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The Difficult Conversation - Lizzy Care Guide

You suspect your loved one has dementia. How should you approach the conversation with them?

Watching a loved one age is incredibly difficult. All caregivers struggle with bringing up the subject of a memory care condition, like Alzheimer’s or dementia, with their loved one. It’s natural to be worried that you will upset or anger a person you care deeply about but dealing with the conversation early can make sure that your loved one still has an input in what they want in terms of care, treatment and support. 

Before you talk to your loved one about your thoughts you should spend some time thinking about how they feel. Consider their approach, the way they respond to bad news, their value structure, their attitudes to change and their current capacity for making decisions. 

Don’t dismiss your loved ones concerns or worries, be an active listener and retain a sense of humor.

Tips for talking to someone you love about a memory care issue

Dementia and memory conditions can affect how a person communicates. Your loved one may find it difficult to complete their thoughts so be patient and look out for non-verbal signs of anxiety or irritation. Make sure that only one person is talking at a time and that you’re looking at your loved one when talking to them. 

Start early 

If you have noticed some signs that your loved one may have dementia (see our course on Learning about different types of dementia for a list of possible symptoms) it is best to discuss it with your loved one early on. The longer you leave it the harder it will become to discuss and you will be delaying getting your loved one the help, treatment and support they need as well as allowing them to be an active voice in their own decision making. 

Plan ahead

Are you the right person to have the conversation with your loved one? Is there someone else that can help the conversation? Another family member? One of their good friends? 

Do it when your loved one is in a good mood. Choose a time of day that’s good for them, that might be first thing in the morning. Do it in a location that they feel comfortable, that’s free of distractions or outside noise. 

We have suggested ways you can broach the conversation in the next section.  

Provide reassurance 

This will be just as scary for your loved one as it is for you and possibly more so. Reassure your loved one that you will be there to support them. New treatments can help support memory loss. You can help them navigate the healthcare system and come to any appointments. 

Acknowledge that it won’t be easy 

No matter how much you plan and how sensitive you try to be, your loved one may not be ready or willing to discuss the changes you’ve noticed. They may become angry or defensive. Don’t force the issue. You can return to the issue in a later conversation. 

Conversation starters

When having the conversation it is best to talk in short sentences using a simple vocabulary. Make sure you pause between thoughts  to let things sink in and give your loved one a chance to respond. 

One tactful approach can be to ask if they have noticed any changes in their behavior. Ask them: “Have you noticed the same changes in your behavior that I have?”  Or you can ask them if they would like you to let them know if you’d noticed changes in their behavior. Your loved one may say they haven’t noticed any changes. They may be scared to admit things they’ve noticed or they may not be able to recognize the changes for themselves. Don’t force the issue. Acknowledge your loved one’s feelings and plan to revisit the conversation at a later point. 

You can also take the approach of planning for the future. Say something like: “I/we are concerned about what happens if you have a medical event or if you’re in need of additional support. Can we talk about what you’re looking for as you age and I/we best support you?”

What should be considered in any discussion

In this section we outline some of the key items that you should consider discussing with your loved one when you are broaching the topic of memory care. 

It is probably best not to bring all of this up at once but instead to plan a series of smaller, shorter conversations to cover each topic. 

You can use the list below as a checklist of items to cover. Some items are more sensitive than others and depending on the exact situation and your relationship with your loved one may not always be appropriate. 

Observations and concerns 

  • Have they noticed a decline in their memory? How has it made them feel? Do they have any concerns? 

Daily living

  • Do they need any help with daily tasks or chores? 
  • Are they able to keep the house clean and tidy? 
  • Are they able to cook and prepare food by themselves? 
  • Are they still driving? Do they feel safe on the road? If driving is difficult or dangerous you may need to discuss transport alternatives. 

Healthcare information

  • Make a list of their current doctors, what each doctor is providing care for and their contact information. 
  • Make a list of any current medications and which pharmacy they are using. 
  • Who is their insurance provider? What is their Medicare number? Are they using any co-insurance, long-term care insurance, medigap coverage? Do they have any VA benefits? Are they enrolled in a Medicare Part D plan?  
  • Make a list of their insurance carriers and if necessary a copy of their insurance cards. Don’t forget to consider eye and dental care as well as healthcare. 
  • Do they use a medical alert pendant or response system? Do they know where it is? How to use it? How to keep it charged? 

Other insurance

  • Do they have homeowner’s insurance? 
  • Do they have a life insurance policy? 
  • Make a note (and copy if needed) of any policy or insurance information. 

Legal 

  • Have they drawn up a will? 
  • What about a living will or an Advance Directive? 
  • Have they appointed someone to make a decision for them if something were to happen? 

Finances 

  • Can they cover their current expenses? Do they have a regular income? 
  • Who do they bank with? 
  • Do they remember to pay their bills? 

We wish you the best of luck in discussing the subject of memory care with your loved one. If you need any additional help or guidance please drop us a line to info@hilizzy.com and we’ll do our best to help. 

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