What to do if you suspect your parents of having dementia?

According to the World Health Organization, over 55 million people worldwide live with dementia, with nearly 10 million new cases diagnosed each year. Navigating the possibility of your parents having dementia is a challenging journey, but understanding the steps you can take is the best way to move forward with confidence and compassion.

Quick Summary

Address concerns about your parents' cognitive changes by observing their behavior, documenting specific incidents, and initiating a gentle conversation with them. The next step involves consulting their doctor for a professional assessment, followed by planning for future care and support as a family. Early intervention is key.

Key Points

• Identify and Document Signs: Notice and write down specific instances of memory loss, confusion, or behavioral changes to provide concrete examples to a doctor.

• Plan a Gentle Conversation: Approach your parents with empathy and a non-confrontational tone, focusing on your concern for their overall health rather than accusing them of forgetting things.

• Consult a Medical Professional: The primary care physician is the first point of contact; they can conduct an initial assessment and refer you to a specialist like a neurologist for a definitive diagnosis.

• Explore Diagnosis and Care Options: Understand that getting a diagnosis is a process involving various tests and be prepared to discuss future care plans, whether in-home, assisted living, or other residential options.

• Establish Legal and Financial Preparations: While your parents are still able, address legal documents like Power of Attorney and healthcare directives to prepare for future needs.

• Prioritize Family and Self-Care: Caregiving is a marathon, not a sprint. Seek support groups, educate yourself, and utilize respite care to maintain your own well-being.

Recognizing the Early Signs of Dementia

Identifying potential dementia in a loved one is the first, often difficult, step. The signs can be subtle and might be dismissed as normal aging at first. It's crucial to distinguish between age-related forgetfulness and more persistent, concerning changes.

Common Warning Signs to Look For

• Memory Loss: Not just forgetting names occasionally, but forgetting recently learned information, important dates, or asking the same questions repeatedly.
• Challenges in Planning or Solving Problems: Difficulty following a familiar recipe, managing monthly bills, or struggling to concentrate on complex tasks.
• Difficulty Completing Familiar Tasks: Getting lost on a route they've driven countless times or forgetting the rules to a favorite game.
• Confusion with Time or Place: Forgetting what day it is or where they are, or losing track of seasons.
• Trouble Understanding Visual Images and Spatial Relationships: Difficulty with judging distances, reading, or navigating stairs.
• New Problems with Words in Speaking or Writing: Struggling to follow a conversation or repeating themselves, calling things by the wrong name.
• Misplacing Things and Losing the Ability to Retrace Steps: Putting items in unusual places (e.g., car keys in the refrigerator) and being unable to find them.
• Poor Judgment: Making questionable financial decisions or neglecting personal hygiene.
• Withdrawal from Work or Social Activities: Losing motivation to pursue hobbies or engage with others.
• Changes in Mood and Personality: Becoming easily upset, anxious, depressed, or suspicious, especially when routine is disrupted.

The First Conversation: Approaching Your Parents

Talking to your parents about these changes requires a gentle and sensitive approach. You want them to feel supported, not defensive. Choose a time when everyone is calm and comfortable, and speak in a private setting. Frame your concerns from a place of love and a desire to help.

How to Initiate the Conversation

1. Use 'I' statements: Instead of saying, "You're forgetting things," say, "I've noticed some changes, and I'm a little concerned. I want to make sure you're okay."
2. Refer to specific, non-threatening examples: "The other day when we were cooking, I noticed you seemed to have trouble with the recipe. We should probably get that checked out."
3. Focus on health, not dementia: Suggest a visit to the doctor for a general check-up. Phrase it as, "Let's go see the doctor together, just to be sure everything is fine."
4. Involve other family members: If you have siblings, discussing the situation with them first can provide a united front and additional support.

Navigating the Medical System

Getting a professional diagnosis is the next crucial step. It can rule out other conditions that cause similar symptoms, such as medication side effects, thyroid problems, or depression. The process will likely involve several steps.

The Diagnostic Process

1. Initial Doctor's Visit: Schedule an appointment with your parents' primary care physician. It is often helpful to accompany them to provide a clearer picture of your observations.
2. Medical Evaluation: The doctor will perform a physical exam and review medical history. They may conduct a basic cognitive screening test.
3. Specialist Referral: If dementia is suspected, a referral to a neurologist, geriatrician, or neuropsychologist is common. These specialists can perform more detailed assessments.
4. Testing: This may include blood tests to check for underlying health issues, brain scans (MRI, CT) to look for structural changes, and comprehensive neuropsychological testing.
5. Receiving the Diagnosis: The diagnosis will provide a clearer path forward, whether it's a form of dementia or another condition requiring different treatment.

