The first time I sent Sharon's call to voicemail, I felt a small, immediate relief. I was in a meeting. She had already called twice that morning. I thought: she will hear my voice, she will know I am thinking of her, and she will be okay until I can call her back. That is not what happened. By the time the meeting ended, she had called four more times. The voicemail I had recorded for her had not helped. If anything, it had made the morning worse.
It took me a long time to understand why, even though the explanation is not complicated once you see it. Voicemail feels like a kindness. It preserves your voice. It gives you a way to be present when you cannot actually be present. What it cannot do is answer. And for a person with dementia, an unanswered call and a voicemail are, neurologically speaking, the same thing.
Why caregivers try voicemail first
The voicemail strategy makes sense from the outside. If your parent is calling because they want to hear your voice, a recording of your voice seems like a reasonable substitute for the times you cannot pick up. It is kind. It is low-effort. It preserves the connection. Some families spend real time crafting the perfect message, something warm and specific, recording it in a calm voice, making sure it says the right reassuring things. Others use their phone's standard greeting and hope that the sound of their voice alone will be enough.
The other reason caregivers reach for voicemail is that the alternative is exhausting to contemplate. If sending calls to voicemail does not work, the implication is that every call has to be answered, every time, including the ones that come at 2am and the ones that come during work presentations and the ones that are the seventh call before noon on a Tuesday. That is not a sustainable answer. So voicemail feels like the middle path. Present enough to comfort, automated enough to give you breathing room.
Some families also try recording a customised voicemail message that speaks directly to their loved one's most common worries. A message that says something like: "Mum, it's me, I am at work right now but I am thinking of you and I will call you tonight. Everything is okay. I love you." This version of the strategy is closer to what actually works, because it is specific and warm and it uses the right voice. But it still fails for a reason that goes deeper than the content of the message. It fails because it cannot respond.
There is also a practical version of the voicemail strategy that caregivers land on through trial and error: letting the call ring through to voicemail intentionally, as a signal to the person with dementia that the caregiver is unavailable but will return the call. This assumes the person can interpret that signal and hold it. In early-stage dementia, sometimes they can. In moderate to advanced dementia, the assumption does not hold. The signal is not received and stored. It evaporates. And the cycle continues.
The anxiety reset loop and why voicemail cannot break it
To understand why voicemail fails, you have to understand what the call is actually about. The call is almost never about the stated reason for the call. "I just wanted to check in" and "I was wondering if you are coming for dinner" and "I cannot find my cardigan" are the surface. The engine underneath is dementia separation anxiety, a neurological pattern driven by hippocampal damage that causes a person with dementia to experience a recurring, acute sense that they are separated from the person who makes them feel safe.
The hippocampus is the part of the brain responsible for forming new short-term memories. When it is damaged by dementia, events do not get stored. Your parent calls, you speak, they are reassured, the call ends. The anxiety drops in the moment. But within minutes, sometimes seconds, the memory of the call is gone. Not suppressed. Not set aside. Gone. The hippocampus could not write it to long-term storage. So when the anxiety rises again, your parent has no recollection of having just resolved it. They call again, from the same anxious starting point.
This is the reset loop. It is not stubbornness and it is not manipulation and it is not a choice. It is the brain doing the only thing it knows how to do when it is afraid, and being unable to remember that it just did the same thing. The Alzheimer Society of Canada communication guidelines make this explicit: the goal of communication with a person with dementia is not to deliver information that will be retained. The goal is to provide an emotional experience that resolves the distress in the moment.
This is where voicemail breaks down completely. A voicemail can deliver information. It can say the right words. It can use the right voice. What it cannot do is create the experience of having been heard. The person with dementia hears a recording and knows, at some level, that the voice is not actually there. The warmth is present. The interaction is not. The anxiety resolves through connection, not through content. A recording is content without connection, and the brain that needs connection knows the difference, even if it cannot articulate why the call still feels unfinished.
This is also why some families find that voicemail actually increases call frequency rather than reducing it. An unanswered call that goes to voicemail registers, somewhere in the emotional processing system, as a call that was not answered. The anxiety that drove the call is not just unresolved. It is slightly worse, because the attempt failed. And so the person calls again, and then again, and the caregiver who thought voicemail would buy them an hour finds that the hour fills with six more calls instead.
