Navigating Decision-Making Challenges in Dementia Care

How to Help a Parent with Dementia When Decision-Making Becomes Difficult

Supporting a loved one with dementia comes with many challenges, and decision-making is one of the biggest. As their cognitive abilities change, even simple choices—like what to wear or what to eat—can feel overwhelming. This can lead to frustration for both of you, but with the right strategies, you can help make daily decisions easier while still respecting their independence.

Why Decision-Making is Difficult for Someone with Dementia

Dementia affects the way the brain processes information. Choices that once felt simple—like picking a meal from a menu—can suddenly seem confusing or overwhelming. Your loved one may struggle to weigh up options, remember their preferences, or even recognise what they’re choosing between.

This isn’t a reflection of their intelligence or personality—it’s a symptom of dementia. Understanding this can help you approach decision-making with more patience and compassion.

The Impact on You as a Caregiver

Watching your loved one struggle with something that used to be second nature can be tough. You might feel frustrated when they can’t choose between two shirts or when a simple question turns into a long, stressful process.

This emotional strain can add to the stress of caregiving, making daily tasks feel exhausting. If this sounds familiar, remember that you’re not alone. Many Caregivers face the same challenges, and there are ways to make things easier for both of you.

Making Choices Simpler: Practical Strategies

Instead of removing decisions entirely, try adapting the way choices are presented. A few small changes can reduce stress and help your loved one feel more in control:

• Limit the number of options – Too many choices can be overwhelming. Instead of asking, “What would you like to wear today?”, try, “Would you like the blue jumper or the green one?”
• Use visual prompts – Holding up two clothing items or showing pictures of meal options can make decisions easier.
• Stick to familiar routines – When decisions happen in the same way every day (e.g., dressing before breakfast, tea at 3pm), they feel more natural and less stressful.
• Encourage participation – Let your loved one be involved in decisions as much as possible, even if it’s just choosing between two things.

By simplifying choices rather than removing them, you’re helping them maintain independence while making everyday life easier.

When Small Decisions Cause Big Frustration

Even with support, decision-making can still feel overwhelming. You might notice your loved one taking a long time to choose what to wear or struggling to decide what they want for lunch. This can lead to anxiety, frustration, or even refusal to choose altogether.

It’s important to stay patient and remember they’re not trying to be difficult. If they get stuck, gently guide them with reassurance, offer a suggestion, or make the choice for them if needed.

The Shoe Dilemma: A Common Example

Imagine your parent standing in front of the shoe rack, staring at five pairs but unable to decide which to wear. They may try on several pairs, hesitate, or even pick shoes that aren’t weather-appropriate.

To prevent this, simplify the process by keeping just two options visible. This small change can save time and frustration while still allowing them to feel in control.

Simplifying Clothing Choices

Getting dressed can be another daily challenge. Too many options may leave your loved one feeling stuck, while unfamiliar clothes can be confusing.

Try these tips to make getting dressed easier:

• Create a capsule wardrobe with just a few favourite, comfortable outfits.
• Label drawers or use photos to show what’s inside.
• Lay out clothing options in advance to remove the stress of choosing in the moment.

These small changes can help your loved one feel more confident and reduce the time spent on frustrating decisions.

Streamlining Food Choices

Mealtimes can be another tricky area, especially when your loved one struggles to decide what they want to eat.

Instead of asking, “What do you feel like for dinner?”, try giving a clear, limited choice: “Would you like chicken or fish?” This makes it easier for them to respond without feeling overwhelmed.

Pre-prepared meals in portioned containers can also help. If they’re feeling tired or unsure, having easy options available allows them to choose without overthinking.

The Paradox of Choice: Why Less is More

Too many options can lead to decision paralysis, where even simple choices feel impossible. This is particularly true for people with dementia.

To help:

• Keep everyday choices limited to two or three options.
• Offer familiar favourites instead of introducing too many new things.
• Observe what they naturally gravitate towards and incorporate those options more often.

By reducing decision fatigue, you create a more relaxed and supportive environment.

Encouraging Independence While Providing Support

Even though decision-making can be difficult, it’s still important to involve your loved one as much as possible. Feeling in control, even in small ways, can help boost their confidence and sense of dignity.

Here are a few ways to encourage independence while offering support:

• Let them choose when possible – Even small decisions, like picking between two drinks, can make a difference.
• Be patient – Give them time to process and respond rather than rushing them.
• Celebrate their choices – Acknowledge when they make a decision, no matter how small, to encourage participation.

Establishing a simple, predictable routine can also help reduce stress. Regular meal times, dressing routines, and daily activities provide familiarity and comfort.

You’re Doing a Great Job

Caregiving is tough, and decision-making struggles can be one of the hardest parts. But every time you simplify a choice, guide your loved one through a decision, or help reduce their frustration, you’re making a real difference.

By taking small steps to ease decision-making, you’re not just helping them—you’re also making things easier for yourself. Your patience and kindness matter more than you know.

FAQs: Decision-Making in Dementia

What’s the best way to simplify choices for someone with dementia?
Keep options to two or three choices, use visual aids, and create predictable routines. This helps reduce confusion and makes decision-making feel more manageable.
If a choice seems overwhelming, gently guide them towards a familiar option to make it easier.

How can I encourage my loved one to participate in decisions?
Ask for their input, keep choices simple, and celebrate even small decisions. Feeling involved can help them maintain confidence and independence.
Giving them extra time to think can also prevent frustration and rushed decisions.

What should I do if my loved one feels overwhelmed by choices?
Try reducing the number of options even further. If needed, make the decision for them while reassuring them it’s okay.
If they’re anxious, take a step back and try again later when they’re feeling calmer.

How can I make dressing easier for my loved one?
Limit clothing options, use labels or photos on drawers, and lay out a simple outfit in advance. A capsule wardrobe with familiar clothes can also help.
Soft, comfortable fabrics that are easy to put on can make the process smoother and more enjoyable.

How can I help with meal choices?
Instead of open-ended questions, offer two options, such as “Would you like soup or a sandwich?” Pre-prepared meals can also make it easier to choose.
If they’re struggling, serving favourite meals regularly can provide comfort and familiarity.

By using these strategies, you can create a more supportive environment that reduces stress while still allowing your loved one to feel involved in their daily choices.

Rob Mobberley

With a background spanning over two decades in the field of marketing, I have had the privilege of working across diverse industries, ranging from insurance to sports, technology, and health & well-being.

While my previous experience did not directly involve care services, I have acquired a deep understanding of the sector’s needs and challenges through my wife. For the past eight years, she has been dedicated to providing the highest level of support to her clients as a compassionate caregiver.

Witnessing the profound impact that committed caregivers have on their clients’ lives when the opportunity arose to join the esteemed team at Unique Senior Care, it was an easy decision for me to make.

During my free time, you may find me leisurely strolling across fields with a metal detector in hand, eagerly exploring the possibility of unearthing hidden treasures. Alternatively, I love nothing better than making the most of our National Trust membership and cherishing precious moments spent with my family.

I am genuinely thrilled to be a part of the Unique Senior Care team, where I can bring my expertise to the table and share a sincere passion for enhancing the lives of those we serve.