The Ebb and Flow of Dementia……
Why Good Days Don’t Erase the Need for Support
Dementia rarely follows a straight path. Families often describe it as coming in waves—some days their loved one seems engaged, capable, and almost like themselves again. Other days, confusion, forgetfulness, or disorientation take center stage. This ebb and flow can make it hard for caregivers to know how their loved one is truly doing and when it’s time to seek more support.
When Clarity Appears
On good days, a person with dementia might carry on a conversation, remember familiar names, or complete a task with surprising ease. These moments are a gift, bringing comfort and hope to families. But as encouraging as they are, they don’t mean the disease is slowing down. Dementia continues to progress even when symptoms temporarily seem less obvious.
Why Good Days Can Be Misleading
It’s natural to interpret moments of clarity as proof that your loved one is “managing fine.” Yet, these good days can mask serious safety concerns. Someone who remembers to take medication today may forget to do the same task tomorrow. A loved one who cooks a meal one evening may leave the stove on the next. This unpredictability creates hidden risks that aren’t always visible when things seem to be going well.
The Caregiver’s Dilemma
For family caregivers, these shifts can be emotionally exhausting. The relief of a good day can quickly turn into worry or grief when confusion returns. This back-and-forth can delay decisions about getting help, because it’s easy to second-guess: If they’re doing so well today, do they really need more care? Over time, however, constant vigilance and uncertainty can take a heavy toll on caregivers’ health and well-being.
Recognizing When It’s Time for Support
Instead of focusing only on the “good days,” it helps to look for patterns and risks:
Are there repeated safety concerns, even if they don’t happen daily?
Do you feel constantly on edge, waiting for the next crisis?
Is caregiving starting to feel overwhelming or unsustainable?
Answering “yes” to these questions may be a sign that additional support is needed—whether that means professional in-home care, respite services, memory care or simply a stronger support system for you as the caregiver.
Moving Forward with Compassion
Cherishing the good days is important. They provide moments of connection and joy that can sustain you on this journey. But it’s equally important to plan for the hard days, recognizing that dementia’s unpredictability is itself a reason for added safety measures and support. Seeking help
does not take away from the value of the clear moments, it ensures that both you and your loved one are safe enough to enjoy them fully.
Susan Raychard, MOTR/L, CDP, PAC Ind. Trainer
