When caring for your loved one with dementia, you may come across counselling as a source of support. However, deciding to speak with a counsellor can feel challenging, especially if you are unsure of what to expect or how it might benefit you.
This article discusses how counselling can help caregivers in different stages of dementia, ways to approach counselling, and where to find counselling services in Singapore.
How Counselling Supports the Dementia Caregiving Journey
As dementia progresses, the needs of caregivers can bring feelings of uncertainty, grief and anger. With growing caregiving responsibilities, caregivers may find it harder to prioritise their wellbeing. Over time, this can potentially lead to adverse effects such as burnout, compassion fatigue or stress. Counselling can help caregivers maintain their wellbeing throughout the different stages of dementia by providing a listening ear and emotional support.1
Counselling for Caregivers for Early-stage Dementia
Caregivers may feel stressed or concerned as they try to accept their loved ones’ diagnosis and to figure out how best to support them. This includes how to make their home dementia-friendly and sharing caregiving responsibilities with their family members.
At this stage, it is also common to start thinking about finances and work arrangements. Caregivers may also want to consider making a Lasting Power of Attorney (LPA). This ensures financial and healthcare decisions are made according to their loved ones’ wishes if they lose the ability to make decisions.
During this transition into their caregiving roles, counselling may help in understanding and processing unpleasant emotions as they come to terms with their loved ones’ diagnosis. Support may also be provided in the form of dementia education, which may be helpful for caregivers who are unfamiliar with dementia.2
Counselling for Caregivers for Middle-stage Dementia
Caring for one’s loved one with middle-stage dementia demands more responsibilities. The person with dementia may go through behavioural changes and further cognitive decline, thus requiring more support in handling daily activities such as showering, using the toilet, and getting dressed.3
Caregivers may need to set aside their own priorities to take care of their loved ones.4 At this stage, they may also consider bringing in a domestic helper for support.
With the increased responsibilities, caregivers may feel more stressed and struggle with their loved ones’ changing needs. Caregivers may also face a loss of boundaries and not having enough time for themselves to unwind. Counselling can help to develop personalised coping strategies, manage other forms of stress, make time for themselves, and seeing situations from a different perspective.
Counselling for Caregivers for Late-stage Dementia
Persons with late-stage dementia require their caregivers to continuously manage and supervise their daily needs, as their abilities decline further. These include extensive assistance in walking, verbal communication, and eating. 5 They may also struggle with remembering familiar faces.6 As a result, connecting with their loved ones can be challenging, leaving caregivers feeling upset, discouraged or grief.
During this stage, caregivers often have to make difficult decisions, such as end-of-life matters.7 This may include discussions on palliative care and alternative living options, such as nursing homes or hospice care. Making these decisions can lead to guilt from thinking that caregivers are not doing enough for their loved ones. However, they may also feel relief at the same time.
These mixed feelings are often accompanied by grief as their loved ones’ life draws to a close. As such, counselling can provide a safe space for caregivers to process different forms of grief such as anticipatory grief, handle difficult decisions, and provide emotional reassurance, during this last lap of caregiving. Counselling also supports caregivers in looking towards the future after their loved ones pass on.
How to prepare for the first counselling session?
Think about what you want to talk about and to achieve from counselling beforehand.
Useful Prompts:
•Is there a specific event or incident you wish to bring up?
•Are there feelings and thoughts that have been bothering you?
•Are there any patterns of behaviours you have noticed about yourself that could be of concern?
•Are there any areas of your life that has been impacted?
Knowing what you want to achieve from counselling can help you in expressing your needs to your counsellor, making it a more fruitful and meaningful session.
To guide you along, especially during your first session, your counsellor may ask personal questions to get to know you better. This may include setting of counselling goals, counselling frequency, and questions about your family history.
Keep an Open Mind
It may take time for you to see progress in your counselling journey. It is important that you remain patient and approach each session with an open mind. One session may not resolve the issues you are facing, and it is helpful to remember that progress in counselling is rarely linear.
Approaching sessions with an open mind to new ideas, such as trying new coping strategies, can help you discover more effective selfcare or caregiving approaches.
Be Ready to Share Your Inner Feelings and Thoughts
Counselling can be a daunting experience for those who are not comfortable with sharing their emotional state with strangers or acquaintances. During your first counselling session, you may feel uneasy or struggle to speak about your experiences to your counsellor.
This is part of the counselling journey. As your rapport with your counsellor develops, it can become easier for you to open up to your counsellor.
Relaxing activities can help alleviate uncomfortable feelings that arise. You could make yourself some tea or read a book to relax and unwind.
Joining caregiver support groups can also give you a dedicated space to share your feelings and connect with other caregivers who can relate to your experiences.
Types of Counselling and Where to Find Them
Types of Counselling | Where to Find Them |
Helplines
| These helplines provide quick support for caregivers over the phone. This can be done in the comfort of your home in case you need to be home for the person living with dementia. Dementia Singapore (Mon-Fri: 9am-6pm, Sat: 9am-1pm): 6377 0700 Samaritans of Singapore (SOS) (24-hours): 1800-221-4444 |
CREST-CSN | Caregiver Support Network Community Outreach Team (CREST-CSN) specialises in providing support services for caregivers: mindline.sg | Free Mental Health Resources & Mindfulness Tools in Singapore |
COMIT | Community Intervention Team (COMIT) provides mental health support which include counselling for caregivers. There are over 100 teams in Singapore, making it accessible for caregivers: |
Conclusion
Caregiving for a loved one with dementia is a meaningful yet challenging journey, and your wellbeing matters just as much as that of your loved one. Seeking support from counsellors and other support services is a sign of strength. It is by taking care of your own wellbeing that you can continue to provide care for and preserve the dignity of your loved one. Regardless of where you are in your caregiving journey, you deserve the support, and counsellors are ready to support you every step of the way.
Additional Resources
- Caregiver Support Singapore: From Overwhelm to Empowerment. (2025, October 27). In Focus. https://www.in-focus.com.sg/caregiver-support-singapore-mental-health-wellbeing/
- Siow, D. (2008). Managing the caregiver from the general practitioner’s (GP’s) perspective. https://www.cfps.org.sg/publications/the-singapore-family-physician/article/376_pdf
- Ali, S., & Bokharey, I. Z. (2016). Caregiving in dementia: Emotional and behavioral challenges. Educational Gerontology, 42(7), 455–464. https://doi.org/10.1080/03601277.2016.1156375
- Alzheimer’s Society (2021). The middle stage of dementia. https://www.alzheimers.org.uk/about-dementia/stages-and-symptoms/middle-stage-dementia
- Clifford, K., Moreno, M., & Kloske, C. M. (2024). Navigating late-stage dementia: A perspective from the Alzheimer’s Association. Alzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring, 16(1). https://doi.org/10.1002/dad2.12530