Approaching difficult conversation about dementia

It is important to express your concerns and support the person to get an assessment and treatment.

Talking with someone you think may experiencing changes which might be dementia is never easy. The following five steps (summarised from our more in-depth website guide: How to talk to someone about getting an assessment) can help you think through and plan your approach to this difficult conversation with someone you care about.

Step 1: Consider – should I be concerned?

Everyone forgets things, but if you know someone is experiencing changes in ability, behaviour, personality, thinking or memory it might be dementia.

Write down things that concern you or download and use the Checklist for Dementia Symptoms and Changes.
If appropriate, talk with a family member or trusted friend about your concerns. Read Get family support for an assessmen t.
Call Dementia Australia (1800 100 500) to confidentially talk through your concerns.

Step 2: Anticipate potential reactions

Before you start aconversation, use your knowledge of the person to think through their potential reactions. How has this person reacted in the past to general conversations about their health or well-being? Their future? Or other sensitive topics like death or dying? Are they open to chatting about issues like this? Or do they get defensive or upset?

Consider if the person has expressed concerns about themselves. For example, have they mentioned:

Difficulties with memory or thinking already? (e.g., I’m worried, I just don’t seem to be able to organise myself… I’m forgetting to pay the bills)
Opinions about dementia? (e.g., there is no point seeing a GP as you can’t do anything for it).
Fear for their future? (e.g., they may have had a parent with dementia)

Consider what may stop the person from going to the GP? (e.g., do they have a long-term/good relationship with a GP?)

Step 3: Prepare for difficult conversation(s) and set the scene

There will probably be more than just one conversation. There may be many conversations over a period of time.
Prepare for fear and negativity by understanding common misconceptions about dementia and be ready with positive information about the benefits of diagnosis.

Think about:

Who? is the best person (or people) to have the conversation? Consider existing relationships, and family dynamics. Some family members might be better placed to raise the issue.
What do you talk about? You might approach the topic by talking about your concerns for their wellbeing. You might talk about seeing the GP about another health issue they are concerned about and mention concerns about brain health.
- Try to spend more time listening than speaking. Ask about their concerns.
- Be aware when the person tries to shut the conversation down.
- Know when to stop (e.g., if the person becomes angry or very defensive).

Where? Where is the best place to chat? (e.g., familiar, quiet, comfortable, place is usually best.
When? What is the best time of day? Ensure the person is not hungry or at a time their favourite TV program is on.

Step 4: Be positive and supportive

Use language carefully to show you want to support the person and you are on their side. Don’t insist you are right and don’t argue!
Your body language is often more important that your words! Keep your posture relaxed, smile, make eye contact and use reassuring words.
Offer to go with them to the GP.
If the conversation goes poorly, try to change the subject or stop the conversation. You can learn from what went well or what went poorly, to change the approach to the conversation for a later date.
Try to talk about changes and difficulties, not dementia.
Know that some conditions might ‘look like dementia’ (for example depression can mimic dementia) and an assessment by a GP is needed.
Know there are treatments, rehabilitation and support services for dementia and that many people live positively with dementia.
Read about the experiences of others as well as the benefits of getting an assessment and benefits of a diagnosis.

Step 5. Be prepared to keep trying

Key is listening to the person and adapting the conversation as you go.
Remember it is not the only chance and this may be the start of many conversations.
If they do agree to an assessment, offer continuing support (such as making the appointment and going with them to see the GP).

For some people, dementia affects insight – their awareness and ability to recognise their own difficulties. For more information read the page: How to talk with someone about getting an assessment and the section at the end titled “If the person does not want to talk about their difficulties.”