"What You Do for Me, You Take Away from Me": Rethinking Help in Dementia Care
- Maureen Braen
- Mar 24
- 6 min read
This simple, profound statement—often attributed to Dr. Maria Montessori—offers a powerful lens for how we support people living with dementia. While the original context was about fostering independence in children, the heart of the message speaks clearly across generations and conditions: help, when given too soon or too often, can unintentionally rob someone of dignity, capability, and meaning.
In dementia care, our intentions are often deeply loving. We see a task becoming difficult, and we want to make things easier, smoother, safer. But when we step in too quickly or take over without invitation, we may unknowingly silence the person’s voice or erase an opportunity for connection and self-worth. The very thing we offer as kindness may feel like a quiet kind of loss.
Through my work with RISE Dementia Care, I’ve seen how a shift—from doing for to doing with—can restore agency, spark joy, and strengthen relationships. Even small moments of shared effort can build confidence and preserve identity. This post explores how we can rethink our approach to helping—not by withholding support, but by offering it in ways that empower rather than replace.
The Intention Behind Helping
Helping is human. Especially when someone we care about is living with dementia, the instinct to step in can feel almost automatic. We want to protect, to ease frustration, to prevent mistakes. But often, our efforts to help say more about our discomfort than theirs.
Maybe we feel a sense of urgency. Maybe watching someone struggle brings up feelings of sadness or fear. Or maybe we’ve grown used to a rhythm of doing everything ourselves—believing it’s quicker, easier, or kinder.
But here’s the truth: when we jump in too soon, we may unintentionally send the message, “You can’t.” Over time, this message—however unspoken—can begin to chip away at confidence. A person who once reached for the spoon, or started to dress themselves, might stop trying. Not because they’ve lost the ability, but because they’ve lost the opportunity.
Montessori’s Message: Independence Builds Identity
Dr. Maria Montessori believed that every person—regardless of age or ability—deserves the chance to develop confidence through action. Her educational approach centers around the idea that independence fuels growth, and that doing things on your own builds a sense of self.
Her famous quote, “Never help a child with a task at which he feels he can succeed,” reflects the belief that struggle is not something to fear or eliminate—it’s something to honor. When we offer too much help, too soon, we risk taking away more than the task itself: we take away pride, autonomy, and identity.
In dementia care, we see a similar opportunity. People living with brain change may do things more slowly, differently, or with support—but they still can. They still want to. Just like in Montessori classrooms, where the environment is prepared to foster independence, we too can create care environments where success is possible. Where dignity is preserved through participation, not perfection.
Moments of independence aren’t always about big achievements. They’re found in choosing what to wear, wiping a counter, stirring the soup—or being part of a normal conversation over a cup of coffee. These moments matter. They say, “You are still you. You are needed here.”
Doing With, Not For
One of the most transformative mindset shifts in dementia support is this: move from doing for to doing with. This subtle but powerful change invites collaboration instead of replacement. It shifts care from a one-way transaction to a shared experience—where each person brings value.
Doing with might mean offering your hand rather than taking over. It could be passing the cloth instead of cleaning the spill. It’s offering a gentle prompt—“Would you like to try?”—before assuming the answer is no.
This approach honors what the person can still do and provides just enough support for them to succeed.
Montessori-based approaches also draw on activities that tap into long-term memory—which often remains accessible even as short-term memory fades. Familiar rhythms, learned routines, and muscle memory can offer a powerful pathway for connection and success. Folding towels, matching socks, sorting cards, or snapping beans aren’t just tasks—they’re opportunities. They’re ways to stay engaged, to feel helpful, to be part of a shared world.
The Hidden Cost of Over-Helping
When we think of helping, we usually imagine positive outcomes: something gets done, someone feels cared for, life moves more smoothly. But in dementia care, helping too much—or too often—can carry a hidden cost.
Each time we take over a task that a person might have done themselves, we risk sending a subtle message: “You’re not able.” Over time, these moments can add up. The result may be less visible engagement, fewer attempts, even emotional withdrawal.
