Dementia & elder care

Dementia care is not just memory loss. It is the late-afternoon confusion, the repeated question, the night wandering, the meal that suddenly is not safe, the appointment where you need three months of evidence in ten minutes, and the quiet work of planning while your person can still take part.

CareHaven supports that work in two ways. First, it gives you tools that work today: memory-care tracking, pain and behavior observations, mealtime watch, advance directives, the Letter of Intent, scripts for hard conversations, and doctor-ready summaries. Second, it has a focused dementia roadmap that keeps deepening those tools without turning the app into a diagnosis engine or a course library.

Nothing on this page diagnoses dementia, predicts a stage, or replaces a clinician. It helps you notice what changed, remember what helped, and carry a clearer story into the next conversation.

What works today

Memory care and behavior changes

For a person with dementia or cognitive changes, CareHaven can show memory-care surfaces that gather behavior episodes, pain checks, routines, familiar faces, orientation cues, and practical safety tools in one place. Open them at Main Menu -> Memory Care. Available

When a hard moment happens, you can log what you saw in plain language: restlessness, confusion, agitation, wandering, repeated questions, or another behavior change. A behavior episode can include what came before it, what you tried, and whether the moment passed. Those notes are especially useful when the pattern is not obvious in the moment.

PAINAD and hidden pain

When someone cannot easily say "I hurt," pain may show up as a behavior change. CareHaven includes PAINAD, a structured way to observe breathing, sounds, facial expression, body language, and whether comforting helps. It is for people who can no longer report pain clearly, not a general quiz for every older adult. Available

PAINAD does not diagnose pain. It gives you a shared language and a dated record to bring to a nurse, doctor, hospice team, or care facility.

Could it be medical?

If your person suddenly acts different, the first useful question is often physical: tooth pain, ear pain, constipation, infection, reflux, dehydration, or a medication change. The "Could it be medical?" walkthrough helps you check the body first and turn what you find into a doctor note. Available

Medication safety for Lewy body and Parkinson's dementia

If your person has Lewy body dementia or Parkinson's-disease dementia, CareHaven surfaces an important, easily-missed safety point: people with these diagnoses can be severely sensitive to some antipsychotic (also called neuroleptic) medications — a bad reaction can look like a sudden worsening of stiffness or tremor, deep sleepiness, or being unable to move. So the caution appears where it matters most in a hurry: on the Memory Care watch-for card, on the printable Medical ID card, and in the handoff summary you share with a clinician or hospital team.

The message never overrides a prescriber — it just makes sure the diagnosis is on the table: ask the prescriber or ER team to review this Lewy body or Parkinson's dementia diagnosis before starting or changing an antipsychotic, and never start, stop, or change a medication without the prescriber. Some of these medicines are still the right, carefully-chosen option in certain situations; the point is that whoever prescribes knows about the diagnosis first. The caution appears automatically once that diagnosis is recorded for the person, and it softens appropriately in Comfort-Only mode. Available

Mealtime Watch

Mealtime can change with dementia. CareHaven's Mealtime Watch is a quick way to mark whether someone ate well, picked at food, or refused, and to note signs of swallowing trouble such as coughing, throat-clearing, pocketing food, or a wet voice. When those patterns build up, the app surfaces that it may be worth raising with a clinician. Available

Scripts for hard moments

The In-the-Moment Coach includes say / skip / why cards for common dementia moments: the same question again and again, "I want to go home," accusations, refusing care, and late-day confusion. The goal is not to win an argument. It is to have kinder words ready when your own words are gone. Available

Legal and emergency readiness

CareHaven includes several readiness tools that matter in elder care:

• The Health & Communication Passport explains how to care for this person.
• The Care Card gives first responders the first-ten-seconds essentials.
• The Letter of Intent captures what should happen if you cannot be there.
• Advance directives and decision notes help you remember what was decided and where the papers live.

