Relationships That Hold: Trust, Connection, and Support in Dementia Care

Relationships are at the heart of dementia care. They can be a source of comfort, connection, and support—or, at times, tension and misunderstanding. When someone is living with brain change, the quality of their relationships often shapes their experience more than the diagnosis itself. And yet, we don’t always talk about what makes a relationship healthy, or how to show up in ways that build trust and preserve dignity.

Too often, care partners find themselves defaulting to control, correction, or “doing for” rather than “being with.” Not out of ill intent—but out of fear, urgency, or a lack of tools. This post is about shifting that dynamic. It’s about defining what healthy relationships look like in dementia care—and how trust, honesty, and respect create the foundation for connection, even in the midst of change.

What Is a Healthy Relationship?

At its heart, a healthy relationship offers safety. That safety comes from trust, consistency, mutual respect, and the freedom to be seen and heard without fear of judgment or control. In dementia care, these qualities aren’t optional—they’re essential.

The late Tom Kitwood, a pioneer in person-centered dementia care, taught that well-being depends not just on the individual but on the quality of their relationships. He identified harmful behaviors like ignoring, infantilizing, or controlling a person with dementia as forms of “malignant social psychology”—acts that chip away at dignity.

On the other hand, when we build relationships with compassion and presence, we affirm the person’s worth and agency—even as their needs and abilities shift.

What a Healthy Relationship Is Not

A healthy relationship is not about power. It’s not about rescuing or micromanaging. It's not about keeping secrets or speaking about someone instead of with them.

When we lead with control—often unintentionally—we can create walls instead of bridges. We may silence the person’s voice, override their preferences, or rush to fix something they didn’t ask us to fix. In the name of helping, we can accidentally harm.

Especially in dementia care, it’s easy to fall into patterns of "doing for" instead of "being with." But what the person often needs most is our presence, not our perfection.

Why Relationships Matter for People Living with Dementia

Relationships that are grounded in trust help reduce distress, support cooperation, and maintain a sense of identity. Studies show that people living with dementia are more likely to experience comfort, engagement, and purpose when their caregivers build emotional safety into daily interactions.

Approaches like Teepa Snow’s Positive Approach to Care®, Montessori for dementia, and trauma-informed care all reinforce this message: our words, body language, and attitudes shape the person’s experience of the world.

Secure, respectful relationships:

• Support autonomy and meaning

  
  

• Reduce the need for medications or surveillance

  
  

• Help the person feel safe, seen, and valued

  
  

Communication Strategies That Build Connection

So how do we build these relationships, especially when words may no longer come easily?

Here are a few practical tools rooted in evidence-based approaches:

• Ask, don’t assume: “Would you like help with that?” instead of stepping in without permission.

• Pause and listen: Silence gives space for response. Wait at least 6 seconds before repeating or rephrasing.

• Validate emotions: “That sounds frustrating.” This builds trust and reduces defensiveness.

• Match your body and tone: A calm, warm presence can speak louder than words.

• Come alongside, not above: Sit beside rather than stand over. Use touch gently and with consent.

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These aren’t scripts. They’re invitations to connection.

A Tool for Care Partners: Building Relationships That Support

Because relationships are built through intention, not perfection, I’ve created a free one-page tool: "Building Trusting Relationships: A Care Partner’s Guide to Communication and Connection.”

This guide offers simple strategies, reflection prompts, and examples of what to say instead to foster trust and reduce resistance. I hope it serves as a gentle companion on your journey.

👉 Download the free one-page guide here.

Access the Guide

Final Thoughts

Relationships have the power to heal—and to harm. In dementia care, where so much can feel out of our control, the relationship is one thing we can choose to tend with love and intention.

When we lead with honesty, respect, and compassion, we create a bond that holds, one that says: you matter, I’m here, and we’re in this together.

References:

• Kitwood, T. (1997). Dementia Reconsidered: The Person Comes First. Open University Press.

• Snow, T. (Positive Approach to Care). www.teepasnow.com

• Camp, C. J., & Skrajner, M. J. (2004). Montessori-based activities for persons with dementia. Western Journal of Nursing Research, 26(2), 139–160.

• Substance Abuse and Mental Health Services Administration. (2014). SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach.