Family & Caregiver Resources

These methods promote clarity and understanding for our loved one

How to be a “best friend” and take their perspective

Developed by Virginia Bell and David Troxel during the 1990s, the Best Friends approach is based on the notion that what a person with dementia needs most of all is a “best friend”: one who empathizes, remains loving and positive, and promotes the perspective and dignity of a person with dementia. Here are some examples of how you can incorporate strategies from the Best Friends Approach when communicating with loved ones who have Alzheimer’s disease or other forms of dementia.

Reading about your loved one’s particular form of dementia will help you better understand why they can act or speak the way they do. It can help you to expect that they may ask the same question several times, and thus, build patience to answer that question every time. It can also help prepare you for sundowning symptoms and other calls for assistance and patience. And by understanding that dementia can damage your loved one’s cognitive and conversational abilities, you can practice empathy to help you meet them where they are.

Recall information from their past and let-go of corrections

One important part of the Best Friends Approach is the intimacy that comes from knowing that person’s life story. It means that we can help them remember times of meaningful joy and success. This can be especially needed on days when they’re struggling or frustrated. And even if we don’t know all of their history, we can employ what we do know about them to help them feel connected (like asking someone who loves to bake to help us with an apple pie).

As long as health and safety aren’t at risk, it can be helpful to let it go when your loved one says the wrong name or year, mixes up details, or repeats the same questions. Constant correction is frustrating even for people with healthy cognitive abilities. For the person with dementia, it can raise levels of confusion and fear—all of which can elevate the symptoms of dementia.

Keep your loved one involved in decisions and communicate simply

It’s important that your loved one retains a strong sense of agency and empowerment. Having dementia can sometimes mean that others make decisions for them, especially critical ones. This can lead to a sense of helplessness. Keep them engaged in their life and others by involving them in decisions both big and small. Ask which shirt they’d like to wear that day or if they want to keep working in their garden or hire a service. And for those serious decisions when the final say does lie with you, ask how they feel about your decision and talk about those feelings together.

Everyone wants to feel that they’re appreciated, and one important way to do this can be showing that you value their opinion in your own decisions. Remember to keep it simple: you can ask them whether they like the outfit that you have chosen for an important meeting or ask for their advice on which of two ties you should wear.

As you involve your loved one in decisions, it’s best to keep the choices simple and limited. Too many options can be overwhelming, so for questions, think “multiple choice” or “true/false”, rather than open-ended. This can mean breaking down dinner options to chicken or fish, or offering two dresses to choose from. This also goes for information that you’re sharing. For example, if there’s a need to talk about any stressful current events, such as when they ask about something in the news or friends’ behaviors around the pandemic, keep the details to the bare minimum. (You might say, “There’s a nasty bug going around and everyone’s being extra careful.”)

Move and laugh together, show affection, and help them stay connected

By increasing blood flow to the brain, exercise can help increase clarity and mental focus, having a positive effect on some dementia symptoms. And by producing the feel-good endorphins, exercise is important for emotional health as well. Being an exercise buddy, whether with light weightlifting, yoga, or walking, can be a great way to spend time together while helping your loved one keep themselves healthy and stick to good habits.

Always therapeutic, laughter relieves stress and helps strengthens connections. When you’re with your loved one, make sure to tell jokes or funny stories in your life, and remind them of laughs they’ve had in the past as well.

Affectionate touch, like hand squeezes and hugs, can also help loved ones with dementia feel safe, connected, and less alone. And when you can’t be there in person, keep them feeling connected to you with consistent phone or video calls. Make sure they’re able to stay connected to others often, whether with in-person visits, community engagement, or phone and video calls. You might also help your loved one make a scrapbook of important events from their life, and ask one or two people who attended those events to join (whether virtually or in-person) and reminisce.