Have you begun to notice signs that your parent may be suffering from the early stages of dementia? Sometimes the signs are as subtle as uncharacteristic behavior, forgetting to take their medication, or momentarily forgetting their grandson’s name. Other times the red flags can be more glaring, like repeatedly missing important appointments, not eating properly, or ruinous financial behavior.
Talking to your parent about dementia can be tricky, but it’s always better to have these conversations before a crisis occurs. It’s also ideal when a productive conversation leads to an early medical diagnosis, as this provides your parent with the opportunity to make important preparations in case their condition takes a turn for the worse.
Recognizing the early signs of dementia or Alzheimer’s disease
Memory loss is a normal part of the aging process, but it can be a symptom of dementia or Alzheimer’s when it disrupts daily life. To help people recognize the early signs of cognitive impairment, the Alzheimer’s Association has published a list of 10 warning signs and symptoms to watch out for:
- Challenges in planning or solving problems
- Changes in mood or personality
- Confusion with time or place
- Decreased or poor judgement
- Difficulty completing familiar tasks at work, at home, or at leisure
- Memory loss that disrupts daily life
- Misplacing things and losing the ability to retrace steps
- New problems with words in speaking or writing
- Trouble understanding visual images and spatial relationships
- Withdrawal from work or social activities
If your parent exhibits any of the symptoms or warning signs on this list, you should create a plan to talk to address your concerns. Regardless of how you choose to initiate the plan, a visit to your parent’s doctor or psychologist for a professional evaluation should be a priority.
How to talk to your parent about dementia
When it’s time to have a discussion about your concerns, it’s understandable to feel nervous and apprehensive. Your parent raised you and has provided for your needs for most of your life, so the role-reversal of becoming their caretaker can feel unnatural for both parties. There will almost certainly be resistance when the topics of conversation include limiting their mobility, independence, and the freedom to manage their own affairs, too. But don’t let fear and apprehension keep you from doing what’s necessary—it’s critical to have this conversation sooner than later, and it helps to know that the conversation can be a lot easier with a little advance planning.
When you’re ready to speak with your parent about your concerns, here are a few guidelines to follow:
- Write an outline – this should help you organize your thoughts and stick to your talking points during the conversation. Focus on the most important considerations, including their health, safety, freedom, social connections, peace of mind, financial independence, and the ability to make important decisions.
- Plan who will be there for the conversation – while it’s often a good idea to make this a family discussion, you don’t want to overwhelm or intimidate your parent with an intervention. Think carefully about who should attend the meeting, and make sure everyone is on the same page before you get there.
- Do a practice run – if you’re nervous, try staging a practice conversation with a few of your family members who will attend the discussion.
- Be respectful and considerate – try to put yourself in your parent’s shoes and view things from their perspective. If you were in their position, how would you feel if a loved one expressed doubts in your cognitive abilities? How would you react if someone recommended taking steps that limited your personal independence?
- Listen more than you speak – this is a good rule for life in general, and it certainly applies here. Make your points directly, ask good probing questions, and then listen to what your parent has to say. This should be a conversation, not an intervention.
- Remain open to their input – emphasize that there aren’t any right or wrong options and be open to their ideas and preferences when you’re discussing possible options. Even if you’re right about something, you still need to honor and respect your parent’s personal rights.
- Consult with a professional – if you’re still too nervous to initiate the conversation, consider meeting with a psychologist or social worker to discuss your situation. If your parent is willing, the professional may be able to attend the meeting with your parent and serve as an unbiased moderator to guide the conversation.
Whether you’re starting a conversation about dementia, aging, senility, or just general estate planning, it helps to start with a smooth transition into the conversation. We’ve all been in those awkward conversations where someone abruptly changes the subject to an uncomfortable subject, and those never go well. As you’re preparing your outline for the discussion with your parent, consider starting with one of these ice-breakers:
- “What are your priorities? How can we help to make it easier for your to do the things you want to do?”
- “I admire how you’ve handled your retirement. What should I be doing to prepare as well as you have?”
- Try referencing an external event or news story, then comment, “you know, that’s something we haven’t talked about, and I think we should. I don’t want to pry, but it would bring me peace of mind to know that there’s a plan if we need it.”
How to prepare for potential incapacitation
While the priority for your initial conversation should be to schedule an evaluation with your parent’s physician or psychologist to assess their cognitive abilities, one of the ensuing conversations needs to address their estate plan. It’s essential to take care of these critical preparations while your parent still has the mental capacity to do so, as individuals with advanced dementia or Alzheimer’s may lose the testamentary capacity to sign important legal documents. If that happens and the proper documents aren’t already in place, you may be forced to resort legal guardianship and conservatorship to become their caretaker. If your parent passes away without a will, their estate will be subject to the state’s intestacy laws, leaving you and your family with little-to-no say over how their estate is distributed.
To prepare for the foreseeable and protect against the unexpected, make sure your parent’s estate plan includes the following:
- Beneficiary designations – not all assets need to be included in the will. Assets that offer a designated beneficiary (retirement accounts, life insurance policies, bank and brokerage accounts with a TOD or POD beneficiary) can transfer directly to the beneficiary listed on the account when the owner dies.
- Will – your parent’s will should nominate an executor to manage their estate and bequeath assets that are subject to probate (individually-owned assets, real estate owned as tenants in common, and personal possessions).
- Advance Directive – also known as a living will, this document outlines your parent’s preferences for healthcare treatment, including (but not limited to) resuscitation, artificial life support, and palliative care.
- Power of attorney – a durable power of attorney authorizes an agent to handle the principal’s affairs. The agreement can offer immediate authority to the agent, or it can withhold authority until the principal becomes incapacitated. Either way, a power of attorney is the best way to avoid the complications of a guardianship or conservatorship.