These tools are not legal documents and do not replace an elder-law attorney, a physician, or your local legal process. They keep the human story and practical details from being trapped in one person's head. Available

What Helped

What Helped adds simple, optional chips to behavior episodes: what might have set the moment off, what you tried, and whether it helped. Free text still stays available, because a 3 a.m. log should never become paperwork. It works for agitation, sundowning, wandering, repeated questions, hallucinations, apathy, or any other dementia behavior you want to understand over time. Available

To log a behavior change:

1. Tap Main Menu -> Memory Care. In the row of quick buttons at the top, tap Behavior (the other two are Cognitive and Music). Or scroll to the Behavior and Mood Changes row, which opens the Behavior Changes list, and tap the + at the top right. That row can be hidden for a person (see Make it yours); the Behavior button at the top is always there.
2. The Log Behavior Change form opens. Under Kind, tap Symptom and choose the closest fit: Agitation (the starting choice), Aggression, Sundowning, Wandering attempt, Hallucination, Delusion, or Apathy / withdrawal.
3. Under Intensity, slide from 1 to 5. The words above the slider change as you go: Mild restlessness, Noticeable, Needed redirection, Hard to manage, Needed urgent help. If you had to bring in another person or call a clinician, turn on Needed urgent help or a clinician call.
4. Under Duration, leave Episode ended off while the moment is still going, or if you do not know yet. When it is over, turn it on and set how many minutes it lasted.
5. Under Trigger (optional), tap any chips that fit: Hungry or thirsty?, Pain or discomfort?, Too much noise, Bored or alone, New place or routine change, Unfamiliar people, Evening hour, Bathing or personal care, or No obvious trigger. You can also type your own words in the box under the chips. Skip this if you are not sure.
6. Under What helped (optional), tap the chips for what you tried: Music, Quiet room, Went outside, Our script / agreed answer, Snack or drink, Changed the subject, Waited it out, or PRN medicine. You can also type your own words, such as a medicine name.
7. Under Follow-up, Did it help? has four choices: Not yet (the starting choice), Helped, Helped a little, and Did not help.
8. Add anything else under Notes (optional). When your iPhone can dictate on the device, a microphone button next to the box adds what you say to the note. Under When, Started at shows the current time; change it if the moment began earlier.
9. Tap Save at the bottom of the screen. (While the keyboard is open, Save moves to the bar above the keyboard.) If the moment is still unfolding, save it now and leave Episode ended off and Did it help? on Not yet; it stays open and you come back to it from the Needs follow-up list below.

To change an episode later, tap it in the Behavior Changes list. The same form opens as Edit Behavior Change, with Delete entry at the bottom. Available

Over time, CareHaven can show careful, honest rollups such as "quiet room helped 3 of the 4 times you tried it" or "noise was marked before 6 of 9 agitation episodes where you marked a trigger." It will always show the count behind the statement, and it will never say a trigger caused the behavior. As-needed (PRN) medicine is kept out of the ranked list of caregiver strategies, so the card stays focused on the day-to-day responses you can try or mention in a handoff.

You'll find these cards in Main Menu -> Track -> Insights -> Patterns (see Daily tracking). A what helped card appears once you have tried the same response at least three times, answered Did it help? each time, and it helped at least once. It reads like "Quiet room has helped: Quiet room helped 3 of the 4 times you tried it. It helped a little 1 other time." A common trigger card appears once at least four episodes of the same kind have a trigger chip marked and one trigger shows up on at least 40% of them. It reads like "Too much noise before Agitation: Too much noise was noted on 6 of the 9 agitation episodes where you marked a trigger." Available

These are observations from your own logs, not medical advice. If behavior changes suddenly or feels unsafe, contact the care team or emergency services.

Closing an open episode. An episode counts as open until it has both an end time and an answer to Did it help?. Open episodes sit at the top of the Behavior Changes list in a Needs follow-up section, with the note "Close the loop when the moment has passed." Each row says what is missing: Still open — did it pass?, Add when it ended, or Did anything help?, followed by a line such as "Tap to add when it ended and what helped." Tap the row, turn on Episode ended and set the minutes, answer Did it help?, and tap Save. The episode then moves down into the main list. Available

The reminder. If an episode is still waiting for an answer to Did it help?, CareHaven sends one gentle notification about two hours after it started. It reads Did it pass? when you have not set an end time ("When you have a moment, add when it ended and what helped.") and What helped? when you have ("When you have a moment, add what seemed to help."). A reminder that would land between 10 PM and 8 AM waits until 9 AM instead. If that pushes a Did it pass? reminder to the next morning, it reads "Last night's episode — did it pass? Close the loop when you can." A What helped? reminder keeps its normal wording. Saving the answer cancels the reminder. It only comes if Local Notifications and Care Nudges are both on (Settings -> Menus & Quick Log -> Features), notifications are allowed for CareHaven on your iPhone, and no Focus is silencing them. Available

