Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Fact Sheet: Caring for Persons with Delirium, Dementia & Depression

Many older adults show signs of delirium, dementia and/or depression. Caring for a loved one who has these problems can be very stressful and tiring. If someone you care about is having these problems, there are things you can do to help.

If your loved one is showing signs of delirium (unable to think clearly, to plan their day, to focus or remember things):

  • Talk with the healthcare team about any signs you see starting to develop.
  • Know that, with treatment, these signs may go away, or decrease.
  • Use a calm, soft voice when speaking to your loved one or with others nearby.
  • Keep rooms calm and quiet with soft, indirect light. Limit noise levels.
  • Try placing a soft light in the room at night. Often some people are restless and agitate easily at night because they feel mixed-up.
  • Remind them where they are, the date, time and season. This will help them stay calm, and help them to connect and orient to where they are.
  • Gently assure them that they are safe and that all is well.
  • Think about making a list of family and close friends to stay with the person around the clock so they will not be alone. This will help them feel secure and less scared. It will also help ensure safety if they are restless or anxious.
  • Bring well known photos into the room and play music they like softly in the background.
  • Know that they may not be themselves. They may forget what was said, what they did or what went on.
  • Try not to take some of the things that your loved one says to heart.
  • Look after yourself. Get some rest and try to relax whenever you can.

If your loved one is showing signs of dementia (slow loss in memory that does not get better, such as not being able to think, reason, remember and plan; and the ability to carry out one’s daily tasks):

  • Talk with your healthcare team about any signs you may see.
  • Use a daily diary book that your loved one can rely on for prompts and reminders.
  • Use notes (e.g., single-day calendars, cues, picture albums with old pictures) and talk about recent events. This will help them focus and be able to connect with you.
  • Keep the setting, schedule, and routine the same (e.g., maintain normal mealtime and bedtime routine). Have their personal items in plain view and in the same place.
  • Try to figure out what your loved one is trying to say especially if they are having a hard time finding words. Give them the words or respond to their thoughts and feelings.
  • Be patient with their repeat statements and respond like it is the first time stated or heard.
  • Try to be flexible and able to change direction in thoughts as well as actions as your loved one may seem hard to follow at times.
  • Provide a safe and secure walking area and go with them on walks so they don’t get lost.
  • Do for your loved one what he or she cannot do, but allow him or her to do as much as they can.
  • Provide an environment where repeat activities can safely be done. Arrange events in the daytime.
  • Use familiar objects that your loved one used throughout their lives as part of their daily plan.
  • Keep unsafe objects out of sight.
  • Remember each situation is different and not every idea mentioned is right for your loved one.

If your loved one is showing signs of depression (most common mental health concern in the older adult, often linked to a time of major life change):

  • Talk with your healthcare team about any signs you have seen.
  • Monitor for any suicidal thoughts or intent to harm others. Have unsafe objects out of sight.
  • Make sure that your loved one is taking their pills to prevent them from sinking back into a depression.