Buzz
It’s difficult to watch someone close to you endure pain. We’ve all felt some form of suffering, so when a loved one is struggling, it brings back memories of our own painful moments. However, there are times when a person you care about begins to suffer in a different way—and they might not even fully grasp what’s happening. While they might not be losing their physical mobility, they could be experiencing a decline in memory or abilities.
This presents a challenging situation. For instance, if your loved one fell and broke their leg, the steps to take would be clear: they’d seek medical help, get an X-ray, and wear a cast or boot, with instructions for moving around using crutches, a walker, or a wheelchair. While the injury would take time to heal, they’d have seen the X-ray and know their leg is broken.
However, seeing a loved one show signs of dementia is a different matter—from recognizing the symptoms, to navigating the path toward a diagnosis, to figuring out how to talk about it with the person and those close to you. Mytour consulted various experts in dementia and memory care to better understand how to approach these delicate situations.
Dementia manifests uniquely in each individual
Seeing a loved one become increasingly forgetful or repeat themselves frequently can be unsettling. You might quickly wonder if these could be signs of dementia, or simply a part of normal aging. On one hand, you don’t want to make them feel patronized or as though you’re infringing on their independence; on the other hand, you're worried about their well-being.
Although the early signs of dementia differ for each individual, there are certain commonalities, explains Teepa Snow, a licensed occupational therapist and memory care specialist with A Place for Mom, a senior living advisory service. “For this person, things are no longer the same as before—something important is changing, such as attention, flexibility, abilities, interests, emotional stability, or awareness of self and others,” she shares with Mytour.
The indicators of dementia
Generally speaking, the signs of dementia fall into two main categories (although there is some overlap): cognitive changes (e.g. memory loss) and psychological changes (e.g. unusual aggression). According to Lisa M. Cini, author of Hive: The Simple Guide to Multigenerational Living, and an expert in aging, Alzheimer’s, and long-term care design, here are some of the most frequent signs of dementia:
Shifts in personality.
Frustration due to difficulty finding the right words.
Repeatedly telling the same stories or comments (not just at different times, but one after the other).
Depressive feelings.
Paranoia, such as believing others are talking behind their back or intending to harm them.
Confusion and disorientation.
Difficulty playing games they once enjoyed.
Challenges with driving, including forgetting where they were headed or how to return home.
Cini also notes that other conditions can lead to symptoms similar to dementia, such as a urinary tract infection (which can cause severe confusion in older adults), a brain chemical imbalance, or issues with their medications. If any of these concerns arise, it's important to see a doctor for diagnostic testing to rule out these other causes.
The symptoms mentioned earlier can manifest in various ways, so Snow—whose expertise lies in dementia—outlined a few specific scenarios that you or your loved one might notice:
Shifting patterns in episodic social interactions or activities
This isn’t about someone suddenly avoiding their daily or regular social interactions, but rather missing out on activities they previously did occasionally. These could include holiday traditions, volunteer or work-related duties, or home maintenance tasks. Sometimes, these activities may be skipped, handled poorly, or lead to emotional distress in ways they never did before.
Falling victim to scams or following advice from unreliable sources
This could also involve situations where your loved one allows someone else to access their valuable resources without hesitation, ignoring details or facts that they would have previously noticed or questioned.
Trouble reaching destinations
This might include increased difficulty traveling to unfamiliar places or returning from familiar ones, especially when a new route is required.
Struggling to locate items in familiar places or areas
They may simply fail to notice them, or claim that someone must have moved or hidden the items.
Unusual or illogical thoughts or statements
These can involve inaccurate or inconsistent views about past events or personal history, which do not align with their prior understanding or knowledge. These thoughts may relate to relationships, finances, resources, or the sequence of events and outcomes.
Facing new difficulties with financial matters
This includes making errors, taking unnecessary risks, missing deadlines, or possibly concealing the evidence of these mistakes.
Difficulties with memory
These may involve forgetting meetings, appointments, conversations, agreements, or decisions. Additionally, the person may struggle to accept something as true, even when there is clear evidence it has happened.
New challenges with perceiving time and its passage
The person might confuse past events with recent occurrences or believe something happened recently, even though it has been a long time. Examples include forgetting visits, calls, connections, or daily responsibilities and routines.
Emotional changes
This can involve changes in emotional flexibility, range, or responsiveness to both familiar and new situations, interactions, or events, ranging from indifference to intense fear, or extreme fight-or-flight reactions.
How to discuss dementia with the person you're concerned about
Although these conversations are always difficult, there are ways to prepare for talking about dementia with a loved one. Below are expert tips that might be helpful:
Be straightforward
When discussing the topic, Dr. Wilfred Van Gorp, a neuropsychologist and director of the Cognitive Assessment Group, recommends being direct. He suggests beginning the conversation with something like, 'I’m concerned about your memory—I’d like to go with you to the doctor to have this checked out.'
Avoid diagnosing the person
Being honest about your concerns regarding a loved one's memory is one thing, but jumping straight into making a diagnosis is not the way to approach it. Caroline Tapp-McDougall, the author of The Complete Guide for Family Caregivers and publisher of Caregiver Solutions magazine, advises against saying that you believe they have dementia. 'Only a qualified healthcare professional, such as a doctor or specialist, can officially diagnose dementia,' she tells Mytour.
Similarly, Tapp-McDougall emphasizes the importance of preparing yourself for the possibility that the person may not have dementia. 'Remember, not all memory loss is the same, and some memory loss can be part of the natural aging process,' she explains.
Make it a private conversation
Rather than confronting the person you're worried about in a group setting about their memory issues, both Cini and Tapp-McDougall recommend having a one-on-one conversation. 'Whatever you do, don’t gang up on them, respect their autonomy, and focus on helping them rather than taking away their independence,' says Cini.
Inquire about their concerns.
If you begin by expressing concern about their memory, Tapp-McDougall advises following up to see if they share the same worries. They might realize they've been struggling to read or write, might feel unusually moody or irritable, or have been forgetting things more often.
However, they may also deny there’s an issue. If that happens, Tapp-McDougall suggests avoiding confrontation. 'It’s important to meet them where they are, don’t argue, and don’t make them feel bad,' Cini advises. 'This situation is far more difficult for them than it is for you.'
Concentrate on safety and finding solutions.
Rather than tackling everything at once, Cini recommends focusing the conversation on areas that impact their safety, such as driving or medication management. If they resist the discussion or oppose your viewpoint, Tapp-McDougall suggests offering a few examples that highlight potential risks, without directly contradicting them, including some key incidents.
Cini suggests that it’s essential to have considered possible solutions to any safety concerns before bringing them up with someone. "If you don't have an answer or a way to assist them, it's best not to discuss the issue," she states. "For instance, if driving has become a concern, offer a solution like driving them or setting up an Uber account so they can continue to enjoy life and get around."
Offer comfort and reassurance
The success of your conversation largely depends on the tone and approach you adopt. Tapp-McDougall advises starting by choosing a quiet, private location for a one-on-one conversation and using a soft, compassionate tone. "Let them know you're worried because they haven't been acting like themselves lately, but avoid sounding critical or accusatory as this could lead to defensiveness," she explains.
Denial is often the first response to these types of discussions, as noted by Tapp-McDougall, and it can be counterproductive to point out specific instances of forgetfulness or confusion in a harsh way. "The most important thing is to reassure them that you are there to help," she says. "This can be a terrifying, sad, and sometimes humiliating experience for them."
If you feel the need for support, don't hesitate to seek it before initiating the conversation.
"Make sure you're in the right emotional, physical, and mental state," Snow advises. "It might be beneficial to consult with a professional who understands the brain changes associated with aging or shifts in life circumstances, so you can receive the necessary support before diving into a difficult and unfamiliar conversation."
If you're uncertain where to begin, Snow points out that there are several agencies, organizations, and professionals who offer such services, including geriatric care managers and your local Area Agencies on Aging.
How to approach discussing potential dementia symptoms with others your loved one relies on
Alongside your loved one who may be facing memory issues, it’s also essential to discuss your concerns with the other people they depend on daily—whether that be a spouse, sibling, or neighbor. However, this can be easier said than done. Van Gorp suggests addressing it directly with family members (or close others), asking something like, "Have you noticed Dad’s memory has been slipping? Maybe we should take him to the doctor for a check-up." Below are some other approaches:
Seek their viewpoint
The first step in initiating this kind of conversation, according to Snow, is to understand the other person’s perspective and their awareness of what you've observed in the person you both care for. "Don’t try to force them to agree with you," she advises. "Instead, try to understand what they’re noticing or how they’re perceiving the situation." She warns that turning it into an argument about differing views will only make future interactions and support more difficult.
If the other person doesn’t seem aware of what you’ve noticed, Snow suggests trying something like this: "I’m wondering if you’ve seen any changes in how Mom is managing meals? I noticed there were a lot of expired or moldy items in the fridge, which doesn’t seem like something she usually does." Then, listen to their response. "If you don’t sense any acceptance or agreement, it might be a good idea to pause and consider seeking support from another source," Snow advises.
Begin discussing a potential plan
You might not be at the stage where a plan is necessary yet, but that doesn’t mean it’s too soon to start the conversation. Michael Bloch, CEO & Founder of Pillar Life—an app designed to help families and communities organize caregiving tasks—explains that a dementia care plan is a formal document created to help caregivers understand the patient's needs and identity, aiming to enhance their quality of life. Here’s more information about what that could entail.
Knowing when to involve professionals
There are times when an incident makes it clear that it’s time to consult healthcare professionals for your loved one. Other instances, however, can leave you unsure about when to take that step. Van Gorp believes it’s always better to act sooner rather than later.
"The ideal time to bring in experts is right after you notice something unusual. Medications and interventions work best in the early stages," he tells Mytour. "Don’t wait too long. Once damage is done, it’s often irreversible." He suggests reaching out to a general practitioner or a neurologist.
