10 Steps to Approach Memory Concerns in Someone You Love

Worried About Someone’s Memory? Here Are 10 Steps for Starting the Conversation

You notice your mother asking the same question several times.

Your father, who has always handled the household bills, suddenly seems confused by them.

A spouse forgets an appointment that was discussed several times.

Or maybe a longtime friend simply seems different.

When you notice changes in someone's memory, thinking or behavior, one of the hardest questions is:

Should I say something?

The answer isn't always simple.

Occasional forgetfulness can happen as people age, and memory problems do not automatically mean Alzheimer’s disease or another dementia. The National Institute on Aging notes that memory difficulties can have many potential causes, including medication side effects, sleep problems, depression or anxiety, nutritional deficiencies and certain medical conditions. Some causes may be treatable.

At the same time, significant changes that interfere with everyday activities deserve attention.

The Alzheimer’s Association has developed a helpful 10-step approach for discussing memory concerns with someone close to you.

Here is how families can put those steps into practice.

1. Identify the Specific Changes You Have Noticed

Before starting a conversation, separate a general feeling that "something isn't right" from specific observations.

Instead of:

"Dad seems forgetful."

Think about what has actually happened.

For example:

• Has he repeatedly forgotten recent conversations?

• Has she become confused in familiar surroundings?

• Are bills being missed?

• Are medications being forgotten?

• Has cooking or another familiar activity suddenly become difficult?

• Have you noticed unusual changes in judgment or behavior?

• Is the person having increasing difficulty finding words?

Specific examples can make a conversation much more constructive.

The National Institute on Aging notes that potentially concerning signs can include repeatedly asking the same questions, becoming lost in familiar places, having difficulty following directions and becoming increasingly confused about time, people or places.

The goal isn't to diagnose someone.

It's to recognize that something has changed.

2. Consider What Else Could Be Happening

This is an especially important step.

Memory problems do not automatically equal dementia.

There are numerous reasons someone might experience changes in memory, concentration or behavior.

Potential contributors can include:

• Medication side effects

• Sleep problems

• Depression or anxiety

• Significant stress

• Vitamin deficiencies

• Thyroid or other medical problems

• Infections or other illnesses

• Alcohol or substance use

• Head injuries

Some conditions can produce symptoms that resemble dementia, and some may improve when the underlying problem is identified and treated.

That's one reason families should avoid trying to diagnose a loved one themselves.

Instead of saying:

"I think you have Alzheimer's."

A more constructive approach may be:

"I've noticed some changes lately, and I think it would be a good idea to talk with your doctor and find out what's going on."

3. Learn the Warning Signs of Alzheimer’s and Other Dementias

Educating yourself can make the conversation easier.

Memory loss is commonly associated with Alzheimer's disease, but cognitive changes can involve much more than forgetting names or appointments.

Possible signs may involve changes in:

• Memory

• Reasoning

• Judgment

• Language

• Problem solving

• Ability to complete familiar tasks

• Orientation to time or place

• Behavior or personality

The National Institute on Aging explains that memory problems are often among the first signs of Alzheimer's, but difficulties with language, visual-spatial abilities, reasoning and judgment can also appear.

However, no single symptom establishes that someone has Alzheimer's.

A medical evaluation is necessary to investigate the cause.

The Alzheimer’s Association provides a helpful overview of common warning signs:

Review the 10 Warning Signs of Alzheimer’s

4. Ask Whether Other People Have Noticed Changes

Sometimes one family member notices a change long before anyone else.

Other times, several people have independently observed similar things.

Discreetly speaking with trusted family members or close friends may help you understand whether what you've noticed is isolated or part of a broader pattern.

Ask factual questions.

"Have you noticed Mom repeating herself more lately?"

is more useful than:

"Don't you think Mom has dementia?"

The objective should be gathering observations, not building a case against the person.

And remember that the individual experiencing the changes deserves dignity, privacy and respect throughout the process.

5. Decide Who Should Start the Conversation

More people aren't necessarily better.

Imagine being invited into a room where five relatives are waiting to tell you they're worried about your memory.

Even with good intentions, it could feel like an ambush.

The Alzheimer’s Association suggests considering who is best positioned to raise the concern and notes that a one-on-one conversation may often feel less threatening.

Think about whom the person trusts.

It might be:

• A spouse

• An adult child

• A sibling

• A longtime friend

• Another trusted family member

The person leading the conversation should ideally be someone who can remain calm, listen and avoid turning the discussion into an argument.

6. Choose the Right Time and Place

Environment matters.

A sensitive conversation about memory probably shouldn't begin during a holiday dinner, family gathering or stressful event.

Choose somewhere private and familiar.

Try to avoid a time when the person is already tired, upset, distracted or rushed.

The objective isn't confrontation.

It's creating enough comfort for an honest conversation.

And although choosing the right setting matters, concerns shouldn't simply be postponed indefinitely because nobody can find a "perfect" moment.

7. Lead With What You Have Observed, Not a Diagnosis

The first few sentences may determine how the entire conversation unfolds.

Try focusing on your observations and concern.

For example:

"I've noticed you've had trouble remembering a few appointments lately. Have you noticed that too?"

Or:

"You haven't seemed quite like yourself lately. How have you been feeling?"

Or:

"You seemed confused when we were working on the bills last week, and that worried me. Has that happened at any other time?"

Notice what these approaches don't say.

They don't begin with:

"You have dementia."

You don't know that.

Instead, you're opening the door for the other person to describe what they're experiencing.

