Best Friends Approach


Developed while Virginia Bell and David Troxel worked at the University of Kentucky Alzheimer’s Disease Research Center, the Best Friends™ Approach suggests that what a person suffering from dementia needs most is a “best friend,” be that a family member, friend or professional caregiver. A best friend is ideally suited to empathize with the situation, while remaining loving and positive and is dedicated to helping the person feel safe, secure and valued. The seven building blocks which serve as the foundation for the Best Friends Approach are included below:

Best Friends Approach Seven Building Blocks

  1. Recognizing the basic rights of a person with dementia. Embracing the points in the Dementia Bill of Rights. Helps us see and acknowledge the person beneath the cloak of dementia who deserves our best care and support and has the right to live with choice and dignity.


  1. Understanding what it’s like to have dementia. Behaviors seem less strange or unreasonable when you understand how dementia impacts the brain. Understanding what it’s like to have dementia helps us develop empathy, become more accepting and patient and better meet with compassion the needs of the person.


  1. Knowing and using the person’s life story. When persons with dementia forget their past, it’s up to their Best Friends to do the remembering for them. Collecting key social and personal history into a form – what we call the Life Story – helps us help the person to recall happy times and successes (a hole-in-one on the golf course or a community award) and gives us tools for redirection when the person is having a bad day (asking a woman who loves to bake to teach you how to make an apple pie).


  1. Knowing just what to say when communication is breaking down. Dementia damages a person’s ability to “make conversation,” express their wishes verbally, understand requests or remember directions. Best Friends understand the importance of slowing down and being present for the person with dementia, using good communication skills.


  1. Developing the “knack” of great dementia care. Knack is the “art of doing difficult things with ease,” or “clever tricks and strategies.” Acting as a Best Friend, our world view changes. We can practice patience and understanding. If the person says that she likes the current president, we don’t correct her. Instead we might say, “I like him too.”


  1. Experiencing meaningful engagement throughout the day. Persons with dementia who no longer can take part in favorite activities or initiate new ones can easily become isolated, bored and frustrated. Best Friends understand that socialization is therapeutic and can fight depression, keep persons physically fit and foster feelings of happiness and success. Best Friends balance formal activities with unstructured, “in the moment” times that fill our days: taking a short walk, chatting, offering hand massages or doing simple chores together.


  1. Recasting the relationship and your language from staff to Best Friend. Use the language of friendship throughout your day. When a team meeting is called to discuss a behavior, ask how the staff can be a Best Friend to that resident. Rework job descriptions to emphasize the importance of relationship. During one-on-one time, let the person know that you appreciate the friendship. Using the phrase “Best Friends” and developing authentic relationships ultimately helps the person feel safe, secure and valued – and creates a caring community where all benefit.


Dementia doesn’t signal the end of learning, but rather requires new types of learning.

Excerpts from Larry’s book, titled “Reinventing Senior Living. The Art of Living With Purpose, Passion & Joy.

Reinventing Senior Living®

We believe that needing assistance and enjoying a rich, active lifestyle are not mutually exclusive. Your loved one deserves to have it all. At Tuscan Gardens®, they do. Contact us to discover the perfect setting for dignified living in a space that feels like home.