Guest Post by MindStart – Caregiver Pitfalls

Guest Post by MindStart – Caregiver Pitfalls

Caregiver Pitfalls

MindStartCaregivers of people with dementia have a challenging job, with many bumps along the way.  There are some common situations, or pitfalls, that caregivers often fall into that can set off a sequence of events that were unintended.

One of the most common dementia communication pitfalls that caregivers make is the ‘open ended question’.  An open ended question is when the caregiver asks the person with dementia a question that could have endless answers.  Examples that a caregiver might ask, include:

  • What would you like for dinner?
  • What tv show would you like to watch?
  • Where would you like to go for lunch?
  • What do you want to wear today?

These open-ended questions are potential pitfalls because people with dementia have difficulty making decisions.   Making a decision in order to answer one of these questions requires the ability to:

  • Generate an idea based on past experiences (such as, “ I know I like fried chicken”)
  • Consider the idea’s pros and cons and other factors (such as, “I had fried chicken for dinner last night”)
  • Make a sound decision based on the analysis (such as, “Let’s have pizza tonight”)

People with dementia have difficulty with each of these brain functions, so do not do well with open-ended questions.  Being asked a question like the ones above can cause the person to become quiet and withdrawn.  Or anxious and upset.  It can cause frustration, embarrassment, possibly even fear, as the person is unsure of what is being asked of him or her.

When the person does not answer the question, the caregiver might ask the question again, thinking the person did not hear or that he or she needs the question repeated.  This can make the person react even more.

So how can caregivers avoid this pitfall?  By re-training their communication to replace open-ended questions with multiple-choice  questions.  Often, it is best to ask questions with only 2 choices given.  For the same question examples listed above, you might instead ask:

  • Would you like spaghetti or soup for dinner?
  • Would you like to watch the football game or this singing show?
  • Would you like to go for pizza or sandwiches for lunch (notice this question was simplified further, giving exact types of food categories instead of restaurant names)
  • Would you like to wear the blue or the green sweater?

This works because the caregiver has eliminated most of the decision-making needed and has narrowed it down to just 2 choices.  This is much more do-able for the person with dementia and successfully keeps the person involved in making choices.

With a bit of re-training with communication approaches, caregivers can avoid pitfalls such as the open-ended question and avoid unnecessary, stressful moments for the person with Alzheimer’s or other dementia and for the caregiver.

Monica Heltemes is an occupational therapist and founder of – a company that designs and sells activity and hobby-style products for people with dementia.  For a free dementia activities tip sheet, go to