Having the Conversation

The doctor told me that, “Dementia is the description for the changes we have all noticed.”

These are sobering words are ones that elicit conversation between loved ones. The location could be an office where a counselor facilitates productive discussion. Or perhaps the best place is an informal one where coffee and cake create an atmosphere of comfort and connectedness.

It’s hard to know where to begin. Some find it easiest to let the conversation gradually drift from the weather to the emotional and practical aspects of Dementia. Others prefer having the help of a counselor to guide productive exchange.

People in the early stages of Dementia may be the one who initiates the discussion. He or she may start by addressing their fears of what they face as well as their distress of becoming a burden. He or she may have words to say about choosing the person who they hope will oversee their care as well as express the desire that Dementia does not create ill-will between family members.

His or her thoughts about end-of-life care are another important topic. Here listening may be more important than discussion. Listen to what he or she has to say about advance directives, comfort (palliative) care, and hospice--the last stage of palliative care.

Conversation among loved ones will undoubtedly include more immediate wishes such as enjoying time together, taking bucket-list adventures, and the challenge of the “things I have always wanted to do” list. This is the time to create memories.

Sometimes families and same-sex couple and their families do not have the luxury of beginning a conversation with a diagnosis of early-stage Dementia. When this is the case, your loved one may still have the capability to listen and perhaps make comments. Be sure to acknowledge his or her presence and, as much as is possible, engage them in the discussion.

Keep the Conversation Going

Speaking with and among loved ones is an ongoing process. Events occur that require reassessment. Family dynamics may have deteriorated and should be addressed before they worsen. It may be time to talk about the conflicts between personal views about death and dying and your loved one’s advance directives. Or perhaps reassessment involves orchestrating a family gathering or a final adventure. It's so important to begin having the conversation early.

Content Contributor: Janet Yagoda Shagam, Ph.D., is a freelance medical and science writer and the author of "An Unintended Journey: A Caregiver's Guide to Dementia.", available through Amazon. Please visit our Author's page to learn more and find this title.

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