Over-helping can lead to:
Loss of confidence – When people are no longer invited to participate, they may begin to doubt their own abilities.
Learned helplessness – When tasks are always done for someone, they may stop trying—not because they can’t, but because they’ve learned they won’t be allowed to.
Increased dependence – Ironically, in trying to help, we can accelerate decline by removing opportunities for practice and participation.
Erosion of identity – Many people find meaning in roles and routines. When those are taken away, the sense of “who I am” may begin to fade.
Of course, there are times when support is truly needed—and offering that support with compassion is vital. But when we make room for capability, even in small ways, we preserve much more than function. We preserve connection, confidence, and self-worth.
What Support Can Look Like Instead
Supporting someone living with dementia doesn’t mean removing challenge—it means creating the conditions for success. When we prepare the environment and adjust our approach, we empower the person to do more with less frustration and greater joy.
Here are some concrete and actionable ways to support without taking over:
Use Hand-under-Hand® Assistance
This technique—developed by Teepa Snow—allows you to connect physically and emotionally, offering guidance while still honoring the person's autonomy. It promotes safety, preserves dignity, and invites participation.
Offer Time, Not Pressure
People living with dementia often need more time to process and respond. Slow your pace. Breathe. Wait. Silence can be supportive—it gives space for initiation and reduces anxiety.
Use Cues and Prompts to Support Verbal Instructions
Instead of saying, “Let me do that,” try:
“Would you like to try?”
“Let’s do this together.”
“I’ll start, then you take over.”
A cue—like pointing, demonstrating, or modeling—can support verbal instructions and build understanding.
Set Up the Environment for Success
A prepared environment reduces confusion and encourages independence:
Organize spaces with purpose
Use labels and visual cues
Remove clutter and distractions
Place items in order of use
Tap Into Long-Term Memory Through Meaningful Activities
Procedural memory remains more intact in many forms of dementia. Activities like folding laundry, kneading dough, sweeping, or singing familiar songs can foster engagement and joy. These are identity-affirming moments—not just tasks.
Simplify Choices, Not Control Them
Too many options can overwhelm. Offer two choices rather than ten. Ask yes/no questions instead of open-ended ones.
Conclusion: Saying Yes to Capability and Connection
At its heart, dementia care is not just about safety or efficiency—it’s about honoring the humanity of the person in front of us. When we slow down, prepare the environment, and shift from doing for to doing with, we open the door to moments of success, self-worth, and shared joy.
Helping isn’t wrong. But helping that replaces, instead of empowers, can take away more than we realize.
The good news? We can choose a different way. One that recognizes and supports the abilities that remain. One that says yes to dignity, purpose, and possibility.
Yes, I CAN
I am Capable with the right support.
I Appreciate a sense of purpose.
I can Navigate each day and thrive.
Looking for support? Reach out. Let’s navigate this together. Together, we can create meaningful moments, promote well-being, and rethink how we support those on the dementia journey.
References
Camp, C. J., & Skrajner, M. J. (2004). Montessori-based activities for persons with dementia: An evidence-based approach. American Journal of Alzheimer’s Disease and Other Dementias®, 19(1), 28–34.
Snow, T. (n.d.). Positive Approach to Care®. Techniques for dementia care. Retrieved from https://www.teepasnow.com
Brush, J. A., & Calkins, M. P. (2008). Environmental interventions and dementia: A new frontier in dementia care. The Gerontologist, 48(1), 103–107.
Seligman, M. E. P. (1972). Learned helplessness. Annual Review of Medicine, 23, 407–412.
Montessori, M. (1967). The Absorbent Mind. (C. Claremont, Trans.). New York: Holt, Rinehart and Winston.
The Association Montessori Internationale. (n.d.). Montessori for Aging and Dementia. Retrieved from https://montessori-ami.org
The Center for Applied Research in Dementia. (n.d.). Montessori-Inspired Lifestyle®. Retrieved from https://cen4ard.com
