My team and I take a strengths-based approach to dementia. This is what I teach my college students and promote when I have speaking engagements. Focus on the strengths of the individual living with dementia in the moment. We emphasize “what’s left” rather than “what’s gone.” And we will continue to do that, but it’s also important that we acknowledge the losses.

If we don’t acknowledge the losses, are we really listening?

The loss of driving. The loss of employment. The loss of marital intimacy. The loss of independence. The loss of physical ability.

Someone I know is mourning the loss of being able to read.

Someone else is mourning the loss of being able to go for a walk alone.

Those are legitimate losses. Care partners sometimes struggle to acknowledge these losses because they are mourning their own (also legitimate) losses.

There are just a lot of losses. And, despite our best efforts to appreciate a person with dementia in the moment, the losses are present and we can’t dismiss that.

My friend who is no longer able to go for walks alone is being told by friends and family that it’s okay….he can go for walks with other people. But he doesn’t want to go for walks with other people. He wants to go for walks alone. And don’t even mention getting a treadmill. He has no interest. It’s not okay.

And, for my other friend, there’s just no substitute for being able to read. So many people have told him that he can listen to audiobooks. He doesn’t want to listen to audiobooks. He wants to read books. And no one around him is acknowledging that loss because they think the substitute, the audiobooks, should fill that void. But it doesn’t. Not for him, anyway.

We find these alternatives for things people can’t do anymore. They seem reasonable to us. We present them with a smile, like we have all the answers. We don’t have all the answers, and sometimes our attempts to pretend these aren’t losses or that they are no big deal is insulting to those living with dementia.

Sometimes, perhaps it’s better to be with someone as they experience the loss.

Everyone has aspects of their identity that are related to certain activities, hobbies, or abilities. He’s a voracious reader. He loves to go hiking alone on the trails. She’s a cyclist. She’s a fantastic cook.

Think about yourself. What aspects of your identity would be hardest to lose? Would you be able to find an adequate alternative? Yeah, I didn’t think so.

You like riding horses? Sorry you can’t do that anymore, but you can watch other people ride horses. It’s pretty much the same, right?

You like volunteering at the hospital? Sorry you can’t do that anymore, but here are some things you can cut and color and we’ll take them to the hospital for a bulletin board. It’s pretty much the same, right?

There can be a lot of life (and good life) after the diagnosis of Alzheimer’s or another dementia. One of my favorite sayings….there is something between diagnosis and death…it’s called life. (I like to think I made it up but I probably stole it from somewhere.)

Talking about these losses doesn’t change that. Loss can be experienced in the same breath as joy, laughter, and love. But the loss is there.

And as hard as we try, we can’t take away that loss.