Supporting a parent through dementia: recreation therapy lessons for family caregivers
An article by Ann Richards, MC
In this article: We explore what it can be like to support a parent through dementia and the emotional challenges that can come with it. We also look at ways to care for your parent while protecting your own well-being.
More than four in ten family caregivers of a person with dementia report severe caregiver burden, and a similar share report symptoms of depression or anxiety at a level worth taking seriously (Garrido et al., 2025). Most of the advice aimed at this group focuses on the person with the diagnosis. Caregivers get comparatively little, even though the caregiving relationship is where a lot of the emotional weight actually sits.
Correcting someone rarely helps, and there's a name for the alternative
A common instinct, when a parent repeats a question or insists something is true that isn't, is to correct them. It rarely works, and it often makes things worse for both people. Validation, an approach to communicating with people with dementia developed in the 1960s and 70s, works from a different premise: instead of correcting the facts, you respond to the feeling behind what's being said. A parent worried about "getting home" to a house they sold years ago is usually not confused about the address. They're anxious, or they want to feel safe, and that's answerable even when the specific claim isn't true.
It's worth being honest about the evidence here rather than overselling it. A Cochrane review of validation therapy found the existing trials too small and too few to draw firm conclusions about its effectiveness (Neal & Barton Wright, 2003). What clinicians and caregivers who use it report, and what the underlying idea rests on, is less about a proven outcome and more about a simple shift: the feeling is real even when the fact isn't, and responding to the feeling tends to go better than arguing the fact.
A lot of what helps isn't a conversation at all
Recreational therapy, the field concerned with structured activity and engagement for people with cognitive or physical impairment, has a reasonably direct evidence base for something caregivers often don't expect: regular, individually tailored activity measurably reduces agitation. In one trial of at-home recreational therapy with community-dwelling older adults with dementia, two weeks of daily, individualized sessions produced a significant drop in both agitation and passivity (Fitzsimmons & Buettner, 2002). The activity itself matters less than the fact that it's structured, regular, and matched to what the person still finds engaging.
That's a useful thing to know if you're supporting a parent day to day. Connection doesn't have to run through conversation. A familiar piece of music, a repeated physical task, sorting or folding, time outside, can carry a relationship even when a conversation can't.
The grief starts before the loss does
One of the harder things about a dementia diagnosis in a parent is that grief doesn't wait for an ending. Family therapist Pauline Boss coined the term ambiguous loss for exactly this: loss without the clear boundary a death provides, where someone is physically present and psychologically absent, gradually or unevenly. Her book written specifically for dementia caregivers argues that naming this as a real form of grief, rather than something to push through until the "real" loss happens later, is itself part of coping with it (Boss, 2011).
That distinction matters because a lot of caregivers feel like they're not allowed to grieve yet, since the person is still there. The ambiguous loss framework says the opposite: this is grief, it started already, and treating it that way is not premature.
Your own wellbeing is part of this, not a distraction from it
Caregiver burden isn't a side effect of the situation. It's one of the more consistently documented findings in this area, and it's associated with worse outcomes for both the caregiver and the person they're supporting. Looking after your own stress, sleep, and support isn't indulgent, and it isn't separate from the caregiving itself.
Frequently asked questions (FAQs) about caregiving for dementia
Is it too late to help if the diagnosis is already advanced?
No. What helps changes over the course of the illness, from more conversation-based support earlier on to more sensory and activity-based connection later, but there's usually something available at any stage.My parent doesn't remember conversations we've had. Is it still worth talking to them?
Yes. The content of the conversation may not be retained, but the feeling of being spoken to with warmth and respect often is, at least in the moment, and that has its own value.I feel guilty for finding this exhausting. Is that normal?
Very. The research on caregiver burden and the anxiety and depression that often accompany it exists because this is genuinely hard, not because caregivers aren't coping well enough.Should I be correcting my parent when they say something factually wrong?
Not usually, and often it's counterproductive. Responding to the feeling underneath a claim tends to go further than correcting the claim itself, even though it can take practice to do in the moment.
About the author: Ann Richards, MC
Hi, my name is Ann and I am a therapist working in Vancouver as an associate at the Vancouver Therapy Collective and my practice Richards Resilience Counselling. Before training as a counsellor, I worked in recreation therapy with older adults through the health authority, including people living with dementia and Parkinson's, and completed dementia care training through Vancouver Coastal Health. If what you're carrying as a caregiver is something you'd rather work through directly, a free 20-minute consultation is a good place to start.
