Dementia expert Teepa Snow advises caregivers to stop forcing routines
The educator suggests focusing on small, specific tasks and recognizing that written reminders often fail due to memory gaps.
By Paula Delgado ·
Teepa Snow, an occupational therapist and the founder of Positive Approach to Care, recently appeared on the program Aging Untold to discuss how families manage daily interactions with relatives who have dementia. Snow, who has taught care teams for decades, argues that the standard approach of enforcing routines often creates friction. She proposes a shift in language and method to reduce stress for both the patient and the caregiver.
Snow prefers the term “brain change” over language that emphasizes decline. She notes that while individuals lose certain abilities, they also develop new behaviors. “Although people are losing some abilities, they’re actually changing others,” Snow said. She observed that people who never swore may start to, while those who would normally hesitate to ask strangers for help might walk up and say they need to get home. She attributes this to neuroplasticity, stating, “People think all the time of brain failure and brain loss, and I talk about brain change because the reality is neuroplasticity exists whether you have dementia or you don’t.”
When addressing specific refusals, such as a parent refusing to shower or take medication, Snow advises against force. Instead of demanding a full shower, she suggests asking for help with a smaller task. In her example, a caregiver might point to a smudge on a cheek and say, “Let’s go to the bathroom, look in the mirror I’m going to give you a washcloth and see if you can’t get that off.” Another option is asking the person to wash their hands before cooking. Snow explained that if a person refuses these smaller steps, a full shower is unlikely to succeed.
The expert also addressed the common use of written reminders, such as sticky notes labeled “coffee cups.” Snow explained that following a written sequence requires the hippocampus, the brain’s learning and memory center, to access previous actions and determine the next step. Because the front of the brain is attempting to sequence these tasks, written lists often fail to translate into action. Snow said families should recognize that the person likely needs more direct support to complete tasks.
Snow emphasized that the caregiver must build specific awareness and skills to adapt to the patient’s changing brain. She noted that not every family member is suited for hands-on care. “You can be great at organizing care because not every family member is built for this,” Snow said. “I mean, it’s hard work.”
In her final message to families, Snow stated that both the person with dementia and the caregiver are doing the best they can. She added, “You’re both doing the best you can, and if you want something to change, one of you is going to have to change.”
