Caring for someone with Alzheimer's or dementia at home

If your parent or spouse has Alzheimer's or another dementia, you're far from alone. The Alzheimer's Association estimates that 7.4 million Americans 65 and older are living with Alzheimer's in 2026, and in Georgia alone more than 188,000 people have the disease, supported by at least 391,000 family caregivers. This guide covers what dementia care at home looks like day to day, what helps and when to bring in their doctor.

What are the stages of Alzheimer's, in plain terms?

The Alzheimer's Association describes three broad stages. Everyone moves through them at their own pace, and the lines between them blur. A person with Alzheimer's typically lives four to eight years after diagnosis, though some live as long as 20 years.

Early stage (mild)

Your loved one may still drive, work and live independently. You might notice them reaching for a word or a name, losing things or having trouble planning. Close family usually sees these lapses before anyone else does. If you're still at the point of wondering whether something is wrong, our guide to the signs a parent needs help at home is a good place to start.

Middle stage (moderate)

This is usually the longest stage. Confusion grows, words get mixed up and frustration or anger can surface. The person needs more help with daily tasks like dressing and bathing. Wandering, personality changes and disrupted sleep often show up here. They can still take part in activities they enjoy, with support.

Late stage (severe)

The person gradually loses the ability to hold a conversation and respond to what's around them. They need help with personal care around the clock, and walking, sitting and eventually swallowing get harder.

How do you build a daily routine for someone with dementia?

A predictable day lowers stress for both of you. The Alzheimer's Association notes that structured, pleasant activities can often reduce agitation and improve mood. Some starting points:

• Build around who they are. Think about how they used to structure their day, what they like and what time of day they're at their best.
• Keep anchors fixed. Regular times for waking, meals, bathing and bed help, especially if sleep is a problem.
• Leave plenty of time. Rushing through meals or getting dressed invites resistance.
• Mix activity and rest. You don't need to fill every minute. Short tasks, breaks and some variety work better than a packed schedule.
• Use real-life tasks. Folding laundry, setting the table, sorting photos, gardening or a short walk can all feel useful and familiar.

Expect to adjust as abilities change.

What helps when talking with someone who has dementia?

Communication shifts with each stage. In the early stage, the Alzheimer's Association advises against assuming the person can't take part in conversations. Speak to them directly and give them time to answer.

In the middle stage, a few habits make a real difference:

• Talk one on one in a quiet room, with the TV off.
• Ask yes or no questions ("Would you like soup?") instead of open ones ("What do you want for lunch?").
• Give one step at a time, and show as well as tell.
• Don't argue or correct. Listen for the feeling behind the words.

In the late stage, touch, music, familiar sights and your tone of voice carry most of the meaning.

What is sundowning, and what can you do about it?

Sundowning is increased confusion from late afternoon into the night. You might see anxiety, agitation, pacing, trouble sleeping or even hallucinations. The Alzheimer's Association points to tiredness, a disrupted body clock and low evening light with confusing shadows as common triggers. The person may also pick up on your stress.

What tends to help:

• Plan outings, appointments and bathing for the morning or early afternoon.
• Get outside in daylight when you can.
• Turn lights on before dusk so the house stays bright through the evening.
• Keep evenings quiet. Cut back on loud TV, visitors and chores.
• Offer something soothing, like a favorite movie or calm music.
• Limit daytime naps, caffeine and alcohol.

Cleveland Clinic lists infection, dehydration, pain and medication side effects among the things that make sundowning worse. Someone with dementia may not be able to tell you they're hurting or have a urinary tract infection. If evenings suddenly get much worse, call their doctor.

How do you keep someone with dementia from wandering?

According to the Alzheimer's Association, six in 10 people living with dementia will wander at least once, and many do it repeatedly. Wandering often happens when a need isn't met or the person is looking for something familiar.

To lower the risk:

• Keep a routine with meaningful activity, and make sure basic needs (toilet, food, water) are covered.
• Avoid crowded, noisy places.
• Place deadbolts above or below eye level, and consider door chimes or pressure mats by exits.
• Put car keys out of sight once driving isn't safe.
• Keep a recent photo handy and look into a wandering response program before you need one.

If your loved one goes missing, start looking right away. The Alzheimer's Association says many people who wander are found within 1.5 miles of where they went missing, and advises calling 911 if you haven't found them within 15 minutes.

Why does someone with dementia refuse to bathe?

Bathing can feel cold, exposing or frightening, and the person may not understand why it's happening. The Alzheimer's Association suggests making the bathroom warm and ready before you start, with towels and supplies laid out and grab bars in place. Check the water temperature yourself, since your loved one may not sense when it's too hot.