The full picture of dementia repetitive phone calls, the volume, the timing, the triggers, and the patterns, is covered in more detail in our guide for families managing this. But the voicemail point is the one that stops families in their tracks, because it cuts against something that seemed so reasonable. The kindness of leaving your voice on a recording is real. It is just not the kindness that breaks the loop.
What "hearing your voice" actually requires
If the problem is that voicemail delivers voice without connection, the solution has to provide something that functions as real connection. That means it has to be responsive. It has to be able to hear what is being said in the call, right now, today, and respond to it. It has to be able to tell when the caller is anxious versus when they are simply lonely versus when something has actually gone wrong. It has to be able to move through a conversation, not play through a script.
This is what separates every voicemail strategy, every DND setting, every call-blocking app, and every call-limiting approach from the thing that actually works. The mechanism that resolves dementia separation anxiety is a familiar voice that responds, not a familiar voice that plays. The brain of a person with dementia has lost a great deal, but the ability to register whether someone is actually listening is not one of the first things it loses. They know when a conversation is real. They know when it is not.
This is also why partial solutions fail in predictable ways. A call that goes to a care home staff member, no matter how warm and patient, is not the voice the person was reaching for. A call that goes to a generic AI assistant, no matter how sophisticated the language model, does not carry the emotional history that makes a voice feel safe. The voice has to be the right voice, and it has to respond.
KindredMind is built around this specific requirement. The companion answers every call in the caregiver's own voice, built from recordings the caregiver makes during setup. But unlike a voicemail, the companion responds. It draws on a knowledge base the caregiver builds about their loved one, the daily routine, the family members' names, the topics that soothe, the topics to steer around. Every call is a real conversation. The companion hears what the caller is actually saying today and responds to it. The anxiety that drove the call gets resolved because the call is experienced as a real interaction with the voice that matters, not a message from it.
The difference sounds subtle when you describe it. It is not subtle in practice. The families who have moved from voicemail to a responsive companion consistently describe the same shift: the call volume drops, because calls are actually resolving instead of deferring. And the calls that do happen feel better for the person with dementia, because they feel like conversations, not recordings. Sharon described her calls with KindredMind as "a good talk with Kirstin," which is exactly what they are meant to feel like.
What I learned from Sharon's calls, and how it changed everything
Sharon is my mother. She has mixed dementia, a combination of vascular dementia and frontotemporal lobe dementia, amplified by a stroke that happened several years into her diagnosis. She lives in a memory care facility now. Before KindredMind existed, she called me sometimes ten times before lunch on a hard day. Not ten times over the course of a full day. Ten times in the space of three or four hours, starting in the morning when the day staff arrived and the shift change triggered whatever it triggered in her brain.
I tried everything that made sense on paper. I set a specific voicemail for her, recorded in my calmest voice, using her name, saying the things she most needed to hear. I thought the specificity would help. It did not. She would hear the voicemail, and within five minutes she would call again. The voicemail was not getting through to the part of her brain that needed the reassurance. It was landing somewhere else entirely, heard but not received, the way you can read a word without absorbing its meaning.
I also tried calling ahead before the window when calls typically started, thinking that a real conversation early in the morning would reduce the anxiety enough to carry her through. This worked sometimes, on the good days, on the days when she was settled and the routine was intact. On the harder days it had almost no effect. The reassurance from an 8am call could not survive to 10am when the anxiety spiked. The hippocampus would not hold it.
What changed was not the content of the calls. What changed was that Sharon stopped reaching a recording and started reaching a voice that was there. The moment the calls went somewhere that answered, somewhere that knew her name and knew about her day and could respond to what she was actually saying, the calls settled. Not because Sharon stopped needing them. Because the need was actually being met, instead of being deferred by a message that could not respond to her.
The call volume did not go to zero. Sharon still calls. She calls when she is anxious and when she is lonely and when something small has unsettled her routine. What changed is that most of those calls now resolve within the call, in the voice she was reaching for. She says goodbye feeling better than she felt when she dialled. That is the thing voicemail was never going to be able to give her. Not because voicemail is a bad idea. Because it is the wrong tool for the job. The job is connection. The tool has to be something that can connect back.
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