Talking to someone about their declining health is a very sensitive topic. You may believe your loved one has Alzheimer’s disease or another issue, but if not handled properly, there will be negative consequences that may push them further away from getting timely help.
Your concerns about your loved one’s cognitive health may be on your mind all of the time. You are likely worried about their happiness, safety, and finances.
However, you or another family member has possibly already pissed them off at least once by pointing out a “mistake” that they made.
Now anytime you try to bring up the conversation, they get defensive and won’t talk about it. Who can blame them? After all, the thought of having Alzheimer’s disease or another dementia is a very scary, and foreboding.
You Can Do This But it Won’t be Easy
Because you love them, you have to work through this. It won’t go away. They love you too but they are embarrassed and afraid. They need your support now more than ever.
Most of us don’t have a psychology degree so we don’t handle difficult situations smoothly. We make a mess of things and we don’t know how to unravel the situation. But you can, with a little guidance.
First, start with a little education. Make sure you read my article, Does Your Loved One Have Alzheimer’s Disease?, before you tell them you think they have Alzheimer’s disease – otherwise, that could be a big, unnecessary mistake.
Talk Now, Before Things Get Worse
Having this conversation after something bad happens will only make things worse. Because you and your loved one will be in crisis mode, your emotions will likely have an adverse affect on your decision making resulting in decisions that you may regret later. So let’s talk about how to have the conversation now, before crisis.
The Talk, part 1
Remember, you can’t force people to change their minds and do things they see no value in doing. The goal is to empower them to come to realizations so they can make decisions on their own (at least let them think they are making them on their own☺).
I find that it usually takes at least one conversation to allow people to express themselves for the first time. Often this is the first time the person has even consciously thought about a topic, let alone made significant decisions regarding the topic.
Let the first meeting be about them talking and you listening unselfishly. Guide the conversation by bringing up similar events that have occurred with other people (friends, family, neighbors, or celebrities) and how it has affected their families.
Ask your loved one what they would do. Do not compare their “mistakes”. Let them make the connection. Listen and guide.
The Talk, part 2
Now that their thoughts have been stimulated by the prior conversation, you can carefully turn the topic towards your concerns. Let them know that you love them, respect their wishes, and want to support them.
Speak in general terms about their health. Don’t use words like Alzheimer’s, dementia, or disease – remember you don’t know what is causing the symptoms. It might be something very innocent such as a vitamin deficiency.
Don’t point out multiple problems or issues that might be embarrassing; doing so may cause them to become defensive and shut down. Mention an example of one thing you noticed. Then listen.
When they downplay the problem, and they will, reaffirm your love and support. Possibly, point out another occurrence of the same issue. If they get angry, back off. Don’t fuel the fire. If you don’t get through this time (odds are you won’t), don’t give up.
Persist
As in most things in life, it’s not about being smarter, quicker, or louder – it’s about persisting. Ask them to have an open dialog with you regarding things that may occur in the future.
Ask them to stay open-minded about a Dr’s visit, if not for them, then to give you peace of mind. Once they agree, assist them in scheduling an appointment, and offer to join them on the visit.
Talking to someone about potential cognitive issues can be very scary for both people. Try to make conversations casual and don’t point out negative situations. If your loved one starts to get agitated, move on and save the conversation for another day.
I wish you the best of luck as you move forward Together in This with your loved one.
For additional insights, check out this pamphlet provided by Eldercare.gov:
Conversation Starter
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Do you have any tips or tricks you have used? Or maybe you have a question? Please share in the comments below.
It took me almost a year to find the “right” moment to talk to my husband about the fact that he had dementia i.e. Lewy Body Dementia. It was a matter of finding just the right moment which turned out to be one morning when he was especially still “sharp” in his mental thinking and attitude. I mentioned some of his symptoms which he periodically recognized, and then told him that it was because he had a certain kind of dementia which was LBD. As the moment was right, he accepted the fact and later would start telling people that “they tell me that I have dementia.”
Carol, I’m happy you were able to talk with you husband about his situation. When their mental sharpness is already fluctuating on a daily basis, finding the right time adds another challenge to the situation. One must be careful not to wait too long to find the right time especially if they don’t live with their loved one such as an adult child.
