BrainWave and the Missing Middle: A New Philosophy for Dementia Care
For years, the senior-care industry has focused heavily on teaching the clinical realities of dementia and the strategies needed when a person becomes overwhelmed or escalates. These topics are undeniably important, yet they represent only two ends of a very long spectrum. Between the moment of diagnosis and the moment of crisis lies the true lived experience of dementia, and it is in this middle space. The space where its quiet, subtle, and profoundly human. Where the industry has left the largest gap unaddressed.
Caregivers often receive excellent instruction on what dementia is, how the brain changes, and why certain behaviors occur. They are taught how to validate, redirect, soothe, and respond when someone becomes distressed. But very few programs teach caregivers how to support the person in the hours, days, and months before distress ever appears. For many seniors, that middle space determines whether they live in a world that feels grounded and familiar or one that feels unpredictable and frightening. It is the difference between dignity preserved and dignity eroded.
This gap became impossible for me to ignore as I worked across adult day programs, home care, and assisted living communities. I watched well-intentioned teams trying to deliver quality care inside systems that gave them clear instructions at the moment of diagnosis and clear instructions at the moment of crisis, but little guidance about how to support the person in the ordinary moments in between. Most of the suffering I witnessed did not come from dementia itself. It came from the lack of structure, predictability, and identity-centered support that people desperately needed long before behaviors surfaced.
That gap is what led me to create BrainWave, a philosophy, not a program, designed to reshape the way dementia care is understood and delivered. Rather than focusing on the decline or on the behavioral expressions of distress, BrainWave begins with the person: who they were before the diagnosis, what patterns shaped their routines, what emotions guided their relationships, and what environments helped them feel safe. It centers the idea that dementia care can only be effective when it preserves identity, supports familiar muscle memory, and creates the conditions necessary for emotional stability.
What the industry often overlooks is that identity is not simply a biography. It is a neurological anchor. People with dementia may lose access to certain memories, but the emotional landscape that defined them. Things like how they moved, how they connected, how they interacted with their surroundings remains deeply embedded. When caregivers understand and support these patterns, the person stays more regulated, more independent, and more connected. When these patterns are ignored, the individual becomes overwhelmed long before their behavior tells us something is wrong.
The body plays a powerful role in this process. While dementia may impact short-term memory or language, the body often retains the instinctive motor sequences that were repeated over years or decades. This muscle memory might include the way someone sets a table, folds laundry, brushes their hair, organizes a workspace, hums while completing a task, or kneads dough as they once did in their kitchen. When these movements are incorporated into daily life, they provide comfort, competence, and continuity. When they are stripped away in favor of task efficiency, the person loses a vital connection to themselves.
Environment is equally influential. Light, noise, clutter, temperature, transitions, and sensory stimulation all shape the emotional world of someone with dementia. A predictable, calm, sensory-supportive environment helps regulate the nervous system and reduces the likelihood of confusion or distress. An unpredictable or overstimulating environment accelerates overwhelm and contributes to behaviors we later label as “symptoms.” Yet environmental regulation receives far less attention in traditional dementia training than it should. What professionals typically classify as a “behavior” is often the direct result of an environment that the nervous system can no longer manage.
BrainWave addresses these overlooked components by teaching teams how to build emotional and neurological safety into everyday care. This includes meaningful engagement tied to the person’s history, trauma- and emotion-informed communication strategies, and preventative approaches that stabilize the nervous system throughout the day. Instead of waiting for a behavior to occur and then intervening, BrainWave helps caregivers understand what keeps the person regulated so that the behavior never develops in the first place.
This shift matters because dementia is not just a cognitive condition. It is an emotional experience. A person with dementia is constantly trying to make sense of a world that feels less familiar over time. When we build care around who they are; their strengths, rhythms, instincts, and deeply ingrained patterns we protect their dignity, autonomy, and sense of self. When we build care solely around their symptoms, we unintentionally contribute to the very distress we are trying to manage.
The future of dementia care must move away from a reactive model that sees behaviors as the central problem. Behaviors are communication. They signal confusion, fear, pain, overwhelm, unmet needs, or a loss of grounding. When care focuses entirely on managing behaviors, it treats the symptom rather than the cause. But when care focuses on identity, predictability, sensory stability, emotional safety, autonomy, purpose, and muscle memory, many behaviors never arise at all. This is not because the condition has changed, but because the person has been supported proactively according to how their brain and body now experience the world.
We do not need more dementia programs that reinforce the medicalized lens through which dementia has traditionally been viewed. We need programs and philosophies that reflect the emotional and neurological complexity of living with the condition. Dementia care must become preventative, identity-anchored, and relationship-driven. It must embrace the truth that the person remains, even if their access to themselves shifts.
BrainWave was built to honor that truth. It recognizes that dementia does not erase selfhood; it alters the pathways to accessing it. The responsibility of caregivers, families, and care environments is to build those pathways intentionally using history, instinct, environment, and relationship as the guideposts. The most meaningful progress in dementia care will not come from more interventions, more correction, or more crisis strategies. It will come from creating fewer reasons for crisis in the first place.
Dementia is not experienced in the dramatic moments alone. It is experienced in the quiet ones. When we learn to support those moments with depth, understanding, and intentional design, we elevate not only the lives of those living with dementia but also the lives of those who love and care for them. The gap in the middle, the part the industry has long overlooked is where the future of dementia care begins.
About the Author
Nicole Haney is a senior-care visionary, entrepreneur, Certified Dementia Practitioner, published leadership author, and podcast host. She is the Founder of Papa’s Place Adult Day Care & Home Care, the Founder of N. Haney Enterprises, and the Owner & CEO of Tustin House Assisted Living.
Her career began in Recipient Rights, healthcare administration, and mental-health oversight—experiences that grounded her mission to build care systems rooted in dignity, autonomy, and meaningful purpose. Today, she leads integrated senior-care operations across adult day programming, home care, assisted living, and dementia-informed services, while coaching leaders across the U.S. to develop sustainable, relationship-centered care ecosystems.
