Limited communicative resources due to dementia-related memory problems can be consequential for opportunities to claim epistemic rights and initiate and pursue communicative projects for persons living with dementia. This conversation analytic case study of a video-recorded homecare visit between Koki and his homecare nurse focuses on an extended negotiation concerning a factual disagreement related to a practical problem. The study explores how Koki manages to mobilize remaining communicative resources for initiating and pursuing a topical agenda, as well as how the caregiver recognizes and supports these initiatives. The analysis describes how a person with dementia manages to influence the course of action and, in collaboration with the interlocutor, succeeds in achieving two interrelated projects, one being within an epistemic domain and the other within a deontic domain. Koki’s persistent use of first actions, with repeated and upgraded knowledge claims, as well as embodied and verbal displays of a practical problem, contributes to influencing both the topical agenda and action agenda. The analysis shows how an attentive interlocutor may collaborate in identifying a practical problem and finding a solution to it, and thereby assist the person with dementia in taking control over his everyday life despite limited communicative resources.