Guest Blogger: Dr. Kalisha Bonds Johnson, PhD, RN, PMHNP-BC
Most families I’ve worked with didn’t wait because they didn’t care. They waited because starting felt like giving up.
When someone is diagnosed with early-stage dementia, there’s a quiet instinct to protect them. This protection often looks like trying to keep life normal for as
long as possible, to avoid anything that feels like “a program for people who are worse off.” So, we wait.
In my work with families, I talk about a kind of spectrum of where care partners find themselves. Most don’t reach for help until they hit what I call constant firefighting — when every day is damage control, the stress never lets up, and you’re running on fumes. It’s the most common time families act. It’s also, quietly, the hardest time to start something new.
Here’s what I want more families to know: early is not too soon. Early is exactly when the most good gets done well before the firefighting begins.
In the early stage, the brain is still remarkably able to respond. That’s the window when the things we know help — really help. Not as a last resort, but as a way of living well right now. Four of them matter most:
Move the body. Physical activity is one of the most protective things we have for the brain. It doesn’t have to be a gym. A daily walk, chair exercises, dancing in
the kitchen all count. Movement supports mood, sleep, and thinking.
Stay connected. Isolation is hard on every brain, and harder on one living with dementia. Regular social engagement, which may be a class, a group, a structured early-stage program gives the person something to look forward to and gives you a breath.
Keep learning. New experiences light up the brain in ways routine can’t. A new hobby, a new place, a simple new skill provide novelty, which is nourishment for the mind.
Nourish the whole person. Good food, good sleep, a healthy heart. What’s good for the heart is good for the brain. None of it is glamorous. All of it adds up. Notice what these have in common: none of them require a crisis to begin. In fact, they work best before one.
So, I’ll gently challenge the instinct to wait. Starting now isn’t admitting defeat.
It’s giving the person you’re caring for the best possible runway. The movement, the connection, the learning: they don’t take the good days away. They make more of them.
You don’t have to wait until you’re in constant firefighting to accept support. The earlier you build it in, the longer everyone gets to live well.
Dr. Kalisha Bonds Johnson, PhD, RN, PMHNP-BC, is a psychiatric mental health nurse practitioner with clinical roots in memory care and long-term care, and the founder of KBJ Collective, where she helps families navigate distressing dementia behaviors with clarity and confidence. Not sure where you’re landing right now?
Take her free Storm to Steady quiz: https://drkalisha.com/spectrum-quiz