At present, two drugs have been approved in the United States for people with early Alzheimer’s disease: donanemab and lecanemab. Unlike older drugs, which only addressed symptoms, the new options target and remove beta-amyloid, thought to be the principal culprit of cognitive impairment, from the brain. While they don’t offer a cure, they slow down cognitive decline.
The introduction of these medications has not been without controversy. Some physicians and health policy experts have questioned whether the benefits justify the costs and the intensive monitoring required. Patients receiving these treatments typically need regular MRI scans to watch for rare but potentially serious side effects, including brain swelling and microbleeds. Coverage varies among Medicare, private insurers, and individual health plans, making access to treatment an important consideration for many families.
Expert Care
Across North America, organizations dedicated to dementia care help thousands of families to navigate what is often a confusing and emotionally demanding process. Fortunately, The Alzheimer’s Association (AA) has a very accessible and informative website. Here you can learn about what changes to expect at each stage of dementia and see what resources are available every step of the way. Also, finding your local Alzheimer’s Association chapter and learning about programs and services in your area, including support groups and educational workshops, can be very helpful.
Many people with mild or moderate dementia continue to live in their own homes, supported by spouses, adult children, friends and neighbors. They attend day programs offered by long-term care facilities in their area.
Once the person with Alzheimer’s (or other dementia) needs more care than can be provided at home, a residential setting may be required. Depending on the severity of the disease, these facilities range from retirement housing to assisted living (also called board and care, adult living, or supported care) to nursing homes (also called skilled nursing facility, long-term care facility or custodial care) to Alzheimer’s special care units (SCUs, also called memory care units).
I spoke to Audra Young, a DementiAbility educator who visits various memory care units in a consulting capacity. She spends much of her time helping staff see the person behind the diagnosis, encouraging practices that protect dignity, foster autonomy, and sustain quality of life. For Audra, dementia care rests on the premise that memory loss does not eliminate the need for emotional connection.
Visiting one Alzheimer’s special care unit, I met Julie Bree, associate director of Allied Services. Her main job, she explained, is enhancing residents’ quality of life. Like Audra and many other stalwarts of the good fight, she has worked at this facility for the past 20 years. The emphasis here is on creating a home-like environment where people who may become disoriented, wander, or leave without recognizing the risks can move about safely and with a measure of independence.
The doors can only be opened by entering a code, and no one has wandered off the unit in a very long time. Around-the-clock nursing staff, certified nursing assistants (CNAs), and care aides assist with dressing and meals and the countless small tasks that help residents remain comfortable and secure. Residents are encouraged to participate in a variety of therapeutic, social, and recreational activities intended to stimulate the mind, maintain abilities for as long as possible, and reduce the anxiety and agitation that so often accompany dementia.
Many features of the facility reflect its values, such as the height-adjustable tables in the dining room or the photographs beside the residents’ doors, usually two pictures of the person, one from their youth or prime of life and the other a recent one.
As Julie showed me around the unit, pointing out the various homelike features and addressing every person we met by name, I asked her how she managed to work in this environment for 20 years. She said she loved her work. The most rewarding moments for her are seeing someone who was anxious, withdrawn, or distressed begin to relax and reconnect with the world around them.
As I said goodbye, I thought how lucky these residents are to have such able and dedicated staff.
Loving Care
When someone close to you begins to show signs of dementia, it’s time to have “the talk.” These conversations can be difficult and uncomfortable (not the tepid “challenging”). Be prepared for opposition to all your proposals and angry, hurtful accusations. No one wants to lose their driver’s license — their pass to independence — or abandon their comfortable, cherished home for an institutional facility. Sooner or later you will need to have a frank talk about legal matters such as key end of life decisions. In this respect, I recommend the Alzheimer’s Association’s (AA) website.
For caregivers, coping with the emotions of the people they are trying to care for and managing their own emotional responses can be exhausting. Yet in meeting these demands, caregivers discover unexpected strengths within themselves such as patience and the ability to advocate persuasively for another. This is not to romanticize hardship but to acknowledge that difficulty, when successfully overcome, can be a source of growth. Caregiving can recalibrate one’s priorities, drawing attention to the essentials of the human experience. Tending another life enriches our own.
Final Thoughts
I am happy to report that the professionals I met who are dedicated to the care of dementia and Alzheimer’s patients were grounded in the belief that every person, regardless of age or cognitive ability, deserves to be seen, known, and valued.
In an era when public discourse often dwells on division, conflict, and self-interest, it is truly heartening to encounter individuals whose lives are devoted to easing the afflictions of others.
This article is excerpted from “The gift of care for people with Alzheimer’s disease”, The Globe and Mail, June 26, 2026.
