Betty Friedan’s belief that ageing is not ‘lost youth’ still has a fine, polished ring to it — the sort of line that looks serene on paper until real life wanders in wearing hospital shoes. Friedan once said, “Ageing is not ‘lost youth’ but a new stage of opportunity and strength.”
It remains a beautiful thought. But when a parent is diagnosed with dementia, families quickly discover that strength is not always grand or cinematic.
Sometimes it is a bath at the same time every morning, a familiar cup on the same side of the table, and the heroic restraint not to argue with someone who has already lost the thread.
Dementia Is Not Just “Getting Old”
Dementia affects millions of people and their families, yet experts are clear on one point: it should not be treated as the standard price of growing older.
That distinction matters. Ageing may bring slower mornings, stiffer joints and a frankly outrageous relationship with staircases. Dementia is different. It involves the loss of brain function and can disturb memory, mood, communication, judgement and the ordinary routines that give a person’s day its shape.
For families, the diagnosis often arrives like weather. One moment life is recognisable. The next, the map is damp, the compass is sulking, and nobody has brought sensible shoes.
The Alzheimer’s Association has warned that the long-term costs of caring for people with dementia are set to reach $1 trillion by 2050. The concern is particularly sharp in Africa, where longer life expectancy is meeting healthcare systems that may not yet be equipped for the scale of need.
Behind every large number, though, is a smaller room: one parent, one family, one question repeated quietly at the kitchen table — how do we do this well?
Start With Routine, Because Uncertainty Is The Enemy
In the early stages of dementia, routine is not dull. It is architecture.
Alzheimers.gov advises that simple daily tasks such as bathing and serving meals should remain consistent. This is not about being rigid for the sake of it. It is about reducing the fear that can creep in when the world starts shifting under someone’s feet.
Gerontological nurse practitioner Tina M. Baxter has highlighted structure as one of the most effective ways to support people living with dementia. Waking up and going to bed at the same time can help. So can a familiar pre-bathing or post-bathing ritual. Small repetitions can reduce anxiety and agitation, which is rather more useful than telling someone to “calm down” — a phrase that, throughout human history, has calmed absolutely nobody.
If your parent is still able, encourage them to use a calendar or planner. Let them record the day’s appointments, meals or activities. But keep it gentle. A planner should feel like a handrail, not an exam paper.
Too much detail can overwhelm. Too little structure can unsettle. The balance is delicate, but when it works, the day feels less like a maze and more like a path.
Choosing Care Without Feeling You Have Failed
One of the hardest parts of caring for a parent with dementia is admitting that love does not automatically come with clinical training, unlimited time or a spare nervous system.
Families often delay conversations about care because the subject feels brutal. Nobody wants to sit across from a parent and discuss long-term support, assisted living or end-of-life care. It can feel disloyal, as though planning for decline somehow invites it in.
It does not. Planning is not surrender. It is preparation with a pulse.
When dementia advances, families may need to discuss comprehensive care with healthcare professionals and relatives. The right choice will depend on the stage of the illness, the parent’s safety, the family’s capacity and the clinical guidance available.
Palliative Care Has A Place In Dementia
There is an urgent need for better end-of-life care for dementia patients, according to UK researchers, who have called for greater investment in health and social care to meet rising demand.
Their work found that the palliative care needs of people with dementia have been greatly underestimated. That underestimation is not confined to one country. Across the world, dementia care is still too often viewed only through the lens of memory loss, rather than as a progressive illness that can require serious, skilled support.
Dr Paul Perkins, from bereavement support charity Sue Ryder, has told The Independent that people are often surprised to learn dementia is a terminal illness. That surprise is part of the problem. If families do not understand the full course of the disease, they may miss the chance to plan compassionate care early.
Palliative care is not simply about the final days. It can support comfort, dignity, decision-making and quality of life. For dementia patients and their families, that can be invaluable.
