When an Older Family Member Starts Forgetting: How to Support Them With Dignity

It can start with small things.

A parent asks the same question twice.

A grandmother misplaces something she normally keeps in the same place.

Someone who has always managed the household finances suddenly becomes confused by a familiar payment.

Sometimes these changes are part of normal ageing. But when memory, thinking or behaviour begin changing consistently, families may start wondering whether something more serious is happening.

For World Alzheimer’s Day on 21 September, we look at how families can recognise concerning changes, start a respectful conversation and support an older relative without taking away their independence unnecessarily.

Dementia is not simply “getting old”

Some slowing of memory can happen as people age.

It may take longer to remember a name or find the right word. Someone may occasionally walk into a room and forget what they intended to do.

Dementia is different.

It involves a decline in memory, thinking or other mental abilities that becomes significant enough to affect everyday life.

According to WHO, around 57 million people worldwide were living with dementia in 2021, and more than 60% lived in low- and middle-income countries. Alzheimer’s disease is the most common cause of dementia.

Dementia is more common in older adults, but it is not an inevitable part of ageing.

What changes should families notice?

Memory problems are often one of the first things relatives notice, but dementia can affect much more than memory.

Changes may include:

• Repeatedly forgetting recent conversations or events
• Asking the same questions several times
• Frequently losing belongings
• Becoming confused in familiar places
• Losing track of dates or time
• Difficulty managing money
• Trouble following conversations
• Struggling to find familiar words
• Difficulty completing tasks they previously managed easily
• Poorer judgement or decision-making
• Becoming withdrawn from social activities
• Noticeable personality or mood changes

WHO also notes that changes in mood, behaviour or motivation can sometimes appear before significant memory problems.

One isolated incident does not necessarily mean dementia.

The concern is usually a pattern of change that gradually becomes more noticeable.

Start the conversation gently

Talking about memory problems can be uncomfortable.

An older relative may feel embarrassed, frightened or defensive.

Avoid beginning the conversation with statements such as:

“You are becoming forgetful.”

“You can’t remember anything anymore.”

“You are getting dementia.”

Instead, try something more supportive:

“I’ve noticed you’ve been struggling with a few things lately. How have you been feeling?”

or:

“You seemed a little confused about the account yesterday. Would you like us to get it checked?”

The goal is not to win an argument.

It is to understand what the person is experiencing.

Don’t automatically assume dementia

Memory changes have many possible causes.

Some may be treatable.

These can include:

• Depression
• Anxiety
• Poor sleep
• Medication side effects
• Alcohol use
• Vitamin deficiencies
• Thyroid problems
• Infections
• Hearing loss
• Vision problems
• Stroke
• Other neurological conditions

A healthcare assessment can help determine whether symptoms are related to dementia or another medical issue.

Sudden confusion needs prompt attention

Dementia usually develops gradually.

If an older person suddenly becomes very confused over hours or days, something else may be happening.

Sudden confusion can occur with illnesses such as infection, dehydration, low blood sugar, medication reactions or other acute medical problems.

It should not simply be dismissed as ageing.

Seek prompt medical care if confusion appears suddenly.

If it occurs together with facial weakness, difficulty speaking, weakness on one side of the body, severe headache or loss of balance, seek emergency medical attention because these can be signs of a stroke.

Help without immediately taking over

When someone begins struggling with memory, families often react by taking control of everything.

They may start managing the person’s money, medication, shopping, appointments and household without involving them.

Sometimes additional support is necessary.

But where possible, the person should remain involved in decisions about their own life.

Support might begin with small changes such as:

• Setting medication reminders
• Writing appointments on a visible calendar
• Keeping keys and important belongings in consistent places
• Helping organise bills
• Attending medical appointments together
• Preparing simple written instructions
• Checking in regularly by phone

The aim is to provide the amount of help that is needed, rather than removing independence before it is necessary.

Routine can provide reassurance

Familiar routines can make everyday life easier for someone experiencing memory problems.

Try to keep important activities reasonably predictable.

For example:

• Meals at similar times
• Medication at consistent times
• Familiar sleeping routines
• Regular exercise
• Weekly family visits
• Frequently used items kept in the same place

Too many changes at once can make confusion worse.

A calm, familiar environment may help the person feel more secure.

Communication may need to change

As dementia progresses, following complicated conversations can become difficult.

WHO recommends speaking clearly and calmly, using simple sentences and discussing one thing at a time when communicating with someone living with dementia.

Helpful approaches include:

• Speaking face-to-face
• Reducing background noise
• Giving the person time to answer
• Asking one question at a time
• Avoiding unnecessary arguments
• Repeating information calmly when needed
• Paying attention to facial expressions and body language

If someone tells the same story repeatedly, constantly correcting them may only create frustration.

