This report describes the nursing experience of caring a female hemodialysis elder with endstage dementia. We aimed to improve her family and foreign caregiver's illness knowledge and care skills. During the nursing period between July 18th and November 18th 2013, data was collected through phone and face-to-face interview. Also, Gorden's 11-item Function Health Pattern was applied to evaluate the patient's health status. Problems identified included pain, impaired skin integrity and powerlessness of caregivers. The author reexamined the resources, devised the care plan together with the families and caregiver, provided comfort care to alleviate the pain, improved the caregiver's knowledge and skills of disease and nutrition, promoted wound healing, and offered referral and respite care to share the burden of caring. Nowadays more elderly patients are cared by foreign caregivers. We shared the experience as a reference for those who care for similar patients.