to find the answer you are looking for and can feel put on the spot to come up with an answer.  
Rule number 2: Listen to the person with dementia and learn from them.  When someone is suffering from dementia, their feelings are more important than facts.  My grandmother had dementia for the last 20 years of her life.  She was very upset that my aunt had not come to visit her.  My aunt had passed away a few years prior.  At first, we thought the best thing was to tell her the truth, that my aunt had died.  We saw that this was new information each time we told her.  She grieved deeply each time she heard that news.  It was kinder to tell her that my aunt was away at school and would be home at the next holiday to visit.  There was no reason to keep inflicting that trauma on her.  We were able to ease her mind.  She was worried she had done something wrong to cause my aunt to not visit.   
Rule number 3: Do not contradict.  The part of the brain that is able to reason is no longer functioning in dementia.  Trying to win an argument with logic is not beneficial. Another time visiting my grandmother, she was very anxious that she had not taken lunch out to her husband.  She believed he was out working in the field on the family farm.  My grandfather had died the year I was born.  Rather than contradicting her, I said that I would make sure that he got lunch and would take it out for her.  This made her feel better.   
These three golden rules can help give the family member with dementia a sense of security and safety.  It can also be helpful for family members to interact with the person they love in a new and meaningful way.  Meet the person with dementia where they are, instead of trying to force them to be where you are.  If you allow them to take the lead, you may learn some beautiful stories from the past and have fond memories for your future.    
Jill Kruse, D.O. is part of The Prairie Doc® team of physicians and currently practices as a hospitalist in Brookings, South Dakota. Follow The Prairie Doc® at www.prairiedoc.org and on Facebook, Instagram, and Threads featuring On Call with the Prairie Doc®, a medical Q&A show, 2 podcasts, and a Radio program, providing health information based on science, built on trust, on SDPB and streaming live on Facebook most Thursdays at 7 p.m. central and wherever podcast can be found.