Sometimes reassurance matters more than correcting every detail.

Don’t embarrass someone for forgetting

Memory problems can already be frightening.

Jokes about someone “losing their mind” or repeatedly pointing out mistakes may cause shame and withdrawal.

Try to correct mistakes discreetly when correction is actually necessary.

It can also help to focus on what the person can still do.

Someone with early dementia may still enjoy:

• Cooking familiar meals
• Gardening
• Attending church
• Spending time with grandchildren
• Walking
• Music
• Socialising with friends
• Household activities

Remaining active and socially connected can contribute to quality of life.

Make the home safer without making it feel like a hospital

As memory problems progress, safety may become more important.

Families can quietly make practical changes such as:

• Improving lighting
• Removing loose rugs or tripping hazards
• Keeping frequently used objects easy to find
• Checking that cooking appliances are switched off
• Storing dangerous medicines or chemicals safely
• Making bathrooms easier to navigate
• Ensuring important phone numbers are accessible

If wandering or getting lost becomes a concern, identification and emergency contact information can also be useful.

WHO recommends planning ahead and keeping emergency contact information available as dementia progresses.

Driving may become a difficult conversation

For many adults, driving represents independence.

Giving it up can therefore be emotionally difficult.

However, dementia can affect reaction time, judgement, spatial awareness and decision-making.

Warning signs may include:

• Getting lost on familiar routes
• New dents or minor accidents
• Confusion at intersections
• Driving unusually slowly or unpredictably
• Difficulty responding to traffic

If you are concerned, discuss the issue with a healthcare professional rather than relying only on a family argument.

Keep an eye on medication

Medication can become difficult to manage when memory declines.

Someone may:

• Forget doses
• Take medication twice
• Mix up tablets
• Continue discontinued medication
• Run out without realising

Using a pill organiser, written schedule or family supervision may help.

Never change prescribed medication without discussing it with the appropriate healthcare professional.

Nutrition can become more difficult too

Someone with dementia may forget to eat, struggle to prepare food or lose interest in meals.

Families should watch for:

• Unexplained weight loss
• Empty cupboards
• Spoiled food
• Signs of dehydration
• Difficulty swallowing
• Frequently skipping meals

Eating together may help encourage regular meals while also providing valuable social interaction.

Don’t forget the caregiver

Caring for someone with dementia can become emotionally and physically exhausting.

Family caregivers may find themselves balancing:

• Work
• Children
• Household responsibilities
• Medical appointments
• Financial decisions
• Personal care
• Night-time supervision

WHO notes that dementia has a major impact not only on the person affected but also on carers and families, and informal caregivers provide a substantial proportion of dementia care worldwide.

Caregivers need support too.

Where possible:

• Share responsibilities between family members
• Accept offers of practical help
• Take regular breaks
• Maintain your own health appointments
• Stay socially connected
• Speak to a healthcare professional if you become overwhelmed

Being exhausted does not make someone a better caregiver.

Looking after brain health throughout life

There is no guaranteed way to prevent dementia.

However, WHO identifies several factors associated with dementia risk that can be addressed throughout life.

These include:

• High blood pressure
• Diabetes
• High cholesterol
• Smoking
• Harmful alcohol use
• Physical inactivity
• Social isolation
• Hearing loss
• Vision loss
• Poor sleep

Regular activity, maintaining social connections and managing conditions such as hypertension and diabetes are therefore important for both general health and healthy ageing.

Early assessment gives families more time

Many families avoid discussing memory changes because they are afraid of what an assessment may reveal.

But knowing what is causing the symptoms can help.

If the cause is treatable, appropriate treatment can begin.

If dementia is diagnosed, earlier recognition gives the person and their family more time to:

• Understand what is happening
• Discuss treatment options
• Plan future care
• Organise finances
• Discuss living arrangements
• Make important decisions while the person can still participate fully

Early assessment is not about taking someone’s independence away.

It can actually help preserve independence for as long as possible.

Speak to a TruMD Eswatini healthcare professional

If you have noticed persistent changes in an older family member’s memory, behaviour or ability to manage everyday activities, TruMD Eswatini gives you convenient access to qualified healthcare professionals.

You can discuss what you have noticed, how long the changes have been present and whether other medical conditions or medication may be contributing.

Where blood tests, cognitive assessment, an in-person examination or specialist evaluation is necessary, a healthcare professional can advise you on the appropriate next step.

Memory changes deserve compassion, not embarrassment.

Supporting an older family member starts by listening, protecting their dignity and getting the right help when something begins to change.