Dementia at Home: OT & Speech Therapy Tips

November is Alzheimer's Awareness Month and National Family Caregivers Month in the US (Awareness Days). If you're caring for someone living with dementia, here are practical ideas from two professions that can make daily life easier: occupational therapy and speech and language therapy.

Every person with dementia is different, and needs change over time. Use these as starting points, and ask a therapist for advice that fits your situation.

Around the home (occupational therapy ideas)

Keep it simple and familiar. Clutter and constant change can be confusing. Keep everyday items in the same place and clear surfaces of things that aren't needed.

Light it well. Good lighting, especially in hallways and on the way to the bathroom at night, reduces confusion and the risk of falls.

Remove trip hazards. Loose rugs, trailing cables and low furniture are common causes of falls.

Use visual cues. Simple labels or pictures on cupboards and doors ("Cups", "Toilet") can help someone find things on their own for longer.

Make the bathroom safer. Grab rails, a shower seat and non-slip mats are often worth considering. An OT can assess what's needed.

Keep a daily routine. Regular times for waking, meals, activities and bed provide structure and can reduce anxiety and agitation.

Break tasks into steps. Instead of "get dressed", lay out clothes in order and offer one step at a time. Doing part of a task still matters for independence and dignity.

Keep doing meaningful things. Folding laundry, gardening, music, looking at photos or simple cooking tasks can give purpose and enjoyment. Adapt the activity rather than stopping it.

Communicating (speech and language therapy ideas)

Get their attention first. Say their name, make eye contact and come to their level.
Reduce background noise. Turn off the TV or radio when you're talking.
Use short, simple sentences and ask one question at a time.
Offer choices instead of open questions: "Would you like tea or coffee?" rather than "What would you like?"
Give time to respond. Pauses are fine. Try not to finish their sentences unless they want help.
Use gestures, pictures and objects alongside words.
Respond to the feeling, not just the words. If what they say doesn't make sense, focus on the emotion behind it, for example "You sound worried."
Avoid arguing or correcting where it isn't important. It can cause distress without helping.

At mealtimes

Eating and swallowing can become harder as dementia progresses.

Serve meals in a calm, quiet place, and sit with the person if you can.
Use plain plates that contrast with the food and table, which can make food easier to see.
Offer smaller portions and finger foods if using cutlery is difficult.
Allow plenty of time.

Ask for a speech and language therapy swallowing assessment if you notice coughing or choking during meals, a wet or gurgly voice after eating or drinking, food staying in the mouth, losing weight, or repeated chest infections. These can be signs of swallowing difficulties, which need professional assessment.

Look after yourself too

Caring is demanding, and your own health matters. Ask about respite, local carers' groups and support services. Accepting help is part of caring well, not a sign of failure.

How to get therapy support

Ask your loved one's doctor or memory service about referrals to occupational therapy and speech and language therapy. Many therapists can visit at home, which is often the best place to give practical advice.

This article is general information, not medical advice. Seek advice from your loved one's healthcare team for their specific needs.