How To Talk With Your Loved One About Their Memory Loss

For the third time this week, your mom is fixated on finding the salad bowl that you know for a fact she sold at the garage sale five years ago. Once again, you think to yourself, “Maybe it’s time to talk with an aging specialist.”

It is time, says geriatric medicine physician Ardeshir Hashmi, MD.

“Research tells us that earlier intervention is critical to preserving memory and independence,” he shares. “Lifestyle changes are vital but need time to take effect, so the key is getting started early.”

But talking to aging parents about memory loss isn’t always easy. If you have no idea how to start the conversation — or restart it after many failed attempts — these tips can help guide you.

Tips to approach the conversation with empathy and understanding

Your loved one may not have noticed any memory problems. Or maybe they’ve noticed but don’t think it’s a big deal. “I’m just getting older, that’s all!” they say. But if you’re concerned, it’s time to act. And a geriatrician can help.

Geriatricians are doctors who specialize in caring for older adults, especially those over age 65 who have complex medical needs (like managing care for multiple health conditions). But anyone over 50 can benefit from a geriatrician’s insight and expertise into healthy aging.

“There are so many ways that our bodies and brains change as we age,” Dr. Hashmi recognizes. “Just like you would take your children to a pediatrician and not to an adult medicine specialist, the same idea is true at the opposite end of life.”

So, how can you get your aging loved one in the door to discuss their memory issues? Dr. Hashmi shares advice and strategies for starting a conversation in a respectful, productive way.

1. Set a gentle and compassionate tone

No one wants to be yelled at or nagged or prodded, especially not about their own health, and definitely not about something as sensitive and personal as their possible cognitive decline.

“The challenges of aging are many, and your loved one may be feeling very vulnerable,” Dr. Hashmi says.

As frustrated as you may be feeling about your loved one’s actions, and as worried as you may be about their brain health, remember: For your concerns to reach them, you have to deliver them in a way that resonates. That means approaching the conversation with kindness, love and compassion and in a nonjudgmental tone.

2. Provide reassurance about the possibilities

As we get older, it’s common to worry that memory changes are a sign of Alzheimer’s disease or another type of dementia. But that’s not necessarily the case.

“Reassure your parent that everyone forgets things sometimes, and emphasize that the only way to get answers is to visit a geriatrician,” Dr. Hashmi advises. “You can even downplay the memory stuff. Tell them the doctor will do a comprehensive exam, and brain health is just one component of that.”

He points out that some degree of forgetfulness and absent-mindedness can be standard with aging. Over time, your hippocampus — the part of your brain responsible for memory and learning — naturally declines in size and activity level over time.

Other causes of memory issues may include:

• Dehydration
• Depression
• Diabetes
• Drug and/or alcohol misuse
• Hearing loss
• High blood pressure (hypertension)
• High cholesterol (hyperlipidemia)
• Side effects of medications or supplements
• Sleep problems
• Social isolation
• Thyroid problems
• Traumatic brain injury
• Vitamin deficiencies

“When it comes to forgetfulness, a lot of it can be completely normal,” reassures Dr. Hashmi. “But to differentiate between what’s normal and what’s not, there are conversations that need to be had.”

3. Emphasize prevention

People who are experiencing dementia often have no idea it’s happening — and even people who are having mild cognitive issues are often reluctant to acknowledge that there’s a problem.

If your loved one doesn’t feel like anything is wrong with them, they may resist seeing a specialist. But you can remind them that nothing has to be “wrong” for them to talk to a geriatrician. A major piece of geriatricians’ work is to identify potential problem areas before they become a bigger problem — and to provide important preventive guidance.

“Geriatricians specialize not just in treating diseases in older people but also in preventing diseases in older people,” Dr. Hashmi explains. “Prevention is the key word. And in terms of successful aging, you can never start too early.”

4. Focus on the positives

It can be helpful to position a visit with a geriatrician as a way to ensure your loved one’s long-term independence. Dr. Hashmi suggests phrases like, “This is important because I want you to be able to remain in your home, like you are now.”

If they’re worried that a geriatrician will put them on more medications, you can try responses like, “I don’t want you to be on more medications than you need, either, and we don’t even know if medication will be necessary. Let’s just see what options are available to help preserve your memory.”

In fact, how’s this for focusing on the positive? Your loved one might leave the visit with less medication than they go in with.

“Oftentimes, part of the solution is taking them off of medications that might be impairing their memory,” he adds. “‘Deprescribing’ is an art that geriatricians have expertise in.”

