Difficult Conversations: How to Talk to a Loved One with Early-Onset Dementia

Julie Bitely

| 3 min read

Adult daughter talking to her dad.
Do you have a loved one you suspect is in the early stages of dementia? According to the Alzheimer’s Association, “people with dementia may have problems with short-term memory, keeping track of a purse or wallet, paying bills, planning and preparing meals, remembering appointments or traveling out of the neighborhood.” Their memory, communications and language, ability to focus, reasoning skills and visual perception could also be impaired. If that sounds at all familiar, it might be time to have a talk, one that likely won’t be easy. Lisa Gardner is a program coordinator for the Alzheimer’s Association. She recently presented the Association’s “Dementia Conversations” talk, which breaks down how to handle talking with a friend or loved one about a potential dementia diagnosis. Gardner was a presenter at the Dementia & Alzheimer’s Resource Committee’s recent caregiver expo. The event was sponsored by Blue Cross Blue Shield of Michigan. Gardner said some of the most difficult conversations revolve around going to the doctor to get the initial diagnosis, deciding it’s time to stop driving, and making legal and financial plans to cover future care needs. Here’s the framework she and the Alzheimer’s Association recommend in starting a healthy and productive dialogue.
  1. Sooner is better than later. Don’t wait for a crisis. By talking about dementia head-on, the person facing it can be part of the conversations, which might help them feel more in control. As the dementia progresses, you’ll also have peace of mind that you’re carrying out their wishes in the way they would have wanted. And, in difficult conversations related to something like driving, you could be preventing harm to your loved one or others.
  2. Develop a plan with finesse. Before you talk to your loved one, stop and really think about what you want to say. More importantly, consider how your loved one will feel hearing it from you. These conversations aren’t easy. Talk to your loved one with the same care and empathy you’d want them to approach the topic with if you were in their place.
  3. Take notes about the changes you’ve seen. Write down the dates, times and situations you’ve observed your loved one doing something out of character or forgetting routine items that should be second nature to them. This way you’ll have concrete examples to share with them. You don’t have to list them all out when you do talk but being able to point to very specific circumstances can be helpful in building your case. Use “I” statements to talk about your feelings regarding their behavior. “I’m concerned …” or “It scares me when …” are good openers.
  4. Practice in advance. Rehearse the conversation so you feel confident going in. Try to anticipate objections and have responses ready. Talk in the mirror or role play with another family member so you don’t lose your nerve to start the discussion.
  5. Talk when you’re both relaxed and comfortable. Is your loved on a night owl? Don’t start a conversation early in the morning. It might be easiest to talk about while you’re both doing something you enjoy, such as going out for brunch on the weekend. By choosing a comfortable and relaxed setting, the conversation is more likely to flow in that same manner.
Have you had to have conversations about dementia with a loved one? What worked for you and what didn’t? Share your tips in the comments. If you found this post helpful, check these out:
MI Blues Perspectives is sponsored by Blue Cross Blue Shield of Michigan, a nonprofit, independent licensee of the Blue Cross Blue Shield Association