They may already be worried about it themselves.

8. Offer to Help With a Doctor's Appointment

If the person is willing to seek medical advice, offer practical support.

That could mean:

• Helping schedule an appointment

• Driving them

• Going with them if they want company

• Helping prepare questions

• Making a list of observed changes

• Preparing a current medication list

A physician may review medical history and medications, assess memory and thinking, perform physical or cognitive evaluations, order laboratory testing, or refer the person to an appropriate specialist depending on the circumstances.

A useful message is:

"There are several things that can cause memory problems. Let's talk with your doctor and find out what's happening."

That is very different from trying to convince someone that they have Alzheimer's.

Why Can Early Evaluation Matter?

There is an important distinction between early evaluation and assuming an early diagnosis.

The purpose of evaluation is to determine what may be causing the changes.

Some conditions producing memory or cognitive problems may be treatable. If dementia is ultimately diagnosed, earlier identification can also provide more time for the individual and family to understand the condition, discuss care, consider safety issues and participate in future planning.

Planning may eventually involve medical, caregiving, financial and legal questions.

The Alzheimer’s Association emphasizes that earlier planning can allow a person living with dementia to participate more fully in decisions about future care, finances and property while they are able to express their wishes.

9. Understand That It May Take More Than One Conversation

What happens if they refuse to see a doctor?

Don't automatically treat the first unsuccessful conversation as the last opportunity.

Someone may respond with:

"I'm fine."

"Everybody forgets things."

"You're making too much of this."

Or they may become angry or defensive.

Consider what happened during the conversation.

Was the timing poor?

Did the person feel confronted?

Were too many family members involved?

Did the discussion become focused on proving that something was wrong rather than listening?

The Alzheimer’s Association recommends considering what worked, what didn't, and what could be handled differently during a future conversation.

Sometimes patience and another thoughtful conversation are more productive than pushing harder in the moment.

10. Know That Families Don't Have to Navigate This Alone

Memory concerns can be frightening for everyone involved.

The person experiencing the changes may be frightened.

A spouse may be overwhelmed.

Adult children may disagree about what they're seeing or what should happen next.

Families can seek professional guidance rather than trying to answer every question themselves.

The Alzheimer’s Association 24/7 Helpline is available at:

800-272-3900

The free service provides information and support to people living with dementia, caregivers, families and members of the public. It can also help connect families with local resources and information about care planning, safety, communication, legal and financial planning, and other dementia-related concerns.

Alzheimer’s Association 24/7 Helpline and Resources

What Should You Say to Someone You're Worried About?

You don't need a perfect speech.

A simple conversation might begin:

"I've noticed a few changes recently, and because I care about you, I wanted to ask how you're feeling. There could be many explanations, but I think it would be worthwhile to talk with your doctor. If you'd like, I'll go with you."

Then listen.

The objective isn't to win an argument.

It's to make it easier for someone you care about to take the next appropriate step.

Frequently Asked Questions About Memory Concerns

How do you approach someone who may have memory problems?

Choose a private, comfortable setting and describe specific changes you've noticed rather than telling the person they have dementia. Ask whether they've noticed the changes themselves, listen to their response and encourage a medical evaluation if the concerns persist or interfere with daily activities.

Does memory loss always mean Alzheimer's disease?

No. Memory problems can have many potential causes, including medication side effects, sleep problems, depression, anxiety, nutritional deficiencies and certain medical conditions. Some causes may be treatable, which is one reason professional evaluation is important.

What are some memory changes that may warrant talking with a doctor?

Repeatedly asking the same questions, becoming lost in familiar locations, increasing confusion about time or place, difficulty following familiar instructions, or changes that interfere with everyday functioning can warrant medical attention.

What if my parent refuses to discuss their memory problems?

Avoid turning the discussion into an argument. Consider whether the timing, setting or person initiating the conversation could be changed. It may take several conversations before someone becomes comfortable seeking an evaluation.

Should I tell someone I think they have dementia?

Unless a qualified healthcare professional has diagnosed the condition, it is generally more constructive to focus on the specific changes you've observed and encourage medical evaluation rather than assigning a diagnosis yourself.

Who can evaluate memory problems?

A primary care physician is often a good starting point. Depending on the circumstances, the person may be referred to specialists such as a neurologist, geriatrician, geriatric psychiatrist or neuropsychologist.

A Conversation Today Can Be an Act of Caring

Talking about memory changes can be uncomfortable, but significant changes in memory, thinking, or behavior shouldn't simply be ignored.

If you've noticed something concerning in a parent, spouse, relative, or friend, begin by observing carefully, educating yourself, and approaching the person with compassion and respect.

You don't have to diagnose the problem. In fact, memory changes can have many causes, and determining the cause is something that should be left to qualified healthcare professionals.

Sometimes the most important first step is simply saying:

“I've noticed some changes, and I care about you. Can we talk about it?”

From there, encourage the person to speak with their healthcare provider and offer to support them through the process.

Help and Support Are Available

If you or someone you love is facing memory concerns, Alzheimer's disease, or another form of dementia, you don't have to navigate it alone.

Alzheimer’s Association 24/7 Helpline:
800-272-3900

The Alzheimer’s Association provides information, education, caregiver resources, and support for individuals and families affected by dementia.

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This article is for general educational purposes and is not medical advice. Changes in memory, thinking, or behavior can have many causes. A qualified healthcare professional should be consulted for individual evaluation, diagnosis, and treatment.