The calm offer. When you save a new episode at intensity 4 or 5, a small screen called 60 seconds of air opens with a one-minute timer (tap Start). It is an invitation, not a requirement, and it appears at most once every 24 hours for each person. Close it and the form closes with it. It does not appear when you edit an existing episode. Available

Three A.M. capture

The hardest episodes often happen when typing is least realistic. Three A.M. capture lets you log dementia-related moments by voice or a very short quick-capture path from Main Menu -> Memory Care, so wandering, agitation, or a night episode does not disappear into a vague note. Available

For the voice route, tap + -> Just say it (the wide row at the bottom of the grid, marked "Speak one sentence"), or say "Just say it in CareHaven" to Siri, and say what you see, for example "she's pacing and agitated." When CareHaven hears a hard moment, it does not save anything on its own. It opens the Log Behavior Change form already filled in: the kind guessed from your words (Wandering attempt if you said wandering, Sundowning if you said sundowning, otherwise Agitation), your words in Notes, the time you tapped Save on the draft as Started at, and the intensity set to 3 (Needed redirection). Check it, change anything, and tap Save. Available

Familiar Faces

For a person with memory changes, familiar people can be part of orientation and comfort. CareHaven lets you add familiar faces with a photo and relationship at Main Menu → Memory Care → Familiar Faces, so the information is ready when a caregiver needs it. Available

Comfort-Only mode (the app softens for hospice care)

When the person's code status is set to Comfort-Only, the whole app re-frames itself for end-of-life and hospice care. The language softens. The surfaces that matter most in comfort care come forward, and goal and milestone language goes quiet. The look stays the same brand, with a more dignified accent.

What changes:

• "Care plan" replaces "treatment plan" in headers.
• PAINAD pain observation becomes the top medical surface, instead of seizures.
• Milestone language, such as "learning to...", is set aside.
• The lock-screen Care Card shows the DNR first, in coral.
• The patterns view leans toward comfort measures such as pain, sleep, and restlessness, rather than developmental milestones.

This is not a one-way door. You can switch back to Full Code, DNR, or DNI at any time in Person profile → Advance Directives → Code Status when the situation changes.

The framing change is for the caregiver; the underlying records are exactly the same. If you set Comfort-Only and then someone joins the care team who needs the regular surfaces, you can flip back whenever you need to. Available

What is coming next

The next dementia work focuses on the moments caregivers hit most often, not on adding more screens.

Found in Fifteen

CareHaven will not track a person by GPS. Found in Fifteen is the opposite approach: prepare the first fifteen minutes if someone goes missing. Coming soon

The plan builds on the existing wandering crisis plan: a current photo, what they look like, where they tend to head, calming words for when they are found, who to call, and a ready-to-share flyer that you choose to send. It is about fast, ethical preparedness, not surveillance.

Say This Now

The script cards already exist. Say This Now brings the right script closer to the moment: after you log a repeated question, refusal of care, or other hard episode, CareHaven can offer the matching card right there. Coming soon

Doctor Day Packet

Doctor Day Packet is a parking-lot summary for the appointment. It will gather behavior episodes, what helped, medication changes, falls, PAINAD trends, mealtime watch notes, and the questions you saved, then turn them into a clear visit packet. Empty sections will stay empty; CareHaven will not pad the story. Coming soon

Crossroads

Crossroads is an early-stage elder-care slice for decisions with closing windows: the driving conversation, power of attorney and advance-directive readiness, Personal Voice banking while speech is strong, and life-story recording as connection. Coming soon

It will be guidance and organization, not legal advice and not a prediction about decline.

Still further out

Several dementia and elder-care ideas remain on the roadmap: a stage-aware compass, a sundown plan, good-hours activity suggestions, grief and ambiguous-loss support, hospital discharge support, and a broader important-papers locker. Planned

CareHaven will keep the same guardrails: no hospice eligibility detection, no stage-duration forecasting, no caregiver-administered cognitive testing, no fake community, and no GPS tracking of a person with dementia.

Related pages

• Medical — pain, health changes, mealtime watch, and doctor visits.
• Safety & crisis plans — wandering plans, Care Card, Passport, and Letter of Intent.
• Caregiver tools — scripts, Calm Tools, Share the Load, and respite planning.
• Support tailored to a diagnosis — how condition-aware tools appear only when they fit.