EverydayArticle link

Coaching Dementia Care Staff by Asking Questions Instead of Telling

If you are a memory care director or trainer, you know that telling staff what to do often leads to resistance or rote compliance, not real skill-building. By shifting to a coaching approach built on asking questions, you invite staff to think critically, share what they notice, and feel respected as partners in care. This article gives you concrete, step-by-step ways to use questions to guide learning, reduce your own burnout, and help direct care staff develop the deep understanding they need to support residents living with dementia. You can do this, and it starts with one small change in how you begin a conversation.

Key points

  • Asking questions instead of telling shifts the dynamic from bossy to collaborative, giving you more data and reducing your burnout.
  • The staff who have the most contact with residents (aides, housekeeping, dietary) need the most training, and coaching through questions is a practical way to build their skills in real time.
  • Use open-ended questions like 'What did you notice?' and 'What do you think might work?' to invite staff to think critically and share their observations.
  • Reflect back what you hear to show you are listening and to ensure understanding before moving forward.
  • Pair questions with positive encouragement and a clear next step ('Would you be willing to try that?') to build staff confidence and ownership.
  • Tailor your coaching to the staff member's experience level, the resident's stage of dementia, and the specific setting (memory care vs. general assisted living).

Why Telling Doesn't Work and Asking Does

When you tell a staff member what to do, you put yourself in the role of the expert and them in the role of the follower. This can feel bossy, and it keeps you in what Teepa Snow calls the 'Lone Ranger mode' — where you carry all the responsibility and data yourself. Instead, when you ask questions, you invite the staff person to share what they think, what they feel, and what they noticed. As Teepa Snow explains, this approach 'keeps you from being bossy' and gives you more data to work with because you are actually taking in information from the person who is with the resident every day. Asking questions also models the same respectful, curious approach you want staff to use with residents. It shifts the dynamic from 'I know better' to 'let's figure this out together.'

The Real Training Gap: Who Needs the Skills Most

In many facilities, the director, the marketer, or the nurse may have some dementia training, but the people who have the most contact with residents are the aides, housekeeping, dietary, and activities staff. As one expert notes, these are the ones who should have extensive dementia training, yet they are often the least trained. When facilities are desperate for staff, they may hire people with no training at all, which creates a risk for neglect or abuse — not from malice, but from being unaware and not knowledgeable. By coaching through questions, you help these staff members build the skills they need in real time, during real interactions, rather than relying on a one-time video or lecture. This is how you close the gap between policy and practice.

The Power of Shared Learning and Reflection

Coaching through questions is not about testing staff or making them feel stupid. It is about creating a culture where everyone is learning together. When you ask a staff member, 'What did you notice about how Mrs. Jones responded when you approached her from the front?' you are helping them become more observant. When you then share back what you thought you heard them say, you are showing them that their observations matter. This process of asking, listening, and reflecting builds trust and helps staff internalize skills rather than just following orders. It also gives you, as the coach, more information to tailor your guidance to the specific resident and the specific staff member's strengths and challenges.

General caregiving information, not medical advice. Check medications and major care changes with your clinician.

Step-by-step

  1. Start with a curious, open-ended question about a recent interaction. For example, ask 'What did you notice about how Mr. Smith responded when you helped him with his shower today?' instead of telling them what they should have done.

  2. Listen without interrupting, then reflect back what you heard: 'So what I hear you saying is that he seemed more agitated when you approached from behind, and that you felt rushed. Is that right?' This validates their experience and ensures accurate understanding.

  3. Ask a follow-up question that guides them to think about alternatives, such as 'What do you think might have happened if you had approached him from the front and given him a few extra seconds to process?' This encourages problem-solving without you giving the answer.

  4. When the staff member shares an idea, affirm it and ask them to try it: 'That sounds like a good idea. Would you be willing to try that approach next time and let me know how it goes?' This gives them ownership and a clear next step.

  5. After they try the new approach, follow up with another question: 'How did that feel for you? What did you notice about his response this time?' This creates a cycle of reflection and continuous improvement.

  6. Use questions to help staff connect resident behavior to underlying needs. Instead of saying 'He's just being difficult,' ask 'What do you think he might have been feeling or needing in that moment? Could he have been scared, in pain, or needing to use the bathroom?'

  7. When a staff member is struggling with a specific skill, ask them to walk you through a scenario: 'Walk me through what you would do if Mrs. Green starts trying to leave the building. What techniques would you use?' This reveals their current knowledge and allows you to coach in the moment.

  8. Model the coaching approach you want them to use with residents. Use statements instead of questions when giving a direction to a resident: say 'Let's have a cup of coffee' instead of 'Do you want coffee?' Then ask the staff member 'What did you notice about how she responded to a statement versus a question?'

  9. Build a team culture of shared learning. Encourage staff to ask each other questions during shift handoffs, such as 'What did you notice about his mood this morning? What worked well for you?' Celebrate small wins by asking 'Who tried something new this week and wants to tell us about it?'

What not to do

  • Do not correct a staff member in front of a resident or other staff. Pull them aside later and ask 'What do you think might have worked better in that moment?'

  • Do not assume experienced staff already know everything; use questions to gently challenge habits, such as 'I noticed you approached her from behind. What do you think she might have experienced in that moment?'

  • Do not use questions that feel like a test or trap, such as 'Why didn't you do it the way I showed you?' Instead, ask 'What made that approach challenging for you today?'

  • Do not give the answer immediately when a staff member is unsure. If they say 'I don't know,' pause and ask 'What do you think might be going on? Even a guess can be helpful.'

  • Do not forget to address the emotional needs behind staff behavior. If a staff member seems frustrated, ask 'How are you feeling about this situation?' before jumping into skill coaching.

Practical tools

  • The 'What Did You Notice?' Question Bank

    Create a short list of go-to questions for any coaching moment. Examples: 'What did you notice about his breathing when you entered the room?' 'What did you notice about her facial expression when you said that?' 'What did you notice about the way he moved his body?' These train staff to be more observant and give you concrete data.

  • The 'Walk Me Through a Scenario' Checklist

    For common challenges like exit-seeking or bathing refusal, have a checklist of questions. For example: 'Walk me through what you would do if a resident starts asking the same question over and over. What would you say? How would you respond to the feeling behind the question?' This helps you assess skill level and coach step by step.

  • The 'Emotional Need Behind the Behavior' Checklist

    When a resident reacts strongly, coach staff to pause and ask what unmet need might be driving the response. Common needs to consider: pain, fear, hunger, thirst, need to use the bathroom, loneliness, boredom, or overstimulation. This reframes the situation from managing behavior to understanding a person.

Discuss with your clinician

If a staff member reports that a resident's behavior changes suddenly or dramatically, ask them to document it and discuss with the nurse or doctor to rule out medical causes like infection, pain, or medication side effects.

If a staff member is unsure how to handle a resident who is physically aggressive or at risk of falling, coach them to ask for a care plan review with the clinical team before trying new techniques.

If a staff member is struggling with a resident who has a complex medical condition (e.g., Parkinson's, Lewy body dementia, or a history of stroke), encourage them to ask the nurse or therapist for specific guidance on positioning, communication, or safety.

Related guides

Sources