5. Set expectations

Emphasize that you want your loved one to preserve or even improve their memory.

“They may be feeling scared and not want to acknowledge that,” Dr. Hashmi acknowledges. “Let them know the goal is to make things better, not necessarily to find out what’s ‘wrong.’”

Discuss what to expect during an evaluation by a geriatrician, which will likely include:

• Exercises to evaluate memory
• Blood tests to rule out vitamin D deficiency and measure thyroid levels
• An MRI, if needed, to help get a snapshot of current brain health

Offer to accompany your loved one to the appointment so you can debrief together afterward and make a plan for whatever comes next.

Help them make lifestyle changes

“Medications may help someone who is dealing with memory loss,” Dr. Hashmi says, “but they’re only 2% of the solution. Their job is mostly to stop memory problems from getting worse.”

The other 98%, he continues, is making brain-healthy modifications that can improve memory, like:

• Aerobic exercise
• Socialization
• Eating a healthy diet, like the Mediterranean diet
• Getting enough quality sleep
• Finding a sense of purpose, like through volunteer work or a faith community

What if it is dementia?

If you’re concerned about your loved one’s memory issues, there is, of course, a chance that it is some type of dementia, like Alzheimer’s disease, vascular dementia or Lewy body dementia.

“We become concerned any time memory loss starts to impact a person’s activities of daily living,” Dr. Hashmi notes, “like getting lost while driving on a familiar road or having trouble managing finances, medications and cooking.”

Early warns signs of dementia, which typically get worse over time, include but aren’t limited to:

• Short-term memory loss
• Changes in mood or behavior
• Getting lost in familiar places
• Increased confusion
• Changes related to spatial awareness

If a geriatrician suspects dementia, they’ll help you and your loved one assemble the right team to get them the care they need and create a treatment plan. This team often includes not just healthcare providers, but also people like social workers, occupational and physical therapists, pharmacists and geriatric case managers.

“The earlier you intervene, the more help we can provide and the better we can support your loved one to stay safe and improve their health,” Dr. Hashmi emphasizes.

This team can also help you or other caregivers in your loved one’s life learn how to provide care for them while tending to your own mental health and well-being, too.

How to cope with a loved one’s memory loss

You’re not alone in this experience. An estimated 40 million families across the U.S. are caring for an aging loved one.

“So many people are doing this with little to no formal help,” Dr. Hashmi says, “but it’s not that those resources don’t exist. They exist, but caregivers don’t always know to have the conversations that will help them tap into them.”

He shares some other tips to help you help your aging parent:

• Learn more about their diagnosis. Take time to really understand your loved one’s condition by delving into trustworthy, evidence-driven information from reliable medical sources.
• Connect with others. Talking to other people who are in your shoes can help you feel less alone and give you a safe and supportive space to swap strategies for handling specific scenarios. Dr. Hashmi recommends reaching out to national nonprofit organizations like the Alzheimer’s Association, Benjamin Rose Institute on Aging and local aging-related organizations.
• Redirect them. Even if your loved one’s short-term memory has faded, they may still remember “the old days.” You can use this to your advantage, Dr. Hashmi says. “Talk about the past or look at old pictures together to help them shift their focus to the present.”
• Practice patience. Patience is a virtue, even if it often feels like an impossible one. “It can be taxing for even the most patient person to deal with a loved one who repeatedly says, does or asks the same thing,” notes Dr. Hashmi. “But patience is a caregiver’s biggest ally.” Learn strategies to become more patient, which will help both you and your loved one keep your cool.
• Lose the argument. If you’ve tried reorienting your parent, but they still insist they’re in Canada when you’re actually in California, let it go. At the moment, this is your loved one’s reality. “It’s more helpful to meet them where they are than to insist that they’re wrong,” Dr. Hashmi says.
• Take care of yourself. Caregiver burnout is a state of physical, emotional and mental exhaustion that happens while you’re taking care of someone else. It’s important to take time to prioritize yourself, even (and especially) when you’re consumed with prioritizing someone else.

Above all, try to remember: It’s not your loved one’s fault. If your parent or someone else in your life has Alzheimer’s disease or another form of dementia, you may have to continually remind yourself that the things they’re doing or saying are a result of the disease — not their personality.

A final word on talking to your loved one about memory loss

Seeing a geriatrician can help your loved one focus on both brain health and physical health — so they can preserve their memory, age gracefully and live better, longer.

“You want your loved one’s brain health to be in top shape throughout their life,” Dr. Hashmi encourages, “and so do we.”