Psychiatric mental health nurse practitioners may also play an important role, providing treatment, care and support for dementia patients and those around them. Their work can include home assessments and practical advice on improving a parent’s quality of life.
To qualify as a psychiatric mental health nurse, a professional must have a bachelor’s degree in nursing and be a registered nurse. Some go on to complete a Master of Science – Psychiatric Mental Health Nurse Practitioner degree, also known as an MSN-PMHNP, which can open routes into community mental health and interdisciplinary group practice facilities. Various institutions offer online master of nursing degree programs to advance nursing education to the next level
Master’s degree programmes combine theory with practical experience, covering areas such as psychiatric mental health assessment, neuropsychopharmacology and theoretical foundations. Cleveland State University advises choosing an MSN degree programme that includes clinical placement services as part of its coursework.
For families, the academic alphabet soup matters less than the result: trained people who know how to read distress, advise calmly and bring expertise into a situation that can otherwise feel like trying to build a staircase in the dark.
Assisted Living Can Protect Independence
During the early and middle stages of dementia, assisted living may be worth considering for people who remain aware of their surroundings to some extent and can still take part in daily life within a safe, supported environment.
That last word matters: supported. The aim is not to remove agency, wrap someone in cotton wool and park them beside a window. The aim is to preserve as much independence as possible while reducing risk.
Doctor of Public Health Mary Mittelman has told Care that finding a balance can lead to a better quality of life. The longer a person can participate in brain-stimulating activities, including going for walks, the better.
Many assisted living facilities have caregivers trained in dementia care. That training matters when confusion, fear or anger appears suddenly. A skilled caregiver can spot the signs and respond constructively, rather than treating distress as awkward behaviour.
For adult children, the decision can be agonising. Placing a parent in assisted living may feel like heartbreak with paperwork attached. But if the setting is appropriate, safe and socially supportive, it can offer structure, companionship and specialist care that a family may struggle to provide alone.
Skilled Nursing Care May Bring Support Home
The National Library of Medicine has reported that the global prevalence of dementia is as high as 24 million. Demand for care can stretch facilities and institutions, meaning not every family will be able to access the setting they first hoped for.
Home care with skilled nursing staff may then become the most practical option.
Specialised Alzheimer’s nurses can play a central role in treatment and monitoring. In some cases, nurses are among the first to recognise dementia during routine check-ups or hospital visits.
The best dementia nurses tend to have more than qualifications. They need strong communication skills, patience in industrial quantities, and the ability to manage emotion without being swallowed by it. As with psychiatric mental health nurses, they need to be qualified registered nurses. Clinical experience is essential, and a graduate degree majoring in psychiatry may also form part of advanced preparation.
For families, skilled nursing care can offer reassurance at home: medication support, observation, behavioural insight and practical guidance. It can also provide something less clinical but equally important — the feeling that someone competent is standing beside you, not merely advising from a safe distance.
The Conversation No Family Wants, But Many Need
Talking to a parent about long-term dementia care is never easy. Nobody relishes discussing assisted living, palliative support or skilled nursing over a cup of tea. It has all the charm of finding a parking ticket on a hearse.
But avoiding the conversation does not make the need disappear. It simply leaves families making decisions later, under more pressure, with less room to think.
The better route is to consult your parent’s healthcare practitioner, speak honestly with family members and build a care plan that can adapt as the illness changes. That plan might begin with routine at home. It may later include assisted living, palliative care or skilled nursing support.
None of this diminishes the person your parent has been, or still is. Dementia can take memory, confidence and independence in cruel little instalments, but it does not erase dignity. That is where families, clinicians and caregivers do their quietest and most important work.
Ageing is not ‘lost youth’, as Friedan’s line reminds us. But when dementia enters the picture, ageing also demands courage, structure, patience and help. Not the glossy sort of strength that fits neatly in a quotation. The real kind. The kind that gets up tomorrow and lays out breakfast again.
