Hope for the Journey by Debbie Unruh
The Power of Choice: Preserving Independence and Dignity in Dementia Care
The other day, one of our scheduled participants came into our Center, somewhat sad
and discouraged. “I really wanted to get to the store to buy a friend a birthday gift, but
no one could drive me,” she said. I had to think quickly about a solution. I wanted to
make her day better and somehow help her feel empowered and equipped to give her
friend a gift. We both thought for a moment, then I said, “Sheila, why don’t you make
her a gift?” Her face brightened as she asked, “what can I make her? “I replied to her
with two options… “Paint her a card,” I said. “And then, how about either a decorated
memory box or a birdhouse?” We have kits in the cupboard that someone from the
community had prepped for us. She and one of the volunteers went right to work. It was
such a beautiful sight to see the two of them figure out the project together, and I was
touched deeply at how Sheila’s disposition and temperament changed in the process.
There was joy on her face at her completed gift for her friend.
When someone is diagnosed with dementia, maintaining independence becomes
increasingly challenging. But while memory and cognitive abilities may change, the
human need for purpose, dignity, and personal choice remains.
According to the Alzheimer’s Association, an estimated 7.4 million Americans age 65
and older are living with Alzheimer’s dementia in 2026. As this number continues to
grow, so does the importance of understanding how we can help individuals living with
dementia maintain their independence and quality of life. *
One of the most meaningful ways to accomplish this is by encouraging autonomy, the
ability to make choices and have a voice in one’s daily life.
A dementia diagnosis does not mean a person immediately loses the ability to make
decisions or participate in everyday activities. In fact, many individuals retain skills,
preferences, and interests long after their diagnosis. Something as simple as choosing
between two activities, selecting a favorite song, picking out a game or puzzle can
provide a sense of accomplishment and purpose.
These may seem like small moments, but they reinforce an important message: Your
choices matter. You still have something valuable to contribute.
The Importance of Meaningful Engagement
Research and dementia care guidelines emphasize the importance of activities tailored
to an individual’s interests, abilities, and personal history. These activities are not simply
ways to pass the time. They provide opportunities for connection, self-expression, and
continued participation in everyday life.
Equally important is allowing individuals the time they need to complete tasks. Although
caregivers may find it easier to step in and help, doing too much can unintentionally
take away opportunities for independence. Sometimes the most supportive thing we can
do is offer encouragement, patience, and just enough assistance for success.
How Day Centers Make a Difference
EDDC and other Dementia Day programs provide a supportive environment where
individuals can participate in meaningful activities, make choices, build friendships, and
experience a sense of belonging. Through music, art, games, movement, conversation,
and familiar daily routines, participants are encouraged to use their remaining abilities
while receiving assistance when needed.
Person-centered care recognizes that every individual has a unique history, personality,
and set of preferences. Dementia may change how someone communicates or
participates, but it does not diminish their worth or need to be respected.
For families and caregivers, the message is equally important: independence does not
always mean doing everything alone. Sometimes it means having the opportunity to
choose, participate, and contribute with support.
Preserving Dignity, One Choice at a Time
As dementia progresses, the opportunities for independence may look different, but the
need for dignity never disappears. That day at EDDC, Sheila found purpose and joy
through making her friend a homemade birdhouse. A simple choice or a moment of
accomplishment can help someone feel valued and connected.
*Source: Alzheimer’s Association, 2026 Alzheimer’s Disease Facts and Figures;
National Institute for Health and Care Excellence (NICE), Dementia Care Guidelines.