It is almost three o’clock in the morning and I’m awake again thinking about my mom. My mom’s disease has advanced to the point we can no longer have a conversation with her. In the early stages she knew something was wrong and we could talk about it. Those days are gone. There are times I think that is best that she no longer remembers she is not who she once was. I did notice at the time when she was confused with what was happening to her she was violent. She has become more loving now. More like a baby wanting attention and love and we give her a lot of that. I was told by a friend that I need to watch Glen Campbell’s last song he will ever write. It is about his life with alheimzers. In it he says “I’m not going to miss you”. This is where we are at with mom. We have lost our mom but she doesn’t miss us because she doesn’t know who we are now. Very difficult. I would tell everyone to listen to this song. It’s heartbreaking but so true.
Annette, you’ve been through so much. I’m hope you are able to find some peace with it now (although it obviously keeps you up) knowing that your mom feels the love that you provide. I also hope Glen’s story helps people understand the disease more so that we can remove the stigma. Here is a link to the video of Glen’s song: http://youtu.be/U8TsAh-zYFI
Thanks mike. I go to my moms tomorrow morning (Saturday ) and will stay with her till Sunday night. I will find it very hard to try to talk to her but as I have learned though what u post to take small steps. I cherish all the time I have with her. I noticed in Glen Campbell’s video the empty look in his eyes and see that same empty look in my moms. Thanks for being there to listen. It is very comforting
Thank you for the above article. I will try to use this approach in my conversations with my husband. Trying to get him to seek the help of a Dr. He absolutely refuses.
Hi Carrie, I’m so sorry you are going through this. If your husband is exhibiting dementia symptoms but has not been seen by a professional, there is a chance that his symptoms are correctable. If he’s refusing to see a Dr, you obviously can’t force him. I also recommend that you use the medication log which I talk about in this article: http://togetherinthis.com/medication-management/ You are doing the right thing by getting informed and being proactive.
Reading about other’s stories remind me of how fortunate I am. My husband was diagnosed with Alzheimer’s after 2 years of rounds of tests, specialists, and attempts to tweak diet, medications, and activities. Although we are unhappy with the diagnosis it is a relief to put a name and a treatment plan in place. We now try to enjoy each and every moment saying, “This is the best it will be so make the best of it.” We have had conversations together and with our children right from the beginning of symptoms so we are not faced with the conversations in the article to start a dialog. That the care plan and future decisions are in place does not ease the heartbreak of watching a fluent speaker ( a former university professor) and vivacious person have trouble finding words and articulating thoughts. That is where this newsletter offers the type of interaction that is a great support system, Thanks Mike
Thanks Katy for sharing. I’m so happy your family was able to finally get an answer so that you could better understand what you are up against. I hear so many people comment how the diagnosis is a mixed blessing because they need to understand why they are struggling. I’m also happy to hear you talking about a care plan because I really believe that makes the difference in a family’s ability to “live well with Alzheimer’s.”
Over the years I have met many people with the early diagnosis and who were exceptional people in the their field of work or had extremelty important positions. Dementia can affect anyone regardless. Their families found it very hard to accept that someone who was so astute could lose language and many other abilities.
Your article is very encouraging for families having to face the diagnosis with their loved one.
I look forward to more as we learn from each other continually on this sensitive issue.
Thank you!
Thanks Lauretta for the comment. I too have met several people with dementia who were very active in life both physically and mentally. My recent interview, in fact, was with David Kramer who was an emergency room doctor for more than 30 years. Alzheimer’s does not discriminate as you mentioned.
Hi Mike,
I just finished reading your article on Sensitive Conversation. I have been working with Alzheimer’s and Dementia clients/residents for many years in the field of Recreation. Even with such experience, when I had to deal with my Aunt’s Alzheimer’s disease all bets were off. Being that she was my Aunt and not my mom, was one issue and the other was trying to have a sensitive conversation with my cousin –her son. This is where it really got difficult. He was in denial and said that his mother couldn’t have Alzheimer’s. The reason he used was she is under a lot of stress taking care of my father b/c of his stroke etc… as soon as she feels more relax she will be fine. Well, years ticked by and even with her “behaviors and signs” showing, it wasn’t until much later and some major falls in the home, my cousin finally sought some help and my Aunt was diagnosed and given some medication. The reason that I shared my personal story with you is because I felt “helpless” with my cousin’s refusal and denial of his mother’s disease. The conversation was approached for several years too late. Thanks for listening…I hope with your article your readers will have the “sensitive conversation” with their loved one sooner. Best wishes,
More and more, I hear from friends and family about the difficult conversations they’ve had with immediate family just like you shared, Cheryl. It’s becoming more common where neighbors or extended family accept that something is wrong before the closest family member does. Maybe it’s easier to accept and be open minded when you’re not the next of kin.
