Dementia Care: A Practical Guide for New Jersey Families

By the care managers at Connections Care Management · Updated November 2026

Is it dementia, or something else?

Memory problems in older adults are not always dementia. Depression, thyroid problems, vitamin deficiencies, medication side effects, hearing loss, sleep problems and infections can all cause confusion. Some of these are very treatable. That is why the first step is a careful medical evaluation, not a guess.

Ask your loved one’s primary care doctor for a memory evaluation. Depending on what they find, they may refer to a neurologist, geriatrician or geriatric psychiatrist. Bring a written list of the changes you have seen, with examples and dates. Go with your loved one if you can. People with memory problems often present well in a short visit.

What should we do soon after a diagnosis?

A diagnosis is hard news. It is also a chance to plan while your loved one can still share their wishes. In the first few months:

1. Learn about the specific diagnosis. Alzheimer’s disease, vascular dementia, Lewy body dementia and frontotemporal dementia can look and progress differently.
2. Review medications with the doctor and pharmacist. Some common medications can worsen confusion.
3. Put legal documents in place. These typically include a durable power of attorney for finances and an advance directive for health care. In New Jersey, an advance directive can include a proxy directive, which names a health care representative, and an instruction directive, which states treatment wishes. You can have either or both. They must be signed in front of two adult witnesses or a notary. An elder law attorney can help with financial documents and long-term planning.
4. Talk about the future. Where would your loved one want to live if they need more care? What matters most to them?
5. Plan for driving. Ask the doctor to weigh in. Many families arrange a professional driving evaluation.
6. Connect with support. The Alzheimer’s Association runs a 24/7 Helpline at 800-272-3900 and offers support groups and education.

How do I make the home safer for someone with dementia?

• Remove or lock up firearms, power tools, car keys if driving has stopped, and toxic cleaning products.
• Lock up medications and use a locked dispenser if needed.
• Install stove knob covers or an automatic shutoff device.
• Reduce clutter and loose rugs. Add good lighting, especially at night.
• Put grab bars in the bathroom and lower the water heater temperature.
• Consider door alarms or chimes if wandering is a risk.
• Keep a recent photo and medical list handy in case your loved one gets lost.
• Consider a medical ID bracelet or GPS device.

Our home safety checklist covers more.

How do I handle behavior changes?

Agitation, repeating questions, suspicion, refusing care and sundowning (more confusion in the late afternoon and evening) are common. These behaviors are often a form of communication. Your loved one may be in pain, hungry, tired, overstimulated, bored or scared and unable to say so.

• Look for the trigger. Pain, constipation, a urinary infection, poor sleep, too much noise or a change in routine.
• Do not argue with the memory. Correcting someone with dementia usually increases distress. Respond to the feeling instead.
• Keep routines steady. Same order of morning tasks, meals at similar times.
• Simplify choices. “Would you like the blue shirt or the red one?” rather than an open closet.
• Use calm, short sentences and give time to respond.
• Redirect with music, a snack, a walk or a familiar task.
• Tell the doctor about sudden changes. A sudden worsening can be a medical problem.

What care options are there as dementia progresses?

Needs change over time, and the right setting may change too.

• At home with support: family care, in-home aides, home delivered meals, medication help. Staying engaged matters too. Home Happenings, which arranges in-home activities for older adults with local providers, is one way to bring something to look forward to into the week.
• Adult day programs: structured activities and supervision during the day, which also give caregivers a break. Some programs specialize in dementia.
• Assisted living with memory care: a secured area with staff trained in dementia care.
• Nursing home care: for people with advanced dementia or complex medical needs.
• Hospice: for people in the late stages of dementia, focused on comfort.

Talk with your loved one’s doctor about a POLST (Practitioner Orders for Life-Sustaining Treatment) form as dementia advances. In New Jersey, a POLST is a medical order signed by the patient’s attending physician, advanced practice nurse or physician assistant. It records preferences about life-sustaining treatment and follows the patient from one setting to another, such as hospital, nursing home or hospice.

What help is available in New Jersey?

Each New Jersey county has an Area Agency on Aging that also serves as its Aging and Disability Resource Connection (ADRC). The statewide number is 1-877-222-3737. They can tell you about programs that may help, which can include:

• The Statewide Respite Care Program, which offers short-term relief for unpaid caregivers of frail or functionally impaired adults who live in the community. There are income and asset guidelines and there may be a copay.
• Jersey Assistance for Community Caregiving (JACC), for residents 60 and older who need nursing home level care but want to stay home and are not financially eligible for Medicaid. There is an income-based copay.
• NJ FamilyCare MLTSS, the state Medicaid program for long-term services at home, in assisted living or in a nursing home, for those who qualify. See our NJ Medicaid long-term care basics.

Eligibility rules and figures change, so confirm current details with your county. In Rockland County, NY, start with the Rockland County Office for the Aging.

Taking care of the caregiver

Dementia caregiving is long, and it is hard. Many caregivers end up with stress, low mood and health problems of their own. Build breaks into the plan from the start, not after you are exhausted. Accept help. Join a support group. Read our guide on caregiver burnout.

How do I plan for a hospital stay?

Hospitals can be especially hard for people with dementia. Unfamiliar surroundings, noise and interrupted sleep can trigger delirium. Keep a ready bag with a medication list, copies of legal documents and a short “about me” page listing routines, preferences and what calms your loved one. Ask whether a family member can stay longer hours, and ask the team to keep glasses and hearing aids in place.

How Connections Care Management can help

Our dementia care management starts with understanding your loved one as a person: history, routines, what calms them and what upsets them. We help with diagnosis follow-up, safety, behavior changes, choosing and overseeing aides through our in-home care coordination, and finding the right memory care community when the time comes. Our medical advocacy means we can go to appointments and make sure doctors hear the whole story. Both Lisa and Kim have deep backgrounds in mental health, which helps when dementia comes with depression, anxiety or behavioral symptoms.

Reach out for a free first conversation.