What does this change mean?
Some memory loss is normal for all of us, and just scary when we are alert to it. Misplaced car keys? Normal. Holding the keys but don't remember that they're for a car? Concerning. You may notice your loved one doing something worse than previously, or not doing it at all. Behavioral changes may merit either a conversation topic with your parents or with their doctors, either due to the cause of the change or its effect.
Doing the same thing but worse Dad is still driving but makes wrong turns. Mom is still cooking but burns food sometimes, and you don't remember that ever happening before. They may not have noticed this decline, or they may not want to know about it. It's useful to figure out which of those it is. My family's phones and vehicles all have some version of Life360, Find My, or an Air Tag to help us keep track of them. We got agreement from everyone about this just as a fun way to keep in touch, and to find where we're parked or where we left our phone.
Avoiding something they used to do regularly Mom now showers weekly, rather than daily. Dad asks you to put the salt in the well, which he used to do on his own. Two things to track here: why did they change, and is this change okay? Is mom feeling unsteady in the shower? Did anything change in there? Or is she forgetting to shower? Try to gather this information with both direct questions and observations or related things, like whether Dad is lifting other heavy items. And, is this change causing other problems that will get worse?
Becoming more rigid Do your parents insist on watching a certain TV show (probably loudly) at a particular time of day, even when you're visiting and the show can be watched later? Do they only want to sit in a particular seat, use a particular spoon, and really would rather eat at home then go out? Believe them that this is the coping mechanism they need, so long as it's not causing harm. But also think about why they are doing it. Are they stressed and need a break from socializing? Is this spoon easier for them to grab? Are restaurants too loud for them to hear, or they can't read the menu? Try to figure it out by listing some of the problems with the thing they're avoiding, checking if any of those are the reason they're avoiding it. They may not be able to come up with ideas on their own but can select a multiple choice option.
It's probably not an emergency
If you live out of town and see your parents just a few times each year, you're likely to notice these changes and not be able to help with them immediately. This can be scary. But the problem likely didn't start right before you arrived. I have repeatedly felt that I should take action immediately after I notice something, either because it was so upsetting or because I wanted to cross it off of my to-do list. My urgency conveys to my parents that there is a big problem, so I need to check if that message is helpful. If you're just visiting for the holidays, your parents and their doctors are unlikely to want to drop everything to do a thorough evaluation today. Try to check on whether your reaction is about your own emotions. Do act quickly if there is an immediate safety concern (the kind treated at urgent care or an emergency room), but many situations that upset you can wait until your next visit. Maybe accelerate that visit, coming back in 3 months rather than 6, and without grandkids. Your parents may not be checking in with medical providers as much as you'd expect. Try to level it up just a single step from what they've been doing. If your parent isn't already seeing a primary care doctor, or hasn't had a vision or hearing exam recently, start with those. 55% of people over age 75 have significant hearing loss, and it can affect their balance and mental health. (National Institute on Deafness and Other Communication Disorders) Urinary tract infections and sleep medications can also lead to quickly-escalating confusion. If those are all ruled out, you can pass along a request for additional screening to the primary care doctor.
The diagnosis isn't the end
You'll likely notice a loved one's decline before they get diagnosed. You may even be the one pushing for the diagnosis while they are unaware (or unaccepting) of the problem. That diagnosis is valuable for the family to make decisions. Be prepared, though: your parents may choose not to take any action. You can use the information to prepare yourself, and to get supports in place. Even if dementia has come on quickly, your parent may have many years of life left and you need to prepare for that marathon. The dementia subreddit (https://www.reddit.com/r/dementia/) is an informative group for those in all stages of supporting family with dementia. I also find Be Light Care (https://www.instagram.com/belightcare/?hl=en) to role model kind ways to interact with your parent with dementia. Although the resources we link here are focused on Alzheimer's, they are likely to be relevant to those with other forms of dementia.
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