How to Have Difficult Conversations About Dementia

If a loved one is showing signs of memory loss or dementia, you likely have some challenging but necessary conversations ahead. While it may be tempting to avoid the issue, initiating these conversations will help ensure your loved one gets the support they need. Here are some of the topics that can be most difficult to broach, along with tips for getting a discussion started:

Consulting a Doctor

Getting a proper diagnosis is one of the first steps in dementia care. Once the reason for your loved one’s confusion or memory loss is properly identified, they may have access to medications that can treat symptoms. You’ll also be able to start planning for their care. But first, your loved one needs to agree to see a doctor. Here are ways to encourage them to take this important step:

• Emphasize the positive. Remind your parents that the doctor may offer treatments that help with their symptoms.
• Suggest a wellness visit. Frame the doctor appointment as a routine check-up rather than a consultation about dementia symptoms.
• Offer an incentive. Sweeten the deal by promising a nice lunch or other fun outing after the appointment.
• Use another ailment as an excuse. Your loved one may be more willing to consult a doctor about balance issues or knee pain than about memory loss.

The Dangers of Driving

The keys to the car can be a symbol of freedom and independence, and most of us would be loath to give them up. Unfortunately, dementia erodes many of the abilities required to drive safely—including mental focus, quick decision-making and the ability to follow logical steps. If you’re finding evidence that your loved one isn’t safe behind the wheel—scratches or dents on the car, for example—you’ll need to address the problem for their own well-being and that of others. These approaches can help your loved one accept that it’s time to give up their keys:

• Appeal to their sense of responsibility. No one wants to endanger others. Remind your parent that unsafe driving poses a risk not only to them, but also to other drivers and pedestrians.
• Enlist a doctor’s support. A doctor’s professional opinion can add weight to your argument.
• Suggest alternatives. Driving can be a lifeline to social opportunities, entertainment, worship services and necessities like groceries. Before starting the conversation, come up with a plan for making sure your loved one still has access to transportation. Suggest friends or family members who are willing to give rides, delivery services for groceries and medications, or community transportation services.
• Be empathetic. For your parent, giving up driving may seem like the end of freedom and self-reliance. Let them know that it’s understandable if they feel grief, resistance, even anger.

Making Financial and Legal Plans

As dementia progresses, your parent will be unable to handle their finances or make sound decisions regarding their healthcare and estate plan. That’s why it’s important to make sure the proper plans are in place. If your parent doesn’t have a will, advance directive, power of attorney, or other important documents already, encourage them to meet with an attorney. To help the conversation go smoothly:

• Come prepared. Have a list of important legal documents your parent will likely need.
• Let them know you care. Explain how these documents will help them get the support and care they need as their dementia progresses.
• Ask questions. Find out which documents your parent already has and where they’re located.
• Discuss their wishes for end-of-life care. Conversations like these aren’t easy, so be patient, keep discussions short and revisit them if necessary.
• Encourage them to make an appointment with their attorney. It’s typically not advisable that you accompany your parent to their meeting with their estate planning attorney, but you can again suggest a celebratory treat after their appointment. Remind them that they’ll breathe a sigh of relief once they know their legal and financial affairs are in order.

Living Arrangements

There will likely come a time when your parent won’t be safe without round-the-clock supervision and care. For most families, this means their loved one will eventually need to move to Memory Care, where specially trained staff, dementia-friendly activities and 24/7 supervision are available. Talking about this while your parent is in the early stages of dementia gives them an opportunity to take a role in the decision-making process. The following steps can help you approach the discussion in a productive, compassionate way:

• Do research. Tour Memory Care communities, so you have a list of options that would be a good fit for your loved one.
• Choose discussion participants. Would your parent prefer a large family discussion or a one-on-one talk with a single trusted family member?
• Focus on the benefits. Describe the amenities and services in Memory Care, such as the maintenance-free lifestyle, activities, supportive staff, and nourishing meals.