Offer choices (bath or shower, now or after breakfast) and let them hold the washcloth. "Let's wash up" can go over better than "time for your bath," and a towel over the lap helps with modesty. If a full bath is a battle every time, no-rinse soap and warm towels can work, or you can wash different parts of the body on different days.

How do you make a home safer for someone with dementia?

The Alzheimer's Association recommends these changes as the disease progresses:

• Kitchen. Use appliances with automatic shut-off, add stove knob covers or turn off the gas when not in use.
• Medications. Lock them in a drawer or cabinet.
• Firearms. Remove them from the home or store them securely.
• Water. Consider an automatic water thermometer, since the person may not tell hot from cold.
• Lighting. Add lights in entries, hallways, stairways and bathrooms, plus night lights along the path to the bathroom.
• Floors. Remove loose rugs and cords, and secure tall furniture.
• Alarms. Keep smoke and carbon monoxide detectors working.

Falls are a big risk too. Our guide to preventing falls at home goes room by room.

When should you call the doctor or 911?

Call their doctor if you notice a sudden change in confusion, behavior or sleep, a new fall, signs of pain, or changes in eating and drinking. Sudden worsening is often caused by something treatable, like an infection or a medication problem. Call 911 for a serious fall or injury, trouble breathing, signs of a stroke, or if your loved one goes missing and you can't find them quickly.

How do you cope with caregiver stress?

The Alzheimer's Association reports that 59% of dementia caregivers describe their stress as high. Watch for signs in yourself, like exhaustion, poor sleep, irritability, pulling away from friends, or feeling anxious or low most days.

Things that help:

• Share the load. A shared calendar lets siblings and friends take specific tasks.
• Take regular breaks through respite care, even a few hours a week.
• Join a support group, in person or online.
• Sort out legal and financial plans early, while your loved one can still take part.

Georgia and Atlanta dementia resources

• Alzheimer's Association, Georgia Chapter. Support groups and education programs across the state, plus a 24/7 Helpline at 800-272-3900.
• Empowerline. Run by the Atlanta Regional Commission, Empowerline is metro Atlanta's front door to aging and caregiver services, including respite help, a free caregiver training platform and free consultations. Call (404) 463-3333.
• Your loved one's doctors. Ask about a referral to a neurologist or memory specialist at one of Atlanta's health systems, such as Emory, Piedmont, Northside or Wellstar. The Alzheimer's Association also points caregivers to Medicare's GUIDE program for help coordinating dementia care.

If you're weighing different kinds of help, our comparison of home care, assisted living and home health in Georgia explains how each one works.

How in-home care helps with dementia

In-home dementia care in Atlanta gives your loved one steady support in a place they know, and gives you time to rest. At Tale Circle Care, trained caregivers keep daily routines familiar, offer gentle reminders about meals and activities, and use calm redirection when confusion sets in. They help with bathing, dressing and toileting, prepare meals and encourage drinks, give medication reminders, keep paths clear and stay with your loved one through the day or overnight. They also notice changes in behavior or daily functioning and report them to you.

Caregivers don't give medication or make clinical decisions. When care calls for a nurse, we can arrange a licensed one. We serve families across metro Atlanta, including Roswell, Marietta and East Cobb and Peachtree City. If you want to talk through what might help, call (346) 278-3018. For a sense of budget, see our guide to the cost of in-home care in Atlanta.

Common questions

Can someone with dementia stay at home safely?

Many people can, often for years, with safety changes, a steady routine and help with personal care. Revisit the plan as needs grow.

Does Alzheimer's always cause sundowning?

It varies. Some people with dementia sundown often, others rarely, and it can come and go. If it starts suddenly or gets much worse, ask their doctor to check for pain, infection or medication side effects.

Should I correct my parent when they're confused?

Usually it's kinder to respond to the feeling than the facts. Arguing tends to raise distress. Reassure them, then gently change the subject or the activity.

When does someone with dementia need care around the clock?

In the late stage, people need help with personal care at all hours. Night wandering or unsafe behavior can make overnight support necessary sooner.

Sources

• Stages of Alzheimer's, Alzheimer's Association
• Alzheimer's Disease Facts and Figures, Alzheimer's Association
• Georgia Chapter, Alzheimer's Association
• Daily Care Plan, Alzheimer's Association
• Communication and Alzheimer's, Alzheimer's Association
• Sleep Issues and Sundowning, Alzheimer's Association
• Wandering, Alzheimer's Association
• Bathing, Alzheimer's Association
• Home Safety, Alzheimer's Association
• Caregiver Stress, Alzheimer's Association
• Sundown Syndrome, Cleveland Clinic
• Empowerline, Atlanta Regional Commission