How to Approach Memory Concerns in You or Your Loved Ones

Memory function is an essential ability for independent daily living. Memory supports and participates in other cognitive functions – including language, decision-making, spatial awareness and motor skills. The human brain executes all these cognitive functions for daily living. 

Alzheimer’s disease is an age-related, progressive condition that slowly affects brain function. In the early stages of developing Alzheimer's pathology in the human brain, memory, thinking and daily behaviors are the first areas of brain function to be affected. 

Recognizing memory concerns in yourself or others 

Because of individual differences based on genetics, developmental experiences, education and occupation training, people experience symptoms of Alzheimer’s disease in a wide variety of ways. Some patients have good insight into changes in their memory and thinking process over a period of time. They voluntarily seek clinical investigation and treatment. 

Other patients who are not aware of changes in their memory and thinking are often brought to the Alzheimer’s Disease and Memory Disorders Center by their spouses and adult children who have observed changes in memory, thinking and behaviors in the recent months or years. 

There is also a group of patients who do not listen to their spouse or adult children or who do not have a loving partner; these patients would not seek medical attention for cognitive changes in the early stage, till they are too severe in cognitive impairment and no longer can take care of themselves. 

10 steps to approach memory concerns 

The Alzheimer’s Association has a guide available with 10 steps to approaching memory concerns in others, but here’s a quick recap: 

1. Note the changes in memory, thinking, or behavior that you see. 
2. Identify other health or lifestyle issues that could be a factor. 
3. Learn about the signs and symptoms of Alzheimer’s—do they match the symptoms you’re seeing? 
4. Talk with others to see if they’ve noticed changes in your loved one. 
5. Consider one person who would be the best choice for a discussion with your loved one about the concerns. 
6. Discuss the best time and place to have the conversation—is your loved one more receptive early in the morning or just after lunch? Where might they feel most comfortable with a discussion? 
7. Brainstorm what to say to your loved one. 
8. Offer to go with your loved one to talk with their healthcare provider. 
9. Recognize that multiple conversations may be needed. 
10. Seek help and support if needed—the Alzheimer’s Association has a free Dementia Conversations program online. 

Observing changes in memory, thinking, or behavior 

Make note of any changes related to memory, thinking, or behavior over a period of time, such as six months up to two years. To understand the extent of these changes, family members must be familiar with the individual’s highest level of performance for daily living—working at a job, cooking for the family, driving places, managing finances and so on. These changes in memory, thinking and behaviors can result in serious consequences, such as losing a job, financial damage and inability to complete a task like preparing a big meal for Thanksgiving as the patient used to do before. 

Additionally, spouses, partners, or adult children must pay attention to their loved one’s changes in personal hygiene, ability to take daily medication and adherence to appointments. 

How to start a discussion around memory, thinking, or behavior changes 

Having a discussion with your partner or parent about changes you see in them can be difficult. Sometimes they may notice the changes first, making the conversation a little easier. If the patient will ask for assistance from caregivers, this indicates the beginning stage of “dementia” has occurred in the patient. By definition, dementia is a diagnosis to describe an individual whose cognitive impairment has resulted in difficulty with independent daily function. Caregivers should consider Alzheimer’s disease as a probable cause of memory changes and cognitive impairment with or without behavioral changes. 

If your loved one is willing to see a physician for an evaluation and treatment plan, you can start to address these cognitive changes with the primary care provider as the first step. 

If your loved one has partial insight or no insight into their changes in memory, thinking and behavior, the spouses and adult children are advised to take a compassionate approach. The spouses, partners and adult children can find a time when patients can relax in an acceptable atmosphere to present observations and to express concerns. The most important thing in these conversations is to explore the extent of the patient’s self-awareness and experience of changes in memory, thinking and behaviors in daily living activities. Additionally, the caregivers should ask the patients about their concerns and worries regarding their own experiences with cognitive impairment affecting their life. Then the patients and their caregivers will form a consensus and develop cohesion for a future diagnosis and treatment plan. 

An early Alzheimer’s diagnosis can make a world of difference 

Understandably, patients may feel anxious about discussing their memory concerns with their primary care provider or a memory specialist. For many people, the worst outcome is a loss of the ability to live independently, including driving and handling finances. If your loved one recognizes they are having symptoms of a memory disorder and are anxious about taking the first step in seeking treatment, emphasize that a diagnosis of Alzheimer’s disease in the early stages results in a much better chance of preserving memory function and thinking, so that an individual’s daily living independence can be preserved for a longer period of time. In other words, delaying the diagnosis and early intervention could result in patients getting worse and losing independence more rapidly. 

Early diagnosis can provide more options for interventions and support, often enabling the patient to live independently with modifications, which can be identified with an in-home visit from a physical or occupational therapist. It may also allow patients to enroll in clinical trials to hopefully slow down the evolution of the disease. An earlier diagnosis would also allow you and your loved ones time to make informed decisions about important documents, such as an advanced directive and durable power of attorney for healthcare. 

Recognizing a loved one is having memory, thinking, or behavioral changes as they age can be difficult. The Alzheimer’s Disease and Memory Disorders Center at Rhode Island Hospital is here to help. Find more information about the center, meet our memory specialists, and find additional resources for patients and caregivers available on our website.