Dementia starts with signs of memory loss.  As this is a common occurrence in old age, it may be hard to detect at the outset.  Frequently there may be hallucinations where the person sees, hears, tastes, feels or smells something that is not actually there.  In the initial stages, the person may be able to differentiate reality from their perception and recognize it as a figment of their imagination.  A casual mention from them about something which they noticed may not seem significant enough for the family to realize that it is imagined.  Gradually, however, it becomes difficult for the sufferer to separate fact from fiction.  The worsening hallucinations, changing personality, diminishing social skills, tendency to keep repeating a question or conversation can be very distressing for near and dear ones and takes time to come to terms with.  Coming to terms with the fact that a dear and near one is afflicted with dementia is extremely difficult and takes an emotional toll on the family.  Emotions can swing from impatience to anger to pain.

The most important step is to understand the problem and that the person is not being careless, irresponsible or repeating themselves just to irritate.  They are really and truly unable to remember, understand, concentrate and consequently unable to participate in meaningful conversations.  Their hallucinations are very real to them and no amount of trying to convince them to the contrary is going to make them see that.  On the contrary may not believe you and may feel you are telling them lies or that you are cheating them.  This may make them feel alienated.

How you handle them depends entirely on yourself.  As soon as you notice a change in the person’s behaviour, take them to a qualified psychiatrist.  Some available treatments help some patients reduce the impact of memory loss in the early stage of the disease. But they do not reverse the progression of the disease.  

Don’t take it personally if you are accused of doing something you did not.  It is not necessary that you humour them or agree with them when they “hear” or “see” something non-existent.  You can simply say that you did not hear it, or you did not see it.  Sometimes diverting the person’s attention may at least temporarily take their mind off the hallucination.  However, if the person is scared or anxious, it may be kind to tell a white lie and say that the sound was caused by some vessel falling down or that it was due to something that you did.  At least it will help reduce their fear or anxiety.

Don’t try to hide the fact from relatives and friends.  For one thing, it cannot be hidden for long.  Secondly informing them and explaining the condition to them will help them be more considerate and kind to the afflicted. 

Give the person small tasks that they can do easily without putting themselves at risk.  Establish a routine for them and keep reminding them of it.  Someone will always have to be around such a person.  They cannot and should not be left alone.

Dealing with a person with dementia can put a tremendous strain on one’s emotional resources, and also on that of the spouse and children.  It is not uncommon for people to get so involved with caring for the ill that they tend to neglect their own needs as well as that of the other family members.  Being aware of all the problems and consciously trying to avoid them would go a long way in helping in dealing with the situation.