The past three years have been devastating for my entire family so I wasn’t surprised, only saddened and angry, by my Mom’s diagnosis of mild Alzheimer’s. The conversation about the diagnosis wasn’t difficult because she had been through so much trauma already and this was just one more thing. I originally took her to her primary care physician in 1/2015 because I had noticed changes in her behavior which I attributed to anxiousness or depression. In 10/2012, my sister was killed in a head-on collision by a drug-induced big rig truck driver. The next 2 1/2 years were spent grieving and facing the extremely frustrating and emotional court process. And then Mom’s last sibling who she was close to died. That’s when I started noticing the big changes in her behavior. I’m so thankful for her doctor who recognized her symptoms, the care her neurologist has been providing, and all the information you have provided so far. I’m dealing with a disease I don’t understand but am trying to stay ahead of the curve so Mom can get the respect and quality care a great mother like her so deserves. Thank you, Mike, for providing support through Together In This.
I’m so sorry to hear about the hardships your family has had but I’m glad you have gotten good medical help for your mother. Now that you know what is happening, you can continue to self educate and fight back. Please make sure you get the legal and financial aspects handled so that you can focus on your relationship with Mom, and continue to help maintain her well-being.
Thank you so much for this article Mike …I’ve been able to share it with my siblings who don’t have any experience in the medical field or “caring” -although they care deeply for my mom.
It takes patience to wait for the right moment to have these sensitive conversations … as my brother admitted “I’d be a bull in a China shop -I just want to tell them ” … so this is assisting all of us.
I’m happy you found this article valuable. Our egos definitely close our ears and minds, and the fear of “losing our mind” is definitely a scary situation. Even with the approach discussed in this article, our loved ones may still push us away. We have to remember to love them, and at times assist them without pointing it out to them. Also, please know that some dementia is reversible when it’s caused by things such as medications, vitamin deficiencies, etc.
My husband’s short term memory is growing shorter. He is aware of some memory loss, but can still carry on a normal conversation to a large extent. He is an excellent driver and can find his way to any place where he has already been, but I need to be with him because he keeps forgetting where we are going.
He also forgets what day and sometimes what month it is. He is 91 and is on only 1 medication, which is supposed to keep his memory from getting worse.
He is still my loving and kind husband and appreciates everything I do for him. He has not been diagnosed as yet, but the primary doctor did prescribe the medication. We take one day at a time and enjoy the good things. Our children have noticed the memory problem also.
Sounds like you and your husband are doing pretty well at 91. I have a friend who just turned 90 and she too is still staying active which I believe makes a world of difference in her health. She says she forgets things but I don’t notice; similar to your husband’s condition. In my opinion, the best thing you can do to help him is to stay active and socially engaged with family and friends. Also, remember to not point out his deficiencies but to silently assist him to help maintain dignity. Thank you for sharing Virginia.
I really do not know how to reply. When I first got concerned about my wife, I thought she had had a stroke because it was so fast. First we had a bout with arrhythmia and we went down hill from there. She was an avid knitter and quilter, then suddenly she dropped all interest and would not even complete projects. Does not even want to look them over. It took a year for me to get her to a neurologist for evaluation. They did a MRI and said she had dementia. She had lost a brother several years ago with the same and an uncle years earlier. So I guess we are on track. I have read your emails but have not received any other information. She does not get angry just at times she tears up and asks why and I just try to explain. As best I recall that we are in our forth year since first noticing changes.
Hi Fred,
Thank you for taking the time to share. I’m sorry for what you and your wife are going through – such a horrible situation. Make sure you leave her yarn and knitting supplies out in the open where she can see them. There may be a point where this helps her mind remember. Or keep a quilt on her chair so she can feel it. If you need any specific information, please let me know and I will do my best to help you find it.
Mike
Hi Fred,
Fred, first let me preface this reply with applauding you for reaching out and sharing your frustrations and asking for help. This being said I agree with Mike to try and leave her knitting materials out and also have a soft quilt for your wife to have for comfort. However, another suggestion I believe might be helpful is to realize that sometimes our loved one living with dementia may appreciate some other activity or in addition to. For example, playing music in the background, sing along, using some instruments or letting her feel and/or touch the softness of the yarn. Sometimes we find that what was once a favorite task or interest is no longer. Good luck and I hope that you will find comfort to know you’re not alone in this fight to End this horrific disease. Blessings to you and your wife,