Use careArticle link

Caring for a person with dementia during COVID-19 at home

Key points

  • Your loved one with dementia likely cannot wear a mask or follow distancing rules—this is a symptom of the disease, not a choice.
  • The most effective protection is for you, the caregiver, to wear a high-quality mask and practice rigorous hand hygiene.
  • Create a 'clean zone' at your home's entrance to prevent germs from entering living areas.
  • Watch for subtle changes in behavior or energy as early signs of illness, since fever and cough may not appear.
  • Use gentle redirection and simple routines for handwashing instead of demands or explanations.
  • Stay connected with your loved one through virtual visits if they are in a facility, and advocate for their safety with staff.

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

Step-by-step

  1. Become the mask yourself: Wear a high-quality mask (like an N95 or KN95) every time you are in the same room as your loved one, especially if you are within six feet. This is the single most effective thing you can do because it protects them from you, and you are the person most likely to bring the virus into the home.

  2. Wash your hands frequently and thoroughly before and after any contact with your loved one, including before meals, after using the bathroom, and after touching common surfaces. Use soap and water for at least 20 seconds, or an alcohol-based hand sanitizer with at least 60% alcohol.

  3. Create a 'clean zone' at your home's entrance: Place a chair, a hook for coats, and a container for shoes just inside the door. When you or anyone else comes home from outside, immediately remove outer clothing and shoes, place them in this zone, and wash hands before touching anything else in the house. This prevents germs from traveling into living areas.

  4. Limit the number of people who enter the home. If you have home care aides, ask them to wear masks and wash hands upon arrival. If possible, have only one or two consistent caregivers to reduce exposure. For other family or friends, arrange virtual visits using a phone or tablet instead of in-person contact.

  5. Increase ventilation by opening windows for a few minutes each day, even in cold weather, to let fresh air circulate. If you have a fan, place it in a window blowing outward to help remove airborne particles. This is especially important if you or your loved one has been in a public space.

  6. Use hand hygiene as a gentle, routine activity rather than a demand. For example, say 'Let's wash up before we have our snack' or 'Let's get our hands clean for this fun activity.' Use warm water and a pleasant-smelling soap. If your loved one resists, try a no-rinse hand sanitizer foam or a wet washcloth with a bit of soap—sometimes the sensation of water is more upsetting than the act itself.

  7. If your loved one wanders or tries to leave the house, redirect them to a different activity or room. Keep a favorite item—like a photo album, a soft blanket, or a simple puzzle—near the door to offer as a distraction. You can also place a sign on the door that says 'Stop' or 'Wait' in large, friendly letters, but be prepared that this may not work for everyone.

  8. Monitor for subtle signs of illness. Because people with dementia may not show typical COVID-19 symptoms like fever or cough, watch for changes in behavior: increased confusion, lethargy, loss of appetite, restlessness, or a sudden decline in their ability to do things they usually can. If you notice any of these, contact their healthcare provider and consider getting them tested.

  9. Keep a daily log of your loved one's temperature, eating, and behavior. A simple notebook or a note on your phone can help you spot patterns. If they do get sick, this record will be invaluable for their doctor.

  10. If your loved one lives in a facility (nursing home, group home, assisted living) and is on lockdown, stay connected through phone or video calls. Schedule a regular time each day. Use simple, cheerful language and talk about familiar topics. If they seem upset by the call, keep it short—even a few minutes of hearing your voice can be reassuring.

What not to do

  • Do not force a mask on your loved one if they resist. This can cause fear, agitation, and a loss of trust. Instead, focus on you wearing a mask and maintaining distance when possible.

  • Do not argue or try to explain the pandemic to your loved one if they don't understand. Reasoning with a brain that cannot process the information will only frustrate you both. Instead, use redirection and simple, calm statements like 'Let's do this together' or 'Time to wash up.'

  • Do not assume your loved one is fine just because they don't have a fever or cough. Their immune system may not show typical signs. Watch for changes in behavior or energy level as early clues.

  • Do not allow multiple visitors or caregivers into the home without a clear plan for masking and hand hygiene. Each person is a potential source of infection. Keep the circle small and consistent.

  • Do not leave hand sanitizer or cleaning products within reach of your loved one if they might accidentally ingest them. Store these items in a locked cabinet or high shelf.

  • Do not isolate your loved one completely from you or from the outside world. Social connection is vital for their emotional well-being. Instead, find safe ways to connect, like phone calls, window visits, or short, masked interactions in a well-ventilated space.

Practical tools

  • The 'Clean Zone' Setup

    Place a small table or chair just inside your front door. Put a basket for keys and phone, a hook for coats, and a bin for shoes. Post a sign that says 'Stop! Wash hands first.' When anyone enters, they immediately remove outerwear, place it in the zone, and wash hands before moving further into the home. This creates a physical and mental barrier against germs.

  • Gentle Handwashing Script

    Use these exact phrases to make handwashing a calm routine: 'Let's get our hands ready for lunch—warm water feels nice, doesn't it?' or 'Time for our hand spa—let's use the lavender soap.' If they resist, try a no-rinse foam sanitizer and say, 'Let's put on some hand lotion to keep our skin soft.' The goal is cooperation, not compliance.

  • Behavior Change Log

    Keep a simple notebook or a note on your phone. Each day, jot down: temperature (if you can take it), appetite, sleep quality, mood, and any new behaviors (like increased confusion or lethargy). This helps you spot early signs of illness and gives doctors useful information if your loved one gets sick.

  • Distraction Kit for Wandering

    Prepare a small bag or basket with items that capture your loved one's attention: a favorite photo album, a soft stuffed animal, a simple fidget toy, or a familiar music player with headphones. Keep it near the door. If they try to leave, offer the kit and say, 'Look what I found—let's look at these pictures together.'

  • Virtual Visit Schedule

    Set a daily time for a phone or video call with a family member or friend. Use a tablet or phone on a stand so your loved one can see the person's face. Keep calls short (5-10 minutes) and talk about simple, happy topics: the weather, a pet, a favorite memory. If they become agitated, end the call gently and try again later.

  • Ventilation Boost

    Open windows on opposite sides of the house for 5-10 minutes a day to create cross-ventilation. If you have a box fan, place it in a window facing outward to pull stale air out. This reduces the concentration of airborne viruses without requiring your loved one to do anything.

Discuss with your clinician

Ask your loved one's doctor: 'Given my loved one's dementia stage and overall health, what is their specific risk for severe COVID-19? Should we consider any preventive treatments like monoclonal antibodies if they are exposed?'

Discuss with the clinician: 'If my loved one develops symptoms like confusion or lethargy, how do I know if it's COVID-19 or a dementia-related change? Should we have a plan for testing at home?'

Ask: 'Are there any medications my loved one is taking that might interact with COVID-19 treatments? Should we have a plan for what to do if they get sick?'

If your loved one lives in a facility, ask the facility's medical director: 'What is your protocol for testing and isolating residents with dementia who cannot wear masks? How will you communicate with me if there is an outbreak?'

Related guides

Sources