Joy: The Primary Focus of Care

I assert that love, joy, and companionship are the fundamental requirements of Alzheimer’s care.  Any other care that may be regulated and enforced to ensure physical health and safety should be delivered in the context of ensuring the presence of love, joy, and compassion.  If the delivery of food, shelter, medicine, hygiene, and other physical care is made in the absence of love, joy, and companionship in the experience of the receiver, then the delivery is inadequate.

birdsPhysical suffering is obvious to a third party and therefore easy to regulate and intervene upon by an observer.  Mental and emotional health are less obvious and require much more attention to discern and attend to.  Spiritual health is still more subtle.  The cultivation of understanding of the mental and emotional health of another person is accomplished in the context of personal relationships over time.  Particularly skillful and sensitive persons can sometimes gain insights to the joy and suffering of an individual quickly, but time and relationship must be respected as the primary sources of authority.  Spouses, family members, and carers with long-standing relationships and observable commitment to a person being cared for can create a mentally and emotionally safe environment that overrides some apparent physical hazards or threats.

In situations where the person being cared for has dementia, great considerations must be addressed when removing a person from their mentally and emotionally safe environment to provide a more physically safe environment.  If the provision of a physically safer environment causes enduring mental and emotional misery, a great assault on the person’s humanity is committed.  The person with dementia is often unconcerned and unaware of their physical condition and their world perception is in the mental and emotional realm.  With Alzheimer’s related dementia present, Maslow’s hierarchy is askew and the sense of love and belonging is a more basic need than physical safety.  In this context, without love and belonging, a physically sustaining environment is a prison of loneliness, sorrow, and grief with no hope for parole.

skyAn article on explores the question “What good is it making someone safer if it merely makes them miserable?”  as a legal inquiry.  The crux of the problem is in the headline, which implies that misery is unrelated to safety.  This is a false premise.  Misery is a threat to the safety of basic measures of health of the human condition:  peace, love, and a sense of belonging.  To introduce misery is to threaten these securities.  Misery is an unsafe condition.

In the physical human form we experience the mental, emotional, and spiritual worlds through the relationships we develop with others and the physical world.  The only proper context for physical care is in support of a JOYFUL mental, emotional, and spiritual experience.


David Lazaroff is author of Live It Up! 10 Ways to Share Joy When Your Friend Has Alzheimer’s.  David coaches family and friends of people with Alzheimer’s Disease in creating a fun and joyful life.  Contact

David is the founder of Holistic Community Living, a Colorado nonprofit founded to operate and teach others to operate neighborhood-based assisted living homes where people can complete their lives with those they love.

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One Response to Joy: The Primary Focus of Care

  1. megan says:

    I think love, joy, and companionship are the keys for everyone’s happiness!
    Great article- and great advice.
    Thank you.

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