Planning for the Future: Support and Care

Once a diagnosis is confirmed, creating a plan for future care is essential. This can be overwhelming, so taking it one step at a time is key.

Comparison of Care Options

Feature	In-Home Care	Assisted Living	Residential Care Homes
Environment	Familiar home setting.	Apartment-style unit within a community.	Smaller, home-like setting with fewer residents.
Cost	Varies widely based on hours.	Often includes a flat monthly rate.	Generally comprehensive, all-inclusive fees.
Independence	Highest degree of independence.	Promotes social interaction and independence.	More structured and higher level of supervision.
Services	Can range from companion care to skilled nursing.	Meals, housekeeping, medication management, social activities.	High staff-to-resident ratio, personalized care.
Benefit	Allows for comfort and familiarity.	Social community and safety.	Intimate setting and high level of personalized attention.

Legal and Financial Considerations

• Power of Attorney: Establishing a Durable Power of Attorney for healthcare and finances is critical while your parents can still make sound decisions.
• Wills and Trusts: Ensure all legal documents are in order and up-to-date.
• Financial Planning: Review their financial situation and plan for the potential costs of long-term care.

Coping as a Family

Supporting a parent with dementia is a family-wide challenge. You need to take care of yourself as a caregiver, too.

Strategies for Coping and Support

1. Educate Yourself: Learn as much as you can about the specific type of dementia your parent has. The Alzheimer's Association is an excellent resource: Alzheimer's Association.
2. Join a Support Group: Connect with other families going through a similar experience to share tips and emotional support.
3. Seek Respite Care: Allow yourself a break from caregiving. This is crucial for your mental and physical health.
4. Maintain Communication: Talk openly and honestly with family members about responsibilities and challenges.
5. Focus on the Person, Not the Disease: Continue to engage with your parent and focus on their remaining abilities and memories, not just the decline.

Conclusion: A Path Forward with Compassion

Discovering that your parent may have dementia is a life-altering experience, but it is not a journey you have to take alone. By recognizing the early signs, communicating with empathy, seeking professional medical guidance, and creating a supportive plan, you can face the future with preparedness. Remember to take care of yourself, lean on support networks, and cherish the moments you have together, adjusting to this new reality with patience and love.

Frequently Asked Questions

What is the difference between normal aging and early dementia?

Normal aging includes occasional memory lapses, like forgetting where you put your keys. Early dementia, however, involves more persistent issues, such as forgetting how to get home from a familiar place, trouble with tasks like managing finances, and significant personality changes.

How should I bring up my concerns about dementia to my parent?

Approach the conversation with empathy and without judgment. Focus on your concerns for their well-being and suggest a doctor's visit for a general check-up. Avoid using the word 'dementia' initially, as it can be alarming.

What kind of doctor should we see for a dementia diagnosis?

Start with their primary care physician, who can perform an initial assessment. If warranted, they will likely refer you to a specialist such as a neurologist, geriatrician, or neuropsychologist for a more thorough evaluation.

Can medication side effects or other issues mimic dementia symptoms?

Yes, many conditions can cause dementia-like symptoms, including thyroid problems, vitamin deficiencies, depression, and side effects from medication. This is why a thorough medical evaluation is crucial to get an accurate diagnosis.

What legal documents should we consider if my parent is diagnosed with dementia?

Key legal documents include a Durable Power of Attorney for healthcare and finances, a will, and possibly a trust. It is vital to get these in place early, while your parent can still legally make and understand these decisions.

How can I, as a caregiver, cope with the emotional stress?

Caregiving for a parent with dementia is emotionally taxing. Seeking a support group, utilizing respite care to take breaks, and staying educated about the disease can help. Remember that it's okay to ask for and accept help.

What is the first step I should take if I suspect dementia?

The very first step is to start documenting your observations. Keep a journal of specific instances and dates of concerning behavior. This information will be invaluable when you speak with a doctor.

Is early dementia diagnosis beneficial?

Yes, early diagnosis is highly beneficial. It can open doors to treatments that can slow cognitive decline, allow for better planning for the future, and provide access to support networks for both